bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is the King–Devick Test a Reliable Tool in Wheelchair Athletes? A Preliminary Prospective Study in Wheelchair Basketball
Authors: Richard Joshua , Lin Yen-Sheng , Wernet Lauren , Kasitinon Donald , Royston Alexa , Bristow Kristen , Garner Douglas , Argo Lindsay Ramey 
Published: September 2020

Objective:
(1) To determine the reliability of the King–Devick (KD) test among wheelchair basketball athletes across a season and (2) to compare the KD test time changes among those with and without a clinically suspected concussion.

Design:
Prospective, observational study.

Setting:
Division 3 college athletics department.

Participants:
Twenty-nine intercollegiate wheelchair basketball athletes.

Interventions:
Athletes were prospectively monitored for concussions throughout the 2018 to 2019 season. King–Devick testing was completed preseason, midseason, postseason, and after clinically suspected concussions.

Main Outcome Measures:
Two-way random effects intraclass correlation coefficient (ICC) was calculated. Friedman's test and pairwise comparison with Bonferroni correction were used to compare for change over time. Mean KD times and changes were compared between athletes with and without suspected concussion.

Results:
The KD test demonstrated good test–retest reliability (ICC = 0.826). Among participants without a concussion, there was a significant decrease in the mean KD test time from preseason to midseason (−3.3 seconds; P = 0.0167) and preseason to postseason (−3.3 seconds; P = 0.0167). No change was seen from mid-to-post season. Six athletes had 7 suspected concussions. Each demonstrated an increase in the KD test time, with a mean increase from 44.3 ± 9.5 seconds to 53.7 ± 12.8 seconds. King–Devick test times returned to or below baseline by postseason.

Conclusions:
The KD test shows good reliability among wheelchair basketball athletes without a concussion. A learning effect is demonstrated initially but plateaus on subsequent testing. Unlike athletes without a concussion, players with a clinically suspected concussion showed an increase in the KD test time.
Postoperative outcomes following inguinal hernia repair in inflammatory bowel disease patients compared to matched controls
Authors: Horesh Nir , Mansour Aiham , Simon David , Edden Yair , Klang Eyal , Barash Yiftach , Ben-Horin Shomron , Kopylov Uri 
Published: September 2020

Objectives
To assess surgical outcome in inflammatory bowel disease (IBD) patients who underwent inguinal hernia repair and to asses possible risk factors.

Methods
A retrospective analysis of a prospective database including all IBD patients treated in a large tertiary center between 2008 and 2019 was conducted. IBD patients who underwent inguinal hernia surgery were matched using a propensity match scoring based on demographic and perioperative characteristics. Clinical operative data were extracted from medical records and analyzed.

Results
Overall, out of 5467 IBD patients treated in our institute, 26 patients (0.47%) underwent inguinal hernia repair. Seventy-six matched patients with similar characteristics were compared to the IBD group. Postoperative complications were found to be more common in the IBD group (30.7% vs 11.8%; P = 0.03) compared to controls. We found no significant differences in length of stay (3.38 vs 2.83 days; P = 0.21) and hernia recurrence rate (7.6% vs 9.2%; P = 1). Within the IBD group, multivariate analysis failed to demonstrate any possible risk factor for postoperative complications, including gender [−1.53 to 2.81 95% confidence interval (CI), P = 0.52], age (−0.34 to 1.15 95% CI, P = 0.25), BMI (−0.041 to 0.019 95% CI, P = 0.43), American Society of Anesthesiologists score (−0.15 to 0.54 95% CI, P = 0.24) or medications (−0.25 to 0.28 95% CI, P = 0.88). In addition, out of various operative factors, including operation urgency, surgical approach and surgery duration, only the latter was found to be correlated with postoperative complications (0.013–0.035 95% CI, P < 0.001).

Conclusion
IBD Patients undergoing abdominal wall hernia surgery are prone to more postoperative complications.
131I-6β-iodomethyl-19-norcholesterol adrenal scintigraphy as an alternative to adrenal venous sampling in differentiating aldosterone-producing adenoma from bilateral idiopathic hyperaldosteronism
Authors: Saiga Atsushi , Yokota Hajime , Nagano Hidekazu , Sawada Koichi , Kubota Yoshihiro , Wada Takeshi , Horikoshi Takuro , Tanaka Tomoaki , Uno Takashi 
Published: September 2020

Objective
To assess the correlation value between adrenal venous sampling (AVS) and 131I-6β-iodomethyl-19-norcholesterol (NP-59) adrenal scintigraphy in differentiating aldosterone-producing adenoma (APA) from bilateral idiopathic hyperaldosteronism (BHA), and the use of NP-59 scintigraphy as an alternative to AVS.

Methods
Overall, 29 patients with APA or BHA who underwent AVS and dexamethasone-suppression NP-59 scintigraphy were included between 2010 and 2017. The correlation value between AVS and dexamethasone-suppression NP-59 scintigraphy was assessed using each lateralisation index (LIAVS and LI1NP-59). Tumour presence and size were evaluated using computed tomography. The sensitivity and specificity of dexamethasone-suppression NP-59 scintigraphy for APA according to each lateralisation index threshold were calculated.

Results
Of 29 patients, 12 presented with APA and 17 with BHA according to AVS. The correlation value between LIAVS and LI1NP-59 was 0.63 (P < 0.001). If the cut-off points were 2.55 and 1.80 in all cases, the sensitivity and specificity were 0.33 and 1.00 as well as 0.58 and 0.94, respectively. In adrenal microtumours (maximum diameter ≤10 mm), no cases revealed a cut-off point of >1.8. However, in adrenal macrotumours (maximum diameter >10 mm), the cut-off point of 2.55 represented the best compromise (sensitivity: 0.44; specificity: 1.00).

Conclusion
NP-59 scintigraphy can be used as an alternative to AVS if there is a strong lateralisation on NP-59 scintigraphy and adrenal macrotumours observed on the computed tomography when AVS is technically challenging, particularly in the right adrenal vein cannulation, and if contraindications, such as allergy to contrast materials and renal failure, are observed.
Pain and Depression Symptoms During the Third Trimester of Pregnancy
Authors: Vignato Julie , Perkhounkova Yelena , McCarthy Ann Marie , Segre Lisa S. 
Published: September 2020

Abstract

Purpose:
To assess the association between depression symptoms and pain characteristics, including pain intensity, location, and effectiveness of pain management strategies, among women in their third trimester of pregnancy. Design: Descriptive, exploratory cross-sectional study.

Setting:
Mobile health pregnancy application (app).

Participants:
A convenience sample of women in their third trimester of pregnancy from across the United States.

Methods:
Women completed demographic questionnaires, the Brief Pain Inventory, and Edinburgh Postnatal Depression Scale (EPDS) through an online Web site.

Results:
N = 132 women participated. The sample was demographically diverse. . Women ranged in age from 18 to 39 years (M 28.1 ± SD 5.2). Most women were Caucasian (68%), with smaller percentages of Hispanic (12%) and African American (11%) women. Most had commercial insurance (59%) and a partner (85%). Of the 132 women, 79.6% reported moderate-to-severe pain. Approximately 93% experienced back and pelvic pain, whereas 27% experienced moderate-to-severe depression symptoms. Bivariate and linear regression analyses revealed that higher EPDS depression scores were associated with higher levels of pain (p < .01). Other variables significantly associated with higher EPDS scores were White race (p = .04), marital status (p = .05), and headache (p < .01).

Clinical Implications:
In the third trimester of pregnancy, pain affects more than two-thirds of women and may occur with and without depression symptoms. Although the value of universal depression screening during pregnancy is widely recognized, our findings suggest clinical outcomes for pregnant women would improve with a standardized, multidimensional screen for both pain and depression symptoms. Nurses are ideally positioned to assess and advocate for the combined treatment of pain and depression.
Connecting with Families through Virtual Perinatal Education during the COVID-19 Pandemic
Authors: Pasadino Francine , DeMarco Kathleen , Lampert Elizabeth 
Published: September 2020

Abstract
The COVID-19 pandemic has caused many changes in health care. The status quo has been upended. We have been challenged in many ways to maintain our ability to meet the needs of our clients while keeping them safe. The Center for Perinatal Education and Lactation at NYU Langone Hospitals, in one of the initial epicenters of the pandemic in New York City, had to abruptly transition the childbirth education program to a virtual format in March of 2020. The goal for this change was to continue to provide evidence-based support and guidance our to our expectant and new families through this crisis. This report focuses on the process and challenges of transitioning to and implementation of the virtual format in the context of the COVID-19 crisis. We discuss the rapidly evolving programmatic changes to our approach and reflect on the themes and changing landscape of our newly structured model. Questions and answers live discussion webinars “Ask the Educator” on various topics were a valuable tool in connecting with families and allaying anxiety and fear.
Family Functioning Mediates the Relationship Between Activities of Daily Living and Poststroke Depression
Authors: Yang Li , Zhao Qiuli , Liu Hongli , Zhu Xuemei , Wang Kunxiao , Man Jing 
Published: September 2020

Background
Poststroke depression is common and includes depressive and somatic symptoms. However, few studies have confirmed the influence of family functioning on poststroke depression or explored the association among daily activities, family functioning, and poststroke depression.

Objectives
We examined the independent risk factors of daily activities and family functioning for poststroke depression and identified the mediating effect of family functioning on the association between daily activities and poststroke depression.

Methods
This cross-sectional study design used convenience sampling to recruit 422 stroke survivors from the neurology department of a hospital in Harbin, China, from February to July 2018. We assessed participants’ demographic and clinical variables, including depression, daily activities, and family functioning. Pearson’s correlations and multiple linear regression analyses were conducted, and a path analysis with bootstrapping was utilized to define direct/indirect effects.

Results
Daily activities and family functioning had a significant and direct negative effect on participants’ depression. The indirect effect of 1,000 bootstrap samples after bias correction with a 95% confidence interval was below zero, indicating that family function had a significant mediating effect on the association between depression and daily activities.

Discussion
This study revealed the importance of family functioning in the association between depression and daily activities in stroke survivors. To the best of our knowledge, this study was the first to explore the mediating role of family functioning in poststroke depression, emphasizing the importance of family for the mental health of stroke patients. To reduce the incidence of poststroke depression, interventions that enhance daily activities and family functioning may include nurses, family therapists, rehabilitation physicians, and community workers.
Suicide Risk Management Protocol for a Randomized Controlled Trial of Cardiac Patients Reporting Hopelessness
Authors: Dunn Susan L. , DeVon Holli A. , Collins Eileen G. , Luong Anna , Buursma Madison P. , Gutierrez-Kapheim Melissa , Bronas Ulf G. 
Published: September 2020

Background
Investigators conducting studies that include potentially suicidal individuals are obligated to develop a suicide risk management (SRM) protocol. There is little available in the literature to guide researchers in SRM protocol development.

Objectives
The aim of the study was to describe an SRM protocol developed for a randomized controlled trial (RCT) currently enrolling cardiac patients who report moderate to severe levels of hopelessness.

Methods
The SRM protocol identifies suicidal ideation and measures ideation severity through use of the Columbia-Suicide Severity Rating Scale risk factor questions. Based on responses, study participants are deemed safe or at low, moderate, or high risk for suicide. The SRM protocol guides research staff through a plan of action based on risk level. The protocol further guides staff through a plan over the course of this prospective study—from hospital enrollment to home-based visits.

Results
Research staff are well trained to identify suicidal ideation risk factors, initiate specific questioning about suicidal intent, determine level of risk, identify protective factors and a safe environment, and make referrals if needed. Of the 51 patients hospitalized with cardiac disease who reported moderate to severe hopelessness, 43 scored at a safe suicide risk level and 8 scored at low risk. Thirty-five of the 51 patients enrolled in the RCT. Of the 35 participants who received home visits to date, there have been three instances of low and one instance of moderate suicide risk. The SRM protocol has been consistently and accurately used by research personnel in both hospital and home settings. One modification has been made to the protocol since study activation, namely, the addition of an assessment of counseling history and encouragement of continued counseling. Booster training sessions of research staff will continue throughout the course of the RCT.

Discussion
Use of the SRM protocol identifies study participants who are safe or at risk for suicide in both hospital and home settings, and research staff can refer participants accordingly.

Conclusion
The SRM protocol developed for this RCT can serve as a model in the development of SRM protocols for future research in acute care, community, or home-based settings.
The Importance of Autopsy in a Case of Digestive Perforation Undetected by Postmortem Computed Tomography
Authors: Macoin Elisa , Kintz Pascal , Gressel Anne , Leyendecker Pierre , Raul Jean-Sébastien , Walch Alexis 
Published: September 2020

Abstract
Cases of foreign body ingestion in the forensic literature are mainly described in children or psychiatric patients. Postmortem imaging can detect most foreign bodies, but its sensitivity depends, among other things, on the type of item and its location. In some cases, the ingestion of foreign bodies can remain unnoticed and have serious consequences for the patient. We describe the case of a patient who died in a psychiatric seclusion room with no obvious cause and for whom a forensic autopsy was requested. Further investigations showed the existence of a subdural hematoma associated with a midline shift, secondary to a skull fracture that was considered to be the cause of death. Toxicological analyses identified in blood several drugs, including diazepam (24 ng/mL) and its major metabolite nordazepam (24 ng/mL), propranolol (57 ng/mL), paliperidone (9 ng/mL), and loxapine (620 ng/mL). The forensic autopsy revealed the existence of a gastrointestinal perforation after the ingestion of a plastic teaspoon, which the postmortem CT scan had failed to detect. Although technological advances continue to assist the forensic pathologist in his diagnosis, autopsy still has a leading role in forensic investigations and does not yet seem to be replaceable by imaging techniques alone.
Frequency of Polyautoimmunity in Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus
Authors: Ordoñez-Cañizares M. C. , Mena-Vázquez Natalia , Redondo-Rodriguez Rocio , Manrique-Arija Sara , Jimenez-Núñez Francisco Gabriel , Ureña-Garnica Inmaculada , Fernández-Nebro Antonio 
Published: September 2020

Objective
To describe the frequency of polyautoimmunity and multiple autoimmune syndrome in patients with rheumatoid arthritis (RA) and patients with systemic lupus erythematosus (SLE).

Patients and Methods
This was a cross-sectional observational study of patients with RA, SLE, and controls without autoimmune rheumatic disease. Cases were those with RA according to the 2010 American College of Rheumatology/European League Against Rheumatism criteria and SLE according to the 2019 American College of Rheumatology/European League Against Rheumatism criteria, consecutively recruited in a rheumatology clinic. Controls were subjects with no rheumatic autoimmune disease (AIDs) recruited in the same area. Patients filled out a questionnaire on polyautoimmunity. Variables of interest were polyautoimmunity (RA or SLE with other AIDs), whereas secondary variables were rheumatic, skin, endocrine, digestive, and neurological AIDs. Multiple autoimmune syndrome is defined as the presence of 3 or more AIDs and a family history of AIDs. Statistical analyses performed were descriptive, bivariate, and multivariate (dependent variable: polyautoimmunity).

Results
The study population comprised 109 patients with RA, 105 patients with SLE, and 88 controls. Polyautoimmunity was recorded in 15 patients with RA (13.8%), 43 with SLE (41%), and 2 controls (2.2%). The most frequent AID in RA was Sjögren syndrome (53.3%), followed by Hashimoto thyroiditis and psoriasis; the most frequent AIDs in SLE were Sjögren syndrome (55.8%) and antiphospholipid syndrome (30.2%), followed by Hashimoto thyroiditis. Obesity was associated with polyautoimmunity in RA (odds ratio [OR], 3.362; p = 0.034). In SLE, joint damage (OR, 2.282; p = 0.038) and anti-RNP antibodies (OR, 5.095; p = 0.028) were risk factors for polyautoimmunity, and hydroxychloroquine was a protective factor (OR, 0.190; p = 0.004).

Conclusions
Polyautoimmunity is frequent in RA and even more frequent in SLE. It was associated with obesity in RA and with joint damage and anti-RNP in SLE. Hydroxychloroquine was a protector.
Ex Vivo Administration of Mesenchymal Stromal Cells in Kidney Grafts Against Ischemia-reperfusion Injury—Effective Delivery Without Kidney Function Improvement Posttransplant
Authors: Lohmann Stine , Eijken Marco , Møldrup Ulla , Møller Bjarne K. , Hunter James , Moers Cyril , Leuvenink Henri , Ploeg Rutger J. , Clahsen-van Groningen Marian C. , Hoogduijn Martin , Baan Carla C. , Keller Anna Krarup , Jespersen Bente 
Published: September 2020

Background.
Mesenchymal stromal cell (MSC) therapy may improve renal function after ischemia-reperfusion injury in transplantation. Ex vivo renal intraarterial administration is a targeted delivery method, avoiding the lung vasculature, a known barrier for cellular therapies. In a randomized and blinded study, we tested the feasibility and effectiveness of MSC therapy in a donation after circulatory death autotransplantation model to improve posttransplant kidney function, using an ex vivo MSC delivery method similar to the clinical standard procedure of pretransplant cold graft flush.

Methods.
Kidneys exposed to 75 minutes of warm ischemia and 16 hours of static cold storage were intraarterially infused ex vivo with 10 million male porcine MSCs (Tx-MSC, n = 8) or vehicle (Tx-control, n = 8). Afterwards, the kidneys were autotransplanted after contralateral nephrectomy. Biopsies an hour after reperfusion confirmed the presence of MSCs in the renal cortex. Animals were observed for 14 days.

Results.
Postoperatively, peak plasma creatinine was 1230 and 1274 µmol/L (Tx-controls versus Tx-MSC, P = 0.69). During follow-up, no significant differences over time were detected between groups regarding plasma creatinine, plasma neutrophil gelatinase-associated lipocalin, or urine neutrophil gelatinase-associated lipocalin/creatinine ratio. At day 14, measured glomerular filtration rates were 40 and 44 mL/min, P = 0.66. Renal collagen content and fibrosis-related mRNA expression were increased in both groups but without significant differences between the groups.

Conclusions.
We demonstrated intraarterial MSC infusion to transplant kidneys as a safe and effective method to deliver MSCs to the graft. However, we could not detect any positive effects of this cell treatment within 14 days of observation.
Retinal and Optic Nerve Deformations Due to Orbital Versus Intracranial Venous Hypertension
Authors: Kupersmith Mark J. , Sibony Patrick A. 
Published: September 2020

Introduction:
Abnormal forces around the optic nerve head (ONH) due to orbital diseases, intracranial hypertension (IH), glaucoma, and space travel, are associated with alterations of the ONH shape. Elevated cerebral and ophthalmic venous pressure can contribute to stress and strain on the ONH and peripapillary retina. We hypothesize that IH and elevated ophthalmic venous pressure without IH cause different ONH and retinal changes.

Methods:
We compared MRI and spectral domain optical coherence tomography (SDOCT) findings in patients with cavernous sinus arteriovenous shunts (CSAVSs), where orbital venous pressure is known to be elevated, with patients with intracranial dural venous sinus thrombosis and secondary IH. We also compared the results to those obtained in the Idiopathic IH (IIH) Treatment Trial.

Results:
Among 18 patients with dural venous sinus thrombosis, the MRI/magnetic resonance venography displayed partial empty sella (61%) and optic nerve sheath distension (67%). None exhibited ophthalmic vein dilation or signs of orbital congestion. SDOCT of these eyes and IIH eyes showed a similar frequency of abnormal thickening of the mean retinal nerve fiber layer, anterior displacement of the basement membrane opening, peripapillary wrinkles, retinal folds (RF), and choroidal folds (CF). Among 21 patients with CSAVSs, MRI showed ipsilateral dilated superior ophthalmic vein (76%) and orbital congestion (52%) without distension of the optic nerve sheath or globe distortion. SDOCT showed CF (19%), one with overlying RF, and no ONH deformations.

Conclusions:
SDOCT findings for dural venous sinus thrombosis are similar to those seen with IIH but distinct from changes due to local ophthalmic venous hypertension. These data support the concept that IH even if due to a vascular cause and local orbital venous hypertension cause different stresses and strains on the ONH.
Ageing and physical function in East African foragers and pastoralists
Authors: Sayre M. Katherine , Pontzer Herman , Alexander Gene E. , Wood Brian M. , Pike Ivy L. , Mabulla Audax Z. P. , Raichlen David A. 
Published: September 2020

Human lifespans are exceptionally long compared with those of other primates. A key element in exploring the evolution of human longevity is understanding how modern humans grow older. Our current understanding of common age-related changes in human health and function stems mostly from studies in industrialized societies, where older adulthood is often associated with an increased incidence of chronic diseases. However, individuals who engage in different lifestyles across industrialized and non-industrialized contexts may display variance in age-related changes in health and function. Here, we explore aspects of physical function in a non-industrialized context using three objective measures of physical function. We assessed physical activity levels, walking endurance and muscle strength in two East African populations: Hadza hunter–gatherers in Tanzania and Pokot pastoralists in Kenya. Both Hadza and Pokot participants displayed significant age-related differences in most, but not all, functional measures. Our results suggest that some age-related differences in physical function seen in industrialized contexts could be consistently experienced by most humans, while other age-related differences may vary across populations. Studies of ageing should expand to include a broad range of populations so we can create a more comprehensive understanding of how senescence varies across different lifestyle contexts.This article is part of the theme issue ‘Evolution of the primate ageing process’.