bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cross-sectional Examination of Quadriceps Strength, Biomechanical Function, and Functional Performance From 9 to 24 Months After Anterior Cruciate Ligament Reconstruction
Authors: Curran Michael T. , Bedi Asheesh , Kujawa Megan , Palmieri-Smith Riann 
Published: July 2020

Background: Patients who undergo anterior cruciate ligament reconstruction (ACLR) have deficiencies in strength, functional performance, and biomechanical function at return to activity. Patients who have abnormal strength and function after ACLR may be at a greater risk for secondary injury and posttraumatic osteoarthritis. Purpose: To examine quadriceps strength, functional performance, and knee biomechanics in patients who are 9, 12, 18, and 24 months after ACLR. Study Design: Cross-sectional study; Level of evidence, 3. Methods: We recruited 82 participants (45 female) who underwent ACLR and were cleared to return to activity . Participants were assigned to 1 of 4 groups based on their time from ACLR: 9 months (285.26 ± 8.16 days), 12 months (373.59 ± 8.81 days), 18 months (557.50 ± 11.96 days), and 24 months postoperative (741.05 ± 11.86 days). Quadriceps strength was measured concentrically at 60 deg/s. Functional performance was assessed by measuring maximal hop distances or heights during dynamic hopping/jumping tests (single-leg hop, triple hop, crossover hop, and single-leg vertical hop). Biomechanical function was evaluated during the dynamic hop tests by using peak sagittal plane knee flexion angles recorded during landings. Strength, performance, and biomechanics data were collected for both limbs and reported as symmetry scores ([injured/uninjured] × 100). Self-perceived function was measured using the International Knee Documentation Committee subjective knee form. Results: Quadriceps strength in the 9-month (77.61 ± 16.73) and 12-month (77.80 ± 13.99) groups was significantly lower ( P < .01) compared with the 24-month group (92.40 ± 15.55). Self-perceived function for the 9-month group (79.33 ± 10.40) was significantly lower ( P < .01) when compared with 12-month (87.58 ± 10.29), 18-month (89.81 ± 8.36), and 24-month (91.59 ± 5.70) groups. Single-leg hop distance symmetry was significantly lower ( P < .01) for the 9-month group (90.01 ± 9.46) when compared with the 18-month (96.24 ± 6.47) and 24-month (96.30 ± 6.46) groups; triple hop symmetry was significantly lower ( P < .05) for the 9-month group (90.26 ± 10.03) when compared with the 18-month (96.83 ± 9.60) and 24-month (95.91 ± 6.36) groups; and crossover hop was significantly lower ( P < .05) for the 9-month group (88.35 ± 13.53) when compared with the 18-month (95.85 ± 8.63) and 24-month (97.10 ± 4.12) groups. Conclusion: Quadriceps strength, self-perceived function, and functional performance improve 9 to 24 months after ACLR, indicating that recovery is ongoing after return to activity. Return-to-activity criteria after ACLR should objectively account for strength and function.
Outcomes in Children and Adolescents With Psychogenic Nonepileptic Events Using a Multidisciplinary Clinic Approach
Authors: Terry Debbie , Enciso Laurie , Trott Kristen , Burch Maggie (Mary) , Albert Dara V. F. 
Published: July 2020

Background: Psychogenic nonepileptic events (PNEE) are paroxysmal events that resemble epileptic seizures but are caused by psychological factors. Coordination of care has been recommended as one strategy to integrate care and improve outcomes. We aim to evaluate patient outcomes in a multidisciplinary pediatric psychogenic nonepileptic events clinic that includes care coordination. Methods: All patients referred to the multidisciplinary psychogenic nonepileptic events clinic were entered into a prospective database. Follow-up calls were made by the clinic nurse at 1 and 3 months following the visit. Results: A total of 101 unique patients were reviewed. Ninety-six appointments were scheduled, and 83 appointments were completed (86%). Social work identified barriers in 38 patients, and 76% of those assisted completed their appointment. At 1 month, two-thirds of families were reached, 50% were accepting of the diagnosis, and 70% had clinical improvement in events. By 3 months, 75% had clinical improvement, 76% were receiving mental health services, and 73% were accepting of the diagnosis; however, more had also returned to the emergency department. Families needing assistance from social work tended to have worse outcomes. Increase in acceptance was nearly statistically significant ( P = .058) from 1 to 3 months; however, it was not so for clinical improvement in events ( P = .623). Conclusions: Implementation of a multidisciplinary team with care coordination allowed for follow-up for children and adolescents with psychogenic nonepileptic events and mitigation of barriers to care and can improve clinical outcomes. After being seen in our clinic, many families had accepted the diagnosis, most of the patients reached had event improvement and were successfully linked with counseling at the 1- and 3-month follow-ups.
Why it’s worthwhile training as a psychiatrist
Authors: Looi Jeffrey CL , Finlay Angus JF 
Published: July 2020

Objectives: We provide experiential reflections upon the process of training and working as a psychiatrist, with the aim of sparking and maintaining interest in psychiatry as a medical career. Conclusions: There are many benefits and worthwhile experiences from training and working in psychiatry, especially in the privilege of providing holistic care for persons suffering from mental illness.
Three-Dimensional Analysis of Bilateral Cleft Lip and Palate Nasal Deformity
Authors: Harrison Lucas M. , Hallac Rami R. , Derderian Christopher A. 
Published: July 2020

Objective: This cross-sectional study utilizes 3-dimensional analysis to assess nasal morphology in patients with bilateral cleft lip and palate (BCLP) compared to controls across the timeline of cleft care. Design: Retrospective comparative cross-sectional study. Setting: Tertiary pediatric academic institution. Patients and Participants: One hundred and twelve patients with BCLP and an equal number of age and sex-matched control participants. Main Outcome Measure(s): Nasolabial angle, nasal length, nasal protrusion, columella length, columella width, nasal tip width, alar width, and alar base width were collected at each time point. The measurements were collected pre-nasoalveolar molding (NAM) therapy, post-NAM therapy, post-primary cleft rhinoplasty, 1 year, 5 years, 10 years, and 15 years of age. Results: Nasolabial angle and nasal tip width were significantly different from controls from pre-NAM through 15 years of age time points. Nasal length was not significantly different at any time point. Alar width and alar base width were significantly different from pre-NAM through 10 years of age time points. Nasal protrusion, columella length, and columella width were significantly different from pre-NAM through 5 years of age time points. Conclusions: This study demonstrates that three-dimensional photogrammetry is effective in assessing the changes in nasal morphology that occur throughout the course of care in patients with BCLP from before cleft lip repair to the completion of nasal growth.
Skeletal Muscle Ratio: A Complete Mediator of Physical Activity and HbA1C in Type 2 Diabetes
Authors: Wang Sen-Te , Lin Yen-Kuang , Weng Shuen-Fu , Huang Chen-Ling , Huang Hui-Chuan , Chiu Yi-Chun , Hu Sophia 
Published: July 2020

Background: An increase in the physical activity level reduces body weight, decreases body fat, increases skeletal muscle mass, and improves serum glucose; however, the influence of body composition parameters on the relationship between physical activity and serum glucose remains unclear. Objective: This study investigated whether skeletal muscle and visceral fat affect the relationship between high physical activity and long-term serum glucose goals. Method: This cross-sectional study recruited patients with type 2 diabetes. The Chinese version of the International Physical Activity Questionnaire was used for estimating the physical activity level, and a bioimpedance device was used to measure the skeletal muscle ratio (skeletal muscle mass/total body weight, %) and visceral fat area (cm2). Hierarchical logistic regression models and mediation tests were conducted according to Hayes’ procedures. Results: Of the total 543 Chinese individuals with type 2 diabetes enrolled, HbA1C levels of fewer than half (n = 243, 44.8%) met the target of ≤7.0%. The skeletal muscle ratio was found to be a complete mediator (OR = 0.920, 95% CI: 0.848 to 0.998; indirect effect: −0.238, 95% CI: −0.525 to −0.020) of the relationship between high physical activity and the target HbA1C level after controlling for visceral fat area (indirect effect: −0.013, 95% CI: −0.183 to 0.156), age, time since diabetes diagnosis, and rice intake. Conclusion: Nurses should include an increase in the skeletal muscle ratio as an objective in physical activity interventions for patients with type 2 diabetes to help them achieve their long-term serum glucose goals.
An examination of suicidal behaviour among veterans receiving mental-health appointments in person versus clinical video telehealth
Authors: Rojas Sasha M , Piccirillo Marilyn L , McCann Russell A , Reger Mark A , Felker Bradford 
Published: July 2020

Introduction The US Department of Veterans Affairs (VA) is a national leader in the implementation of clinical video telehealth (CVT) services. Despite the growth of mental-health services offered via CVT, it is unclear to what extent these services are offered and accessed by veterans with previous suicidal behaviour. Methods The current quality improvement project examined this question within a local VA health-care system using data from suicide behaviour reports (SBRs), the Veteran Health Administration’s official reporting and surveillance system. The frequency of SBRs was compared during two different time points among veterans who received individual mental-health appointments in person only or via CVT during the 2017 calendar year. Among veterans with a SBR, time in days elapsed from their first mental-health appointment to a SBR was examined as a function of treatment modality. Results Results indicated veterans who received in-person treatment only were more likely to present with a SBR six months prior to their first mental-health appointment compared to those who received CVT during the observation period. There were no differences in SBRs during the 12 months after the first appointment or the time from the first appointment to the SBR as a function of treatment modality used. Discussion Although veterans who received in-person mental-health services were more likely to have had a SBR six months prior to treatment, suicide risk throughout the observation period did not differ between groups. Clinical implications that arise from these findings are described in the discussion.
Sex-related patterns of intrinsic functional connectivity in children and adolescents with autism spectrum disorders
Authors: Olson Lindsay A , Mash Lisa E , Linke Annika , Fong Christopher H , Müller Ralph-Axel , Fishman Inna 
Published: July 2020

Although a growing literature highlights sex differences in autism spectrum disorder clinical presentation, less is known about female variants at the neural level. We investigated sex-related patterns of functional connectivity within and between functional networks in children and adolescents with autism spectrum disorders, compared to typically developing peers. Resting-state functional magnetic resonance imaging data for 141 children and adolescents (7–17 years) selected from an in-house sample and four sites contributing to the Autism Brain Imaging Database Exchange (ABIDE I and II) were submitted to group independent component analysis to generate resting-state functional networks. Functional connectivity was estimated by generating resting-state functional network correlation matrices, which were directly compared between males and females, and autism spectrum disorder and typically developing groups. Results revealed greater connectivity within the default mode network in typically developing girls as compared to typically developing boys, while no such sex effect was observed in the autism spectrum disorder group. Correlational analyses with clinical indices revealed a negative relationship between sensorimotor connectivity and history of early autism symptoms in girls, but not in boys with autism spectrum disorder. A lack of neurotypical sex differentiation in default mode network functional connectivity observed in boys and girls with autism spectrum disorder suggests that sex-related differences in network integration may be altered in autism spectrum disorder. Lay summary We investigated whether children and adolescents with autism spectrum disorders show sex-specific patterns of brain function (using functional magnetic resonance imaging) that are well documented in typically developing males and females. We found, unexpectedly, that boys and girls with autism do not differ in their brain functional connectivity, whereas typically developing boys and girls showed differences in a brain network involved in thinking about self and others (the default mode network). Results suggest that autism may be characterized by a lack of brain sex differentiation.
Attitudes toward assisted death amongst doctors in Northern Portugal
Authors: Gonçalves Ferraz 
Published: July 2020

Introduction Context: In Portugal assisted death was approved in February 2020 by the Parliament, although the law is not yet in force. Objectives To find out what doctors think about those practices. Methods A link to a questionnaire was sent by email three times, at intervals of one week, to the doctors registered in the Northern Section of the Portuguese Medical Association, before the Parliamentary approval. Results The questionnaire was returned by 1148 (9%) physicians. A minority of doctors would practice a form of assisted death under the present law or if it was legalized, but a higher percentage think that euthanasia should be legalized, and more would like to have that option if they themselves were in a terminal phase of a disease. Religion has a strong influence on the attitudes of doctors, so too does their contact with patients in a terminal phase, as doctors who deal with more patients with far advanced diseases are more likely to be unfavorable to assisted death. On the other hand, younger doctors are more in favor of these practices. Conclusion The small percentage of questionnaires sent back is a weakness in this study and casts doubts on the generalizability of the conclusions. However, this is, so far, the best approximation to the opinions of Portuguese doctors on assisted death.
Investigating the Impact of Healthcare Environmental Design on Staff Security: A Systematic Review
Authors: MohammadiGorji Soheyla , Bosch Sheila J. , Valipoor Shabboo , De Portu Giuliano 
Published: July 2020

Objective: To systematically review the literature regarding the role of the physical environment in preventing or mitigating aggressive behavior toward healthcare professionals in acute care, outpatient, and psychiatric/behavioral health facilities. Background: Globally, the incidence of violence against healthcare professionals is alarming. Poor environmental design has been identified as a risk factor of violence toward employees. The design of the physical setting in which healthcare is provided may moderate the incidence and severity of violence against healthcare workers. Methods: We conducted electronic database searches of PubMed and CINAHL through November 2018. Result: Findings were organized according to four categories identified in the literature regarding crime prevention through environmental design (CPTED) including natural surveillance, access control, territoriality, and other CPTED elements. Fifteen studies (published between 1991 and 2017) met the inclusion criteria. Of the 15 studies, 4 incorporated environmental interventions. In the 11 remaining studies, physical environment attributes (i.e., layout, location, ambient conditions, equipment) were among the factors affecting violent incidents and staff security. Most study settings were hospital-based (11, with 10 of those specifically focused on emergency departments), followed by behavioral health facilities (4 studies). Design-focused recommendations, such as providing a second door in a triage room and a sub-waiting area inside the treatment zone, were summarized according to CPTED categories. Conclusion: This review suggests that the physical environment in healthcare facilities may affect the incidence of violence by patients or visitors against staff. Further research is needed to identify environmental design strategies that may protect the safety of healthcare professionals.
A cost-utility analysis of increasing percutaneous coronary intervention use in elderly patients with acute coronary syndromes in six European countries
Authors: Forné C , Subirana I , Blanch J , Ferrieres J , Azevedo A , Meisinger C , Farmakis D , Tavazzi L , Davoli M , Ramos R , Brosa M , Marrugat J , Dégano I R ,   EUROTRACS Investigators
Published: July 2020

Abstract

Aims
Percutaneous coronary intervention reduces mortality in acute coronary syndrome patients but the cost-utility of increasing its use in elderly acute coronary syndrome patients is unknown.

Methods
We assessed the efficiency of increased percutaneous coronary intervention use compared to current practice in patients aged ≥75 years admitted for acute coronary syndrome in France, Germany, Greece, Italy, Portugal and Spain with a semi-Markov state transition model. In-hospital mortality reduction estimates by percutaneous coronary intervention use and costs were derived from the EUROpean Treatment & Reduction of Acute Coronary Syndromes cost analysis EU project (n = 28,600). Risk of recurrence and out-of-hospital all-cause mortality were obtained from the Information System for the Development of Research in Primary Care (SIDIAP) database from North-Eastern Spain (n = 55,564). In-hospital mortality was modelled using stratified propensity score analysis. The 8-year acute coronary syndrome recurrence risk and out-of-hospital mortality were estimated with a multistate survival model. The scenarios analysed were to increase percutaneous coronary intervention use among patients with the highest, moderate and lowest probability of receiving percutaneous coronary intervention based on the propensity score analysis.

Results
France, Greece and Portugal showed similar total costs/1000 individuals (7.29–11.05 m €); while in Germany, Italy and Spain, costs were higher (13.53–22.57 m €). Incremental cost-utility ratios of providing percutaneous coronary intervention to all patients ranged from 2262.8 €/quality adjusted life year gained for German males to 6324.3 €/quality adjusted life year gained for Italian females. Increasing percutaneous coronary intervention use was cost-effective at a willingness-to-pay threshold of 10,000 €/quality adjusted life year gained for all scenarios in the six countries, in males and females.

Conclusion
Compared to current clinical practice, broadening percutaneous coronary intervention use in elderly acute coronary syndrome patients would be cost-effective across different healthcare systems in Europe, regardless of the selected strategy.
Pelvic-floor relaxation techniques using biofeedback – more effective therapy for chronic prostatitis/chronic pelvic pain syndrome
Authors: Pandey Manish , Shrivastava Vaibhav , Patidar Vijay , Dias Sabby , Trivedi Sameer 
Published: July 2020

Objective: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic pain and voiding symptoms, the management of which is challenging. The present study was designed to assess the efficacy of biofeedback and pelvic-floor relaxation treatment for CP/CPPS. Methods: A total of 84 patients diagnosed with CP/CPPS were randomly assigned to one of the two groups: conventional therapy (group A) and pelvic-floor muscle relaxation and biofeedback (group B). The Biofeedback and Electrical Stimulation apparatus was used for pelvic-floor muscle electrical stimulation and relaxation with biofeedback. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were evaluated at the start of therapy, after 3 months of treatment and at 6 months (3 months after last treatment received). Results: At 3 months, patients in both groups had a significant decrease (improvement in symptoms) in NIH-CPSI scoring. However, at 6 months, only 19 (47.5%) patients in group A maintained a fall in NIH-CPSI score >6 compared with 37 (94.8%) patients in group B ( p<0.05). At 6 months, there was significant decrease in NIH-CPSI score in group B, whereas in group A, scores had increased (worsening of symptoms). Conclusions: Pelvic-floor muscle relaxation and biofeedback training is a safe and effective treatment for CP/CPPS with sustained efficacy.
Exploring the equity impact of mobile health-based human immunodeficiency virus interventions: A systematic review of reviews and evidence synthesis
Authors: Nittas Vasileios , Ameli Vira , Little Madison , Humphreys David K 
Published: July 2020

Objective While mobile health-based human immunodeficiency virus (HIV) interventions are often designed to promote health equity, systematic differences in the use of and access to mobile technologies may counteract that and widen treatment gaps. This systematic review applies an equity lens to investigate whether existing research provides adequate evidence on the ethical implications of mHealth technologies in HIV treatment and prevention. Methods This study included a two-stage methodology, consisting of (a) a systematic review of systematic reviews and (b) an evidence synthesis of primary studies. For the review of reviews we searched eight electronic databases, eight electronic journals and Google Scholar. We also screened reference lists and consulted authors of included studies. Primary studies were extracted from eligible reviews. We based our data extraction and analysis on the Place of residence, Race, Occupation, Gender/Sex, Religion, Education, Socioeconomic status, Social capital and other disadvantage related characteristics (PROGRESS-Plus) framework and the use of harvest plots, focusing on the socio-demographic distribution of mHealth effects. Results A total of 8786 citations resulted in 19 eligible reviews and 39 eligible primary studies. Existing reviews did not provide any analyses of the equity impacts of mobile health-based HIV initiatives. Information availability was higher in primary studies, predominantly suggesting no social gradient of mobile health-based HIV interventions. Overall, evidence remains weak and not sufficient to allow for confident equity statements. Conclusions Despite the negative force of socio-demographic inequities and the emerging nature of mobile health technologies, evidence on the equity implications of mobile health interventions for HIV care remains scarce. Not knowing how the effects of mobile health technologies differ across population subgroups inevitably limits our capacities to equitably adopt, adjust and integrate mobile health interventions towards reaching those disproportionally affected by the epidemic.