bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Indicators in Base of Tongue Adenocarcinoma: A Population-Based Analysis
Authors: Kraimer Kristen , Ganti Ashwin , Plitt Max A. , Revenaugh Peter , Stenson Kerstin , Tajudeen Bobby A. , Al-Khudari Samer 
Published: October 2019

Introduction: The objectives of this investigation are to characterize the epidemiology of base of tongue adenocarcinoma utilizing a population-based database and to identify prognostic factors that may affect survival. Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results database. Univariate Kaplan-Meier analysis and multivariate Cox-regression analysis were performed to evaluate the association of suspected prognostic factors with survival. Overall survival (OS) and disease-specific survival (DSS) were the primary outcome measures. Results: A total of 176 cases were eligible based on inclusion criteria. The 5-year OS and DSS were 49% and 66%, respectively. On multivariate analysis, surgical management was associated with improved OS and DSS (OS hazard ratio [HR]: 0.34, 95% confidence interval [CI]: 0.20-0.58, P < .001; DSS HR: 0.20, 95% CI: 0.09-0.48, P < .001), while higher tumor grade was associated with worse OS and DSS (OS HR: 1.58, 95% CI: 1.14-2.19, P = .006; DSS HR: 1.68, 95% CI: 1.01-2.79, P = .045). Administration of chemotherapy or radiation did not have a significant association with OS or DSS. Conclusion: This investigation is the largest to date to analyze the base of tongue adenocarcinoma as its own entity. Surgery remains the mainstay of treatment, and lower tumor grade is associated with improved survival in these patients. Administration of radiation or chemotherapy was not associated with improved survival.
Experiences related to quality of life in people with dementia living in institutional settings – A meta-aggregation
Authors: Kristensen Hanne Kaae , Peoples Hanne 
Published: October 2019

IntroductionWithin dementia care, there remains a general lack of coherence in evidence-based knowledge on issues of importance for subjective experiences of quality of life in people with dementia. The aim of the meta-aggregation was to investigate experiences related to quality of life in people with dementia living in institutional settings.MethodA meta-aggregation inspired by the Joanna Briggs Institute was undertaken. A systematic search was conducted in four databases and additional studies were found in the reference lists of the included studies. Only studies in English, Danish, Swedish, and Norwegian were considered, with publication dates from 2007 to 2018.FindingsTen original qualitative studies were included. Using critical appraisal, methodological quality was assessed. We extracted five main categories: acceptance and adaptation; autonomy; personhood; social connectedness; and activities.ConclusionSignificant findings for future occupational therapy in dementia care concerned the importance of coming to terms with the illness and life situation, while being able to experience feelings of autonomy, independence, and personhood. Meaningful social relationships and activities, individualized flexible routines and regulations, and adjusted physical environments with room for privacy were also prioritized in order to achieve high quality of life.
Children and young people’s perspectives and experiences of a community wheelchair basketball club and its impact on daily life
Authors: Moss Philippa , Lim Kee Hean , Prunty Mellissa , Norris Meriel 
Published: October 2019

Introduction Although the benefits of physical activity are widely recognised, levels of inactivity are considerably higher for children and young people with disabilities than those without. Young people with disabilities struggle to access inclusive opportunities and there is a lack of research surrounding users’ experiences of disability sport more generally. This research aimed to explore members’ experiences of a community-based wheelchair basketball club and its impact on daily life. Method Semi-structured interviews were conducted with 11 disabled and able-bodied members of the club (aged 6–25 years) to gain an in-depth understanding of their experiences. Findings Inductive thematic analysis identified an overarching theme of ‘wheelchair basketball elicits strong emotions’ and four main themes of ‘positive social interactions’, ‘benefitting health and independence’, ‘changing perceptions of disability’ and ‘a meaningful occupation that opens doors’. Participants reported positive experiences of wheelchair basketball, which improved their physical and mental health whilst increasing opportunities for socialisation and encouraging acceptance of disability. Conclusion The findings have implications at individual, organisational and societal levels, and provide some justification for the role of occupational therapy in disability sport. The findings demonstrate the potential for inclusive community sports clubs to improve health and social outcomes for individuals, regardless of disability.
Prevalence and Impact of Pharmacy Students as Patient Care Extenders in Medically Underserved Community Pharmacies
Authors: White Nicole , Galt Kimberly , Ridgway John E. , Skrabal Maryann Z. , Jones Rhonda , Willman Claire C. 
Published: October 2019

Objective: The objective of this study is to evaluate the prevalence and describe the patient care impact of student pharmacists completing community pharmacy rotations in medically underserved areas (MUAs) in Nebraska. Methods: A list of pharmacy student advanced pharmacy practice experience placements over a 3-year period were obtained from 2 pharmacy schools in Nebraska and then mapped in relation to MUAs in the state. A mixed-methods approach was used to compare and relate findings of a student-logged patient care activity database and semistructured interviews with pharmacy preceptors of participating students. Results: Pharmacy students were placed in 21 (13%) of 159 identified pharmacies located in MUAs. Pharmacy preceptors felt students improved the quality of patient care provided as a result of more uninterrupted time with the patient. Preceptors also indicated that student presence assists both the student and the practicing pharmacist engage in more patient care services. Conclusion: There exists a significant opportunity to utilize advanced pharmacy practice students to extend patient care services and address health-care needs in underserved communities, but student placement in MUAs should be optimized.
Real-life anti–vascular endothelial growth factor treatment for age-related macular degeneration and diabetic macular edema in an Italian tertiary referral hospital
Authors: Battaglia Parodi Maurizio , Romano Francesco , Arrigo Alessandro , Sacchi Raffaele , Scanzi Gianluca , Ferri Camilla , Bandello Francesco 
Published: October 2019

Purpose: To study the real-life outcomes of intravitreal anti–vascular endothelial growth factor treatment in patients affected by age-related macular degeneration and diabetic macular edema in an Italian tertiary referral hospital over a 2-year follow-up. Methods: Patients with confirmed diagnosis of age-related macular degeneration or diabetic macular edema and 2 years of follow-up were retrospectively analyzed. They underwent a loading dose of three monthly anti–vascular endothelial growth factor injections, with re-treatment performed following a “pro-re-nata” regimen. Best-corrected visual acuity and central retinal thickness were collected and statistically analyzed. Results: In total, 167 diabetic macular edema eyes and 108 age-related macular degeneration eyes were included. Mean age was 63.4 ± 11.8 years for diabetic macular edema and 75.6 ± 8.4 years for age-related macular degeneration. For diabetic macular edema patients, mean number of injections was 5.0 ± 1.7 at 1 year and 2.8 ± 1.8 at 2 years. Mean best-corrected visual acuity improved from 60 Early Treatment for Diabetic Retinopathy Study letters to 66.7 letters at 1 year, and to 70 letters at 2 years (p < 0.001). Mean central retinal thickness decreased from 459 ± 148 µm to 327 ± 163 µm and 261 ± 89 µm, respectively, at the first and the second year (p < 0.001).With respect to age-related macular degeneration patients, mean number of injections was 5.3 ± 2.2 at 1 year and 3.3 ± 1.5 at 2 years. Mean best-corrected visual acuity improved from 63 Early Treatment for Diabetic Retinopathy Study letters to 68 letters at 1 year and to 70 letters at 2 years (p < 0.001). Mean central retinal thickness was 411 ± 146 µm, decreasing to 271 ± 93 µm at 1 year and 260 ± 68 µm at 2 years (p < 0.001). Conclusions: Our study described the 2-year real-life outcome of anti–vascular endothelial growth factor treatment of diabetic macular edema and age-related macular degeneration.
Development of an ICT-Based Dementia Care Mapping Support System and Its Usefulness Assessment
Authors: Yamamoto Hirotoshi , Yokokohji Yasuyoshi 
Published: October 2019

Objectives: Dementia Care Mapping (DCM) is an established practice method to implement Person-centred Care in dementia care settings. However, it is not easy to carry out DCM because of its high complexity. The aim of this study is to solve DCM complexity by adopting technology. Methods: Authors developed (1) a new information-communication technology (ICT) based DCM support system based on the investigation of difficulties and/or burden encountered during mapping (n = 33) and (2) a new evaluation test method, using role-play videos, for assessing the usefulness and reliability of the system. Mapping data, collected using the support system or the conventional paper-based DCM (n = 22), were compared. Results: We obtained users’ positive ratings of the system for burden reduction and its usability. Moreover, the developed prototype system indicated to have already reached the level of conventional paper-based DCM in terms of mapping accuracy. Conclusion: Usefulness of the ICT-based support system was confirmed to help overcome DCM complexity.
Comparison of the Efficacy of Transthoracic Cannulation into the Ascending Aorta Versus Femoral Artery Cannulation in Minimally Invasive Cardiac Surgery
Authors: Nakajima Hiroyuki , Takazawa Akitoshi , Tounaga Chiho , Yoshitake Akihiro , Tochii Masato , Hayashi Jun , Kaneyuki Daisuke , Asakura Toshihisa , Iguchi Atsushi 
Published: October 2019

Objective To delineate the efficacy and safety of transthoracic cannulation to the ascending aorta through a right pleural cavity during minimally invasive cardiac surgery (MICS). Methods We retrospectively assessed the records of 104 patients who underwent MICS in our institution between December 2011 and December 2018. Procedures included mitral valve repair (88 patients), aortic valve replacement (8 patients), atrial septal defect closure (6 patients), and myxoma resection (2 patients). Aortic valve replacements were performed through the third intercostal space (ICS), whereas the other procedures were mainly performed through the fourth ICS. The femoral group comprised 60 patients in whom an artificial graft was anastomosed to the femoral artery and 4 who underwent cannulation into the femoral artery. The aorta group comprised 40 patients in whom transthoracic cannulation was performed through the second or third ICS, separate from the main skin incision. Results No mortality or critical complications were associated with cardiopulmonary bypass. Perfusion pressure measured at outflow of the artificial lung (224 ± 43 vs. 190 ± 42; P < 0.001) and pump pressure measured at the outflow of the pump (293 ± 50 vs. 255 ± 57; P < 0.001) were significantly higher in the femoral group than in the aorta group. The skin incision lengths were similar (56.9 ± 6.9 vs. 55.1 ± 6.0 mm; P = 0.107). Conclusions Transthoracic cannulation into the ascending aorta is reliable and can be safely performed. The possible risks associated with peripheral cannulation and retrograde perfusion can be avoided thereafter.
Using contrast-enhanced ultrasound to guide a successful biopsy of a splenic sarcomatoid carcinoma
Authors: Leenknegt Benjamin , Moore Stephen , Fang Cheng , Kibriya Nabil , Gregory Stephen , Cancuri Osman , Sidhu Paul S , Yusuf Gibran 
Published: October 2019

Introduction Splenic lesions are uncommon and frequently cause a diagnostic dilemma, often with non-specific findings on both ultrasound and cross-sectional imaging with histological confirmation necessary. To reduce patient morbidity, primarily from haemorrhage and to increase diagnostic yield, precise imaging and biopsy targeting are needed. Case We present a case of an indeterminate complex splenic lesion, with areas of necrosis which required histological diagnosis. Contrast-enhanced ultrasound-guided percutaneous core needle biopsy was undertaken to provide real-time imaging guidance, increasing viable lesion targeting and helping to avoid areas of necrosis. Conclusion Contrast-enhanced ultrasound guidance of the percutaneous core needle biopsy allowed increased operator confidence in lesional targeting accuracy and reduced the number of passes required for biopsy, simultaneously maximising histological yield and minimising patient morbidity.
Brivaracetam attenuates pain behaviors in a murine model of neuropathic pain
Authors: Tsymbalyuk Solomiya , Smith Madeleine , Gore Charles , Tsymbalyuk Orest , Ivanova Svetlana , Sansur Charles , Gerzanich Volodymyr , Simard J Marc 
Published: October 2019

Background The antiseizure racetams may provide novel molecular insights into neuropathic pain due to their unique mechanism involving synaptic vesicle glycoprotein 2A. Anti-allodynic effects of levetiracetam have been shown in animal models of neuropathic pain. Here, we studied the effect of brivaracetam, which binds to synaptic vesicle glycoprotein 2A with 20-fold greater affinity, and has fewer off-target effects. Methods Mice underwent unilateral sciatic nerve cuffing and were evaluated for mechanical sensitivity using von Frey filaments. Pain behaviors were assessed with prophylactic treatment using levetiracetam (100 or 10 mg/kg) or brivaracetam (10 or 1 mg/kg) beginning after surgery and continuing for 21 days, or with therapeutic treatment using brivaracetam (10 or 1 mg/kg) beginning on day 14, after allodynia was established, and continuing for 28 or 63 days. Spinal cord tissues from the prophylaxis experiment with10 mg/kg brivaracetam were examined for neuroinflammation (Iba1 and tumor necrosis factor), T-lymphocyte (CD3) infiltration, and synaptic vesicle glycoprotein 2A expression. Results When used prophylactically, levetiracetam, 100 mg/kg, and brivaracetam, 10 mg/kg, prevented the development of allodynia, with lower doses of each being less effective. When used therapeutically, brivaracetam extinguished allodynia, requiring 10 days with 10 mg/kg, and six weeks with 1 mg/kg. Brivaracetam was associated with reduced neuroinflammation and reduced T-lymphocyte infiltration in the dorsal horn. After sciatic nerve cuffing, synaptic vesicle glycoprotein 2A expression was identified in neurons, activated astrocytes, microglia/macrophages, and T lymphocytes in the dorsal horn. Conclusion Synaptic vesicle glycoprotein 2A may represent a novel target for neuropathic pain. Brivaracetam may warrant study in humans with neuropathic pain due to peripheral nerve injury.
Fluoxetine for stroke recovery: Meta-analysis of randomized controlled trials
Authors: Mead Gillian E , Legg Lynn , Tilney Russel , Hsieh Cheng Fang , Wu Simiao , Lundström Erik , Rudberg Ann Sofie , Kutlubaev Mansur , Dennis Martin S , Soleimani Babak , Barugh Amanda , Hackett Maree L , Hankey Graeme J 
Published: October 2019

Objective To determine whether fluoxetine, at any dose, given within the first year after stroke to patients who did not have to have mood disorders at randomization reduced disability, dependency, neurological deficits and fatigue; improved motor function, mood, and cognition at the end of treatment and follow-up, with the same number or fewer adverse effects. Methods Searches (from 2012) in July 2018 included databases, trials registers, reference lists, and contact with experts. Co-primary outcomes were dependence and disability. Dichotomous data were synthesized using risk ratios (RR) and continuous data using standardized mean differences (SMD). Quality was appraised using Cochrane risk of bias methods. Sensitivity analyses explored influence of study quality. Results The searches identified 3414 references of which 499 full texts were assessed for eligibility. Six new completed RCTs (n = 3710) were eligible, and were added to the seven trials identified in a 2012 Cochrane review (total: 13 trials, n = 4145). There was no difference in the proportion independent (3 trials, n = 3249, 36.6% fluoxetine vs. 36.7% control; RR 1.00, 95% confidence interval 0.91 to 1.09, p = 0.99, I2 = 78%) nor in disability (7 trials n = 3404, SMD 0.05, −0.02 to 0.12 p = 0.15, I2 = 81%) at end of treatment. Fluoxetine was associated with better neurological scores and less depression. Among the four (n = 3283) high-quality RCTs, the only difference between groups was lower depression scores with fluoxetine. Conclusion This class I evidence demonstrates that fluoxetine does not reduce disability and dependency after stroke but improves depression.
Fresh Osteochondral Allograft Transplantation in the Knee: A Viability and Histologic Analysis for Optimizing Graft Viability and Expanding Existing Standard Processed Graft Resources Using a Living Donor Cartilage Program
Authors: Hevesi Mario , Denbeigh Janet M. , Paggi Carlo A. , Galeano-Garces Catalina , Bagheri Leila , Larson A. Noelle , Stuart Michael J. , Saris Daniel B. F. , van Wijnen Andre J. , Krych Aaron J. 
Published: October 2019

Objective This study aims to (1) determine and validate living cartilage allograft transplantation as a novel source for viable osteochondral allograft (OCA) tissues and (2) perform histologic and viability comparisons of living donor cartilage tissues to currently available clinical-grade standard processed grafts. Design Using healthy cartilage from well-preserved contralateral compartments in 27 patients undergoing total knee arthroplasty (TKA) and 10 clinical-grade OCA specimens obtained immediately following operative implantation, standard and living donor OCA quality was evaluated at the time of harvest and following up to 3 weeks of storage on the basis of macroscopic International Cartilage Repair Society grade, histology, and viability. Results Osteochondral samples demonstrated a consistent decrease in viability and histologic quality over the first 3 weeks of storage at 37°C, supporting the utility of an OCA paradigm shift toward early implantation, as was the clinical standard up until recent adoption of transplantation at 14 to 35 days following donor procurement. Samples from the 10 clinical-grade OCAs, implanted at an average of 23 days following graft harvest demonstrated a mean viable cell density of 45.6% at implantation, significantly lower ( P < 0.01) than the 93.6% viability observed in living donor allograft tissues. Conclusions Osteochondral tissue viability and histologic quality progressively decreases with ex vivo storage, even when kept at physiologic temperatures. Currently available clinical OCAs are stored for 2 to 5 weeks prior to implantation and demonstrate inferior viability to that of fresh osteochondral tissues that can be made available through the use of a living donor cartilage program.
A mHealth Support Program for Australian Young Adults with Type 1 Diabetes: A Mixed Methods Study
Authors: Ng Ashley H , Crowe Timothy C , Ball Kylie , Rasmussen Bodil 
Published: October 2019

Aims and Objectives Young adulthood is a life stage comprised of many turning points. For young adults with type 1 diabetes (T1DM), diabetes self-management support is crucial during this period. There is a lack of diabetes education programs and services tailored to this population. This paper presents the findings, according to the STROBE guidelines, on the usability and acceptability of a patient-informed mHealth support program (Diabetes YES) that was developed for young adults with T1DM. Methods A total of 34 young adults aged 18–35 years with T1DM participated in the Diabetes YES program over 12 weeks. Google analytics was used to tracked website use, while a website usability survey measured ease of use. Facebook analytics was used to measure peer support engagement. Evaluation of the program was completed using Likert scales and open-ended questions. Results Participants rated the website favourably for its ease of navigation and easy to understand information. Web page visits declined sharply while peer support group engagement through Facebook remained consistent throughout the intervention period. Participants utilised weekly discussion topics to generate conversation within the peer support group. Emotional support from peers was the highest regarded benefit reported by participants. Conclusions Diabetes YES is an example of an mHealth support program that was readily accepted by young adults living with T1DM. Feasibility studies are an important formative step in the implementation of mHealth programs within mainstream healthcare. Future work should focus on the adaptability of such programs to fit within larger consumer or healthcare organisations.
Investigation of dielectric elastomer human energy harvesting to reduce knee joint torque deviation due to bracing
Authors: Lai Heather , Reid Kristina 
Published: October 2019

Introduction The use of a smart electromechanical material, dielectric elastomer, is investigated for the development of an active bracing technique, which modifies the stiffness and damping of the knee brace during energy harvesting so as to reduce knee joint torque deviation during late swing in braced walking. Methods The bracing technique considered involves a dielectric elastomer energy harvesting cycle, which activates only when the knee flexor muscles are contracting eccentrically during late swing. The brace reduces the leg extension deviation during late swing in braced walking by transforming a portion of the mechanical stored energy into electrical energy, reducing the required internal work performed within the body. Results Simulated behavior of the dielectric elastomer brace worn across the knee joint demonstrates that when properly activated, the dielectric elastomer brace’s reduction in stiffness and increase in damping minimize the added energy expenditure of knee joint bracing during late swing. Conclusions The modeling results demonstrate the effective application of a soft, circumferential, dielectric elastomer energy harvesting knee brace, which utilizes the changes in the dynamic behavior of the knee joint occurring during energy harvesting in order to reduce the added demand placed on the knee joint under braced conditions.
Goal-Based Shared Decision-Making: Developing an Integrated Model
Authors: Elwyn Glyn , Vermunt Neeltje Petronella Catharina Anna 
Published: October 2019

Objective: Definitions of shared decision-making (SDM) have largely neglected to consider goal setting as an explicit component. Applying SDM to people with multiple long-term conditions requires attention to goal setting. We propose an integrated model, which shows how goal setting, at 3 levels, can be integrated into the 3-talk SDM model. Method: The model was developed by integrating 2 published models. Results: An integrated, goal-based SDM model is proposed and applied to a patient with multiple, complex, long-term clinical conditions to illustrate the use of a visualization tool called a Goal Board. A Goal Board prioritizes collaborative goals and aligns goals with interventional options. Conclusion: The model provides an approach to achieve person-centered decision-making by not only eliciting and prioritizing goals but also by aligning prioritized goals and interventions. Practice Implications: Further research is required to evaluate the utility of the proposed model.