bluuebunny/crossref_metadata_2025_split huggingface dataset:
Postnatal corticosteroids to prevent or treat bronchopulmonary dysplasia in preterm infants
Authors: Lemyre Brigitte , Dunn Michael , Thebaud Bernard 
Published: August 2020

Abstract
Historically, postnatal corticosteroids have been used to prevent and treat bronchopulmonary dysplasia (BPD), a significant cause of morbidity and mortality in preterm infants. Administering dexamethasone to prevent BPD in the first 7 days post-birth has been associated with increasing risk for cerebral palsy, while early inhaled corticosteroids appear to be associated with an increased risk of mortality. Neither medication is presently recommended to prevent BPD. New evidence suggests that prophylactic hydrocortisone, when initiated in the first 48 hours post-birth, at a physiological dose, and in the absence of indomethacin, improves survival without BPD, with no adverse neurodevelopmental effects at 2 years. This therapy may be considered by clinicians for infants at highest risk for BPD. Routine dexamethasone therapy for all ventilator-dependent infants is not recommended, but after the first week post-birth, clinicians may consider a short course of low-dose dexamethasone (0.15 mg/kg/day to 0.2 mg/kg/day) for individual infants at high risk for, or with evolving, BPD. There is no evidence that hydrocortisone is an effective or safe alternative to dexamethasone for treating evolving or established BPD. Current evidence does not support inhaled corticosteroids for the treatment of BPD.
From Cancer Rehabilitation to Recreation: A Coordinated Approach to Increasing Physical Activity
Authors: Dennett Amy M , Peiris Casey L , Shields Nora , Taylor Nicholas F 
Published: August 2020

AbstractParticipation in adequate physical activity improves the health status of cancer survivors, enhances their survival, and reduces their risk of cancer recurrence. However, cancer survivors engage in low levels of physical activity and have limited access to rehabilitation services that could increase their participation. No optimal framework has been developed that supports physical activity participation among cancer survivors. Given the growth in numbers of cancer survivors, development of a framework may provide a pathway to facilitate timely and appropriate care. This perspective paper describes the development of the Cancer Rehabilitation to Recreation (CaReR) Framework and its practical implications. The CaReR Framework uses a tailored, stepped approach to guide health services and clinicians on the design and implementation of interventions to promote physical activity among cancer survivors. Implementation of the CaReR Framework will improve continuity and quality of care for cancer survivors and promote physical activity with the ultimate aim of improving health outcomes.
Factors Associated With Rehabilitation Outcomes in Patients With Unilateral Vestibular Hypofunction: A Prospective Cohort Study
Authors: Herdman Susan J , Hall Courtney D , Heusel-Gillig Lisa 
Published: August 2020

Abstract

Objective
The purpose of this study was to determine factors associated with rehabilitation outcomes following vestibular rehabilitation (VR).

Methods
In this prospective cohort study, 116 patients who completed at least 2 supervised sessions participated. Patient characteristics and comorbidities were recorded. Initial and discharge measures included symptom intensity, balance confidence, quality of life, percent of time symptoms interfere with life, perceived benefits of VR, gait speed, fall risk, visual acuity during head movement, and anxiety/depression. Intention-to-treat analyses were performed to determine outcomes at discharge. Bivariate correlations between independent (group characteristics and baseline measures) and dependent (discharge measures) variables were determined. Logistic regressions were performed to identify factors associated with whether a patient would have a normal score or meaningful change at discharge.

Results
There was a large effect of VR with significant improvement for the group as a whole on each outcome measure. For each outcome measure, most patients improved. Based on preliminary logistic regression, 2 patient characteristics were associated with outcome: number of therapy visits predicted meaningful improvement in gait speed, and falls after the onset of the unilateral vestibular hypofunction (UVH) predicted meaningful change in the percent of time symptoms interfered with life. Initial Activities-Specific Balance Confidence Scale (ABC) and Dynamic Gait Index scores predicted normal ABC scores at discharge, and initial ABC scores predicted recovery of Dynamic Gait Index scores. Preliminary prediction models were generated for balance confidence, impact of dizziness on life, dynamic visual acuity, gait speed, and fall risk.

Conclusions
Therapists may use these findings for patient education or to determine the need for adjunct therapy, such as counseling.

Impact
Not all people with UVH improve following VR, but there is little research examining why. This study looked at multiple factors and identified number of visits and falls after onset of UVH as patient characteristics associated with outcomes following VR; these findings will help therapists create better predictive models.
Diagnostic Accuracy of Clinical Tests for the Indirect Assessment of Hip Abductor Muscle Strength in Community-Dwelling Older Women
Authors: Porto Jaqueline Mello , Cangussu-Oliveira Luciana Mendes , Freire Junior Renato Campos , Vieira Flávio Tavares , Martins Pâmela Precinotto , Bandeira Anne Caroline Lima , de Abreu Daniela Cristina Carvalho 
Published: August 2020

Abstract

Objective
The objective of this study was to determine the accuracy of 3 clinical tests (lateral step [LS], tandem gait [TG], and single-leg stance [SS]) in identifying older women with reduced hip abductor muscle strength and to determine the post-test probability of each test and of their combination in changing the certainty of diagnosis.

Methods
In this cross-sectional study, a total of 123 older women received clinical testing to obtain the variables LS height, time for TG execution, percentage of errors in TG, and time of permanence on SS and were tested for isometric hip abductor peak torque using an isokinetic dynamometer. Only the dominant lower limb was evaluated. Multiple linear regression analysis with adjustment was performed to determine the association among variables, followed by the receiver operating characteristic curve to identify clinical variables that can discriminate older women with reduced abductor muscle strength. Post-test probability was then calculated based on the receiver operating characteristic curve data.

Results
Although the 4 clinical variables showed correlation with abductor peak torque, only LS and TG time were able to discriminate reduced abductor muscle strength with low accuracy (area under the curve was between 0.5 and 0.7). However, the combination of LS and TG time increased post-test probability from 47% (prevalence of weakness in the population) to 76% when both tests were positive and reduced it from 47% to 18% when both tests were negative.

Conclusion
The combination of the LS test and TG time is useful for the indirect assessment of hip abductor strength in community-dwelling older women.

Impact
Hip abductor muscle strength is extremely important for function in older women. This study presents clinicians with simple, fast, and inexpensive methods for assessing hip abductor muscle strength.
Magnetic Resonance Imaging Studies in Duchenne Muscular Dystrophy: Linking Findings to the Physical Therapy Clinic
Authors: Senesac Claudia R , Barnard Alison M , Lott Donovan J , Nair Kavya S , Harrington Ann T , Willcocks Rebecca J , Zilke Kirsten L , Rooney William D , Walter Glenn A , Vandenborne Krista 
Published: August 2020

Abstract
Duchenne muscular dystrophy (DMD) is a muscle degenerative disorder that manifests in early childhood and results in progressive muscle weakness. Physical therapists have long been an important component of the multidisciplinary team caring for people with DMD, providing expertise in areas of disease assessment, contracture management, assistive device prescription, and exercise prescription. Over the last decade, magnetic resonance imaging of muscles in people with DMD has led to an improved understanding of the muscle pathology underlying the clinical manifestations of DMD. Findings from magnetic resonance imaging (MRI) studies in DMD, paired with the clinical expertise of physical therapists, can help guide research that leads to improved physical therapist care for this unique patient population. The 2 main goals of this perspective article are to (1) summarize muscle pathology and disease progression findings from qualitative and quantitative muscle MRI studies in DMD and (2) link MRI findings of muscle pathology to the clinical manifestations observed by physical therapists with discussion of any potential implications of MRI findings on physical therapy management.
Multimodal Balance Training Supported by Rhythmic Auditory Stimuli in Parkinson Disease: Effects in Freezers and Nonfreezers
Authors: Capato Tamine T C , de Vries Nienke M , IntHout Joanna , Ramjith Jordache , Barbosa Egberto R , Nonnekes Jorik , Bloem Bastiaan R 
Published: August 2020

Abstract

Objective
To fulfill the potential of nonpharmacological interventions for people with Parkinson disease (PD), individually tailored treatment is needed. Multimodal balance training supported by rhythmic auditory stimuli (RAS) can improve balance and gait in people with PD. The purpose of this study was to determine whether both freezers and nonfreezers benefit.

Methods
A secondary analysis was conducted on a large randomized controlled trial that included 154 patients with PD (Hoehn & Yahr Stages 1–3 while ON-medication) who were assigned randomly to 3 groups: (1) multimodal balance training with RAS delivered by a metronome (RAS-supported multimodal balance training); (2) regular multimodal balance training without rhythmic auditory cues; and (3) a control intervention (involving an educational program). Training was performed for 5 weeks, twice per week. The primary outcome was the Mini-BESTest score directly after the training period. Assessments were performed by a single, masked assessor at baseline, directly postintervention, and after 1-month and 6-month follow-up. Outcomes were analyzed in 1 analysis, and the results were presented separately for freezers and nonfreezers with a linear mixed model, adjusted for baseline Mini-BESTest scores, Unified Parkinson’s Disease Rating Scale scores, and levodopa equivalent dose.

Results
In both freezers and nonfreezers, both RAS-supported multimodal training and regular training significantly improved the Mini-BESTest scores compared with baseline scores and with the control group scores. The improvement was larger for RAS-supported training compared with regular training, for both freezers and nonfreezers. Only the RAS-supported training group retained the improvements compared with baseline measurements at 6-month follow-up, and this was true for both freezers and nonfreezers.

Conclusions
RAS-supported multimodal training is effective in improving balance performance in both freezers and nonfreezers.

Impact
Until this study, it was unknown whether both freezers and nonfreezers could benefit from multimodal balance training. With this information, clinicians who work with people with PD will be better able to apply personalized gait rehabilitation.

Lay Summary
Adding rhythmic auditory stimuli (RAS) to balance training is beneficial for both freezers and nonfreezers, at least in persons with mild to moderate disease stages. This RAS-supported multimodal training has good potential for a wider clinical implementation with good long-term effects.
Factors associated with variation in emergency diagnoses of cancer at general practice level in England
Authors: Joyce Kevin , Zermanos Terezija , Badrinath Padmanabhan 
Published: August 2020

Abstract

Background
Cancer patients diagnosed following an emergency presentation have poorer outcomes. We explore whether practice characteristics are associated with differences in the proportion of emergency presentations.

Methods
Univariable and multivariable logistic regression models were fitted to investigate the relationships between 2017–18 emergency cancer presentations at practice level in England and access and continuity in primary care, trust in healthcare professionals, 2-week-wait (2WW) referrals, quality and outcomes framework (QOF) achievements and socio-demographic factors (age, gender and deprivation).

Results
Our analysis using comprehensive nationwide data found that the following practice level factors have significant associations with a lower proportion of emergency diagnosis of cancer: increased trust and confidence in the practice healthcare professionals; higher 2WW referral and conversion rate; higher total practice QOF score and higher satisfaction with appointment times or higher proportion able to see preferred GP. Our results also show that practices in more deprived areas are significantly associated with a higher proportion of emergency diagnoses of cancer.

Conclusions
Regional cancer networks should focus their efforts in increasing both the quantity and appropriateness of 2WW referrals from primary care. In addition, primary care clinicians should be supported to undertake high quality consultations, thus building trust with patients and ensuring continuity of care.
Clinical value of amyloid-beta1-40 as a marker of thrombo-inflammation in antiphospholipid syndrome
Authors: Tektonidou Maria G , Kravvariti Evrydiki , Vlachogiannis Nikolaos I , Georgiopoulos Georgios , Mantzou Aimilia , Sfikakis Petros P , Stellos Konstantinos , Stamatelopoulos Kimon 
Published: August 2020

Abstract

Objective
Amyloid-beta1-40 (Aβ40) is a pro-inflammatory peptide under investigation as a novel biomarker of vascular inflammation, endothelial dysfunction and atherothrombosis in the general population. Herein we tested the hypothesis that Aβ40 is deregulated in APS, a systemic autoimmune disease characterized by a thrombo-inflammatory state.

Methods
Between January 2016 and July 2017, we consecutively recruited 80 regularly followed thrombotic APS patients (44 primary, 36 SLE/APS) and 80 age- and sex-matched controls. Plasma Aβ40 levels were measured using ELISA and APS-related clinical and laboratory characteristics were recorded. The adjusted Global Anti-Phospholipid Syndrome Score (aGAPSS), a validated risk score in APS, was calculated as a comparator to Aβ40 performance to detect arterial thrombotic APS-related events.

Results
Higher Aβ40 levels were significantly associated with the presence of APS [odds ratio (OR) 1.024 per 1 pg/ml (95% CI 1.007, 1.041)] after adjustment for cardiovascular risk factors (CVRFs), including smoking, arterial hypertension, dyslipidaemia and BMI, and for estimated glomerular filtration rate (eGFR). Among APS patients, increased high-sensitivity CRP (hs-CRP) serum levels was the only independent determinant of Aβ40 levels. Importantly, Aβ40 levels above the optimal receiver operating characteristics (ROC)-derived cut-off value were independently associated with recurrent arterial events [OR 4.93 (95% CI 1.31, 18.51)] after adjustment for age, sex, CVRFs, hs-CRP and high anti-β2 glycoprotein I IgG titres. Finally, by ROC curve analysis, Aβ40 provided incremental additive value over the aGAPSS by significantly improving its discrimination ability for recurrent arterial thromboses.

Conclusion
In APS, Aβ40 plasma levels are elevated and associated with an adverse thrombo-inflammatory profile. The pathophysiological and prognostic role of Aβ40 in APS merits further investigation.
Why Public Sector Union Members Support Their Unions: Survey and Experimental Evidence
Authors: Hertel-Fernandez Alexander , Porter Ethan 
Published: August 2020

AbstractDespite their decline, unions, and especially public sector unions, remain important civic and economic associations. Yet, we lack an understanding of why public sector union members voluntarily support unions. We report on a field experiment conducted during a 2017 Iowa teachers union recertification election. We randomly assigned union members to receive emails describing union benefits and measured effects on turnout effort (N = 10,461). Members were more likely to try to vote when reminded of the unions’ professional benefits and community—but not legal protections or political representation. A follow-up survey identified the specific aspects of professional identity and benefits that members most valued and why. In a context where union membership and support is voluntary among professionalized workers, our findings emphasize the possibility of training for fostering shared identities and encouraging support for public sector unions. Our results have broader implications for understanding the public sector labor movement in a context of legal retrenchment.
Evaluation of the effects of various force configurations and magnitudes on scoliotic curve correction by use of finite element analysis: A case study
Authors: Karimi Mohammad Taghi , Rabczuk Timon , Luthfi Mauludin 
Published: August 2020

Background:
Scoliosis is a three-dimensional (3-D) spinal deformity that is associated with changes in the alignment of the spine in sagittal, frontal, and transverse planes. Various treatment approaches have been used to control scoliotic curve progression and decrease the curve. Although various braces have been used in this regard, it would be difficult to check the effects of multiple types of braces on scoliotic curve correction for each scoliotic patient. Therefore, the aim of this study was to evaluate the effects of various force magnitudes and configurations on scoliotic curve correction.

Methods:
A 3-D model of a scoliotic patient was produced based on CT scan images of the total spine. The scoliotic curves were 21 and 45 degrees in lumbar and thoracic parts, respectively. Mimics software was used to produce a 3-D model of the spine. The stress developed in the spine structure and the magnitude of correction achieved were evaluated following the use of various force configurations and magnitudes by use of finite element analysis (FEA).

Results:
The results of this analysis showed that vertical forces were more effective than transversely directed forces in decreasing scoliotic curve. There was an inverse relationship between the corrections of lumbar and thoracic curves. However, use of vertically directed forces decreased both lumbar and thoracic curves. An increase in the magnitude of transverse forces did not increase the correction, but it did increase the stress developed in the structure.

Conclusions:
The results of this case study confirmed the efficiency of vertically directed forces to decrease scoliotic curves of lumbar and thoracic spinal parts. The results of this analysis confirmed the results of the available literature, which support the efficiency of some braces such as Boston, Lyon, and Cheneau, which were mostly designed based on full contact and vertical traction. The results of this study also support the feasibility of finite element analysis to predict the output of brace treatment by use of various force configurations.

Level of Evidence:
Level IV.
Sublaminar decompression and fusion versus transforaminal lumbar interbody fusion in management of lumbar degenerative disorders: a retrospective cohort study
Authors: Khalid Saleh Mohammed , Elhewala Tarek A. 
Published: August 2020

Introduction:
Sublaminar decompression is a new technique that includes partial laminectomy and facetectomy providing a wide central, foraminal, and lateral recess decompression and leaving maximal bone posterior and posterolateral to allow adequate fusion. The aim of this study was to evaluate the efficacy and safety of sublaminar decompression in comparison to standard transforaminal lumbar interbody fusion (TLIF).

Methods:
Forty patients with degenerative lumbar disorders were managed with spinal fusion at the Zagazig University Hospital. The patients were divided into two groups. Group 1 included 20 patients managed with sublaminar decompression and instrumented fusion with a mean patient age of 47.7±10.4 yr. The patients in group 2 had a mean age of 45.3±10.3 yr and were managed with TLIF. The patients were assessed clinically and by radiographs, and using a visual analogue scale (VAS) of pain and Owestry Disability Index (ODI) as outcome measures. Statistically significant differences between preoperative and the final follow-up means were assessed using paired t-test test. P<0.05 was statistically significant.

Results:
In comparing the two groups regarding correction rate for different radiographic and clinical parameters, this study found significant changes in anteroposterior thecal diameter (P=0.002) and right foraminal height (P=0.004) and highly significant differences in left foraminal height (P<0.001) and thecal sac area (P<0.001) in favor of the sublaminar group. There were no significant differences in VAS for leg (P=0.979) and back pain (P=0.119) or ODI (P=0.0.497).

Conclusion:
When compared to TLIF, sublaminar decompression and fusion is a safe and effective procedure in the treatment of stenotic degenerative spinal disorders.

Level of Evidence:
Level III.
Utility of conventional radiographs in the detection of traumatic knee arthrotomies: a retrospective cohort review
Authors: Sleasman Brian T. , Ence Andrew K. , Hewett Lara , Barfield William R. , Reid Kristoff 
Published: August 2020

Background:
The most common method to determine a traumatic knee arthrotomy is the saline load challenge. Recent literature has suggested high false-negative and false-positive rates using this method and also has shown that CT was effective in detecting these arthrotomies. The purpose of this study was to evaluate another method of diagnosing these injuries. We hypothesized that plain radiographs of the knee could be an effective alternative study in diagnosing a traumatic arthrotomy.

Methods:
After institutional review board approval, this retrospective cohort review identified 32 patients diagnosed with a traumatic arthrotomy by direct visualization in the operating room and another 32 patients with no evidence of traumatic arthopathy, according to the surgeon. The preoperative anteroposterior and lateral radiographs from both cohorts were blinded and randomized and then submitted to a radiologist to review for the presence of air in the joint space. Sensitivity and specificity were calculated based on radiographic review compared with the gold standard of direct visualization.

Results:
Plain film anteroposterior and lateral knee radiographs had a sensitivity of 78.1% and a specificity of 90.6% with a positive predictive value of 89.3% for diagnosis of traumatic arthrotomy in our cohort.

Conclusions:
Our study suggests that radiographs, which are obtained as standard of care during work-up of knee injuries, have a relatively high sensitivity and specificity and can be used as an adjunct to help diagnose a traumatic arthrotomy of the knee joint.

Level of Evidence:
Level III.