bluuebunny/crossref_metadata_2025_split huggingface dataset:
Latent Classes of Substance Use Among American Indian and White Students Living on or Near Reservations, 2009-2013
Authors: Stanley Linda R. , Swaim Randall C. 
Published: May 2018

Objectives: American Indian adolescents who reside on or near reservations report higher levels of substance use than adolescents in other racial/ethnic groups. Little research has addressed patterns of use, which have important implications for prevention and treatment planning. The objective of our study was to describe substance use among a large, population-based sample of American Indian and white students who lived on or near reservations. Methods: We obtained data from 4964 students in grades 7-12 attending 46 schools on or near reservations throughout the United States during 4 academic years (2009-2013). Measures assessed current substance use for alcohol, heavy drinking, marijuana, cigarettes, inhalants, and other drugs. We used latent class analysis to identify patterns of substance use by grade group (grades 7-8 and grades 9-12) and race (American Indian or white). Results: For American Indians in both grade groups, we found 4 classes of substance use (in order of size): (1) nonusers; (2) marijuana and cigarette users; (3) alcohol, marijuana, and cigarette users; and (4) polysubstance users. For white students, we found 2 classes (nonusers and polysubstance users) among younger students and 4 classes (nonusers; alcohol, marijuana, and cigarette users; alcohol and cigarette users; and polysubstance users) among older students. Conclusion: We found significant differences in substance use patterns, especially at younger ages, between reservation American Indian students and white students attending the same schools. Combinations of substances used by American Indian adolescents were most likely to include marijuana, as compared with alcohol for white adolescents. Identifying subpopulations of users allows the design of interventions that will more efficiently and effectively address prevention and treatment needs of groups of individuals than would a one-size-fits-all approach.
Dietary habits and physical activity: Results from cluster analysis and market basket analysis
Authors: Liew Hui-Peng 
Published: May 2018

Background: The prevalence of obesity remains a major public health concern and there has been a significant increase in childhood obesity in the USA. Aim: This study seeks to uncover the major patterns of dietary habits in relation to physical activity, together with students’ opinions about the quality of food in the school’s cafeteria and vending machines. Methods: The empirical work of this study is based on the 2011 Healthy School Program (HSP) Evaluation. HSP assesses the demographic characteristics as well as the dietary habits and exercise patterns of a representative sample of elementary, middle, and high school students in the USA. Results: Findings suggest that students assigned to different clusters have different eating habits, exercise patterns, weight status, weight management, and opinions about the quality of food in the school’s cafeteria and vending machines. There is great variation in dietary profiles and lifestyle behaviors among students who identified themselves as either overweight or unsure about their weight status. Conclusions: Findings from this study may inform future interventions regarding how to promote student’s healthy food choices when they are still in school. Health promotion initiatives should specifically target students with persistently unhealthier dietary profiles.
Can unenhanced MRI of the breast replace contrast-enhanced MRI in assessing response to neoadjuvant chemotherapy?
Authors: Cavallo Marincola Beatrice , Telesca Marianna , Zaccagna Fulvio , Riemer Frank , Anzidei Michele , Catalano Carlo , Pediconi Federica 
Published: May 2018

Background The goals of neoadjuvant chemotherapy (NAC) are to reduce tumor volume and to offer a prognostic indicator in assessing treatment response. Contrast-enhanced magnetic resonance imaging (CE-MRI) is an established method for evaluating response to NAC in patients with breast cancer. Purpose To validate the role of unenhanced MRI (ue-MRI) compared to CE-MRI for assessing response to NAC in women with breast cancer. Material and Methods Seventy-one patients with ongoing NAC for breast cancer underwent MRI before, during, and at the end of NAC. Ue-MRI was performed with T2-weighted sequences with iterative decomposition of water and fat and diffusion-weighted sequences. CE-MRI was performed using three-dimensional T1-weighted sequences before and after administration of gadobenate dimeglumine. Two blinded observers rated ue-MRI and CE-MRI for the evaluation of tumor response. Statistical analysis was performed to compare lesion size and ADC values changes during therapy, as well as inter-observer agreement. Results There were no statistically significant differences between ue-MRI and CE-MRI sequences for evaluation of lesion size at baseline and after every cycle of treatment ( P > 0.05). The mean tumor ADC values at baseline and across the cycles of NAC were significantly different for the responder group. Conclusion Ue-MRI can achieve similar results to CE-MRI for the assessment of tumor response to NAC. ADC values can differentiate responders from non-responders.
Benign and malignant skull-involved lesions: discriminative value of conventional CT and MRI combined with diffusion-weighted MRI
Authors: Tu Zhanhai , Xiao Zebin , Zheng Yingyan , Huang Hongjie , Yang Libin , Cao Dairong 
Published: May 2018

Background Little is known about the value of computed tomography (CT) and magnetic resonance imaging (MRI) combined with diffusion-weighted imaging (DWI) in distinguishing malignant from benign skull-involved lesions. Purpose To evaluate the discriminative value of DWI combined with conventional CT and MRI for differentiating between benign and malignant skull-involved lesions. Material and Methods CT and MRI findings of 58 patients with pathologically proven skull-involved lesions (43 benign and 15 malignant) were retrospectively reviewed. Conventional CT and MRI characteristics and apparent diffusion coefficient (ADC) value of the two groups were evaluated and compared. Multivariate logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess the differential performance of each parameter separately and together. Results The presence of cortical defects or break-through and ill-defined margins were associated with malignant skull-involved lesions (both P < 0.05). Malignant skull-involved lesions demonstrated a significantly lower ADC ( P = 0.016) than benign lesions. ROC curve analyses indicated that a combination of CT, MRI, and DWI with an ADC ≤ 0.703 × 10–3 mm2/s showed optimal sensitivity, while DWI along showed optimal specificity of 88.4% in differentiating between benign and malignant skull-involved lesions. Conclusion The combination of CT, MRI, and DWI can help to differentiate malignant from benign skull-involved lesions. CT + MRI + DWI offers optimal sensitivity, while DWI offers optimal specificity.
Challenges and strategies among women and men with Parkinson’s disease: Striving toward joie de vivre in daily life
Authors: Sperens Maria , Hamberg Katarina , Hariz Gun-Marie 
Published: May 2018

Introduction To offer people with Parkinson’s disease optimal occupational therapy, it is important to have a detailed understanding of how they manage everyday life. The aims of this study were to explore how people with Parkinson’s disease manage the effect of the disease on everyday life and to investigate gender similarities and differences concerning this issue. Method We interviewed 24 people with Parkinson’s disease (14 men), at a mean of 8 years after diagnosis. The interviews were analysed according to Grounded Theory. Findings ‘Striving to maintain a good everyday life’ was established as a core category. To overcome obstacles caused by the disease, the interviewees struggled with perpetual adaptation to the medication regime and ongoing changes in their abilities. To achieve best possible everyday life, it was essential to keep their own spirit up; for example, by prioritising valued occupations. Women and men contributed to all categories and used the same strategies. Conclusion Men and women with Parkinson’s disease used the same strategies to manage daily life challenges. Our findings support the relevance of disease-specific occupational therapy interventions focusing on the individual fit between person, environment and occupation, and highlight the need for joyful occupations to attain a satisfactory daily life.
A survey of local authorities and Home Improvement Agencies: Identifying the hidden costs of providing a home adaptations service
Authors: Curtis Lesley , Beecham Jennifer 
Published: May 2018

Introduction The Royal College of Occupational Therapists has launched a campaign to demonstrate that occupational therapists improve lives and save money for health and social care services. Occupational therapists play a major part in supporting older and disabled people to remain in their own homes through the provision of home adaptations. Among other benefits, studies have shown that home adaptations can reduce falls in the home and could therefore help reduce hospital admissions. However, to evidence savings, information on the full costs of supplying and fitting home adaptations are needed. Method Local authorities and Home Improvement Agencies were surveyed in 2014–2015 to obtain the information required to estimate these costs. Time inputs for staff involved in their provision have been collected and staff costs and total costs calculated for 18 commonly fitted adaptations. The process of obtaining publicly funded home adaptations is also discussed. Findings For major adaptations, the total mean cost was £16,647, ranging from £2474 to £36,681. Staffing costs absorbed up to 24% of the total mean cost. The total mean cost for minor adaptations was £451, with average staffing costs forming 76%. Conclusion Staff costs are an important consideration when estimating the costs of providing home adaptations.
Biomechanical Comparison of Anatomic and Extra-Anatomic Reconstruction Techniques Using Local Grafts for Chronic Instability of the Acromioclavicular Joint
Authors: Le Hanneur Malo , Thoreson Andrew , Delgrande Damien , Lafosse Thibault , Werthel Jean-David , Hardy Philippe , Elhassan Bassem 
Published: May 2018

Background: Anatomic reconstruction techniques are increasingly used to address cases of acromioclavicular (AC) joint chronic instability. These usually involve an additional surgical site for autograft harvesting or an allograft. Purpose: To describe a triple-bundle (TB) anatomic reconstruction using on-site autografts, the semiconjoint tendon (SCT) and the coracoacromial ligament (CAL), and compare its primary stability to the native AC joint ligamentous complex and to a modified Weaver-Dunn (WD) reconstruction. Study Design: Controlled laboratory study. Methods: Intact AC joints of 12 paired cadaveric shoulders were tested for anterior, posterior, and superior translations under cyclic loading with a servo-hydraulic testing system. One shoulder from each pair was randomly assigned to the TB group, where 2 SCT strips were used to reconstruct the coracoclavicular ligaments while the distal end of the CAL was transferred to the distal extremity of the clavicle to reconstruct the AC ligaments; the other shoulder received a modified WD reconstruction. After reconstruction, the same translational testing was performed, with an additional load-to-failure test in the superior direction. Results: In both the TB and the WD groups, no significant differences were found before and after reconstruction in terms of joint displacements after cyclic loading, in all 3 directions. Compared with the WD reconstruction, the TB repair resulted in significantly lower displacements in both the anterior (ie, 2.59 ± 1.08 mm, P = .011) and posterior (ie, 10.17 ± 6.24 mm, P = .014) directions, but not in the superior direction. No significant differences were observed between the 2 reconstructions during the load-to-failure testing, except for the displacement to failure, which was significantly smaller (ie, 5.34 ± 2.97 mm) in the WD group ( P = .037). Conclusion: Anterior, posterior, and superior displacements after an anatomic reconstruction of the AC joint complex using the SCT and CAL as graft material were similar to those of native AC joints and significantly smaller in the axial plane than those of AC joints after a WD repair. Clinical Relevance: An anatomic reconstruction is achievable using the CAL and the SCT as on-site graft materials, providing satisfactory initial stability and thereby allowing earlier mobilization.
Demographics and study practices of psychiatry trainees sitting the RANZCP written examinations
Authors: Khanna Rahul , Matta Gabrielle , Visa Bharat , Ryan Anna 
Published: May 2018

Objectives: This study explored trainee preparation for the Royal Australian and New Zealand College of Psychiatrists (RANZCP) written examinations. We examined the relationship between candidates’ prior psychiatry experience, preparation techniques and expenses, perceptions of the exam and a pass result. We also examined perceptions of well-being. Method: A web-based survey was sent to RANZCP trainees. The association between responses and exam outcome was analysed using SPSS Statistics 23. Results: A total of 23% ( n = 38) of the cohort responded to the survey. Respondents studied for an average of 7.8 months for the essay-style exam and 4.4 months for the multiple-choice questions. The mean months of total psychiatry experience prior to sitting was 36.1 months. Every additional 50 hours of study increased odds of passing by 23%. Respondents who believed that exam preparation would affect outcome had an almost 4-fold higher odds of passing than those who did not. Ratings of well-being before release of results were also positively associated with passing. Conclusions Trainees are sitting the written exams with clinical experience commensurate with RANZCP recommendations. Total study hours and favourable perceptions of exam processes appear to be predictors of success.
Management of a complex patient – intravenous olanzapine use
Authors: Goh Phey Yee , Huang Beatrice , Pehlivan Nancy 
Published: May 2018

Objective: This case report aims to highlight the challenges faced by mental health clinicians in managing complex medical and psychiatric presentation, with a particular interest in intravenous (IV) olanzapine use outside the emergency department (ED) and intensive care unit setting. Conclusion: There is no current prescribing guideline regarding the use of IV olanzapine for acute agitation associated with schizophrenia and bipolar disorder. Most of the literature available regarding the use of IV olanzapine has originated from studies performed in the ED setting, with the majority of studies reporting a favourable efficacy and safety profile for IV olanzapine. Further research on the utilization of IV olanzapine in the general medical ward is required. Until more data is available, use of IV olanzapine in the acute arousal setting on a general medical ward remains off-label.
Bone remodelling of the proximal femur after total hip arthroplasty with 2 different hip implant designs: 15 years follow-up of the thrust plate prosthesis and the Bi-Metric stem
Authors: Christiansen Janus D , Laursen Mogens B , Ejaz Ashir , Nielsen Poul T 
Published: May 2018

Introduction: The thrust plate prosthesis (TPP) was introduced to preserve bone in patients undergoing total hip arthroplasty. We assessed the long-term results of hip arthroplasty in patients who received the TPP compared to a traditional intramedullary stem (Bi-Metric). Methods: In this prospective observational cohort study, we evaluated bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), radiological imaging and clinical outcome using Harris Hip Score (HHS). Twenty patients received the TPP (group A) and 18 patients received the Bi-Metric stem (group B). Baseline was the 1st postoperative day, and subsequent follow-up was performed at 6 months, 1, 2, 8, 12 and 15 years after surgery. A four regions of interest (ROI) protocol was developed to assess BMD. Results: In ROI1, bone resorption was significantly higher for group A at 6 months with a mean difference of 10% (95% confidence interval [CI], 4–16; p = 0.003) and 8% (95% CI, 1–15; p = 0.03) at 8 years. Regarding ROI4, group A had a lesser decrease in general compared to group B. The radiological findings did not reveal any subsidence or detectable implant migration. HHS improved from 53 (23–69) to 93 (55–100) in group A and from 51 (24–72) to 94 (78–100) in group B. Conclusion: The TPP was not found to be inferior to the Bi-Metric stem regarding bone preservation. The decrease in BMD in ROI4 was greater in group B. Clinical and radiological results also revealed that the TPP was not inferior to the Bi-Metric stem.
Long-term impact of a six-month telemedical care programme on mortality, heart failure readmissions and healthcare costs in patients with chronic heart failure
Authors: Frederix Ines , Vanderlinden Lien , Verboven Anne-Sophie , Welten Maria , Wouters Donna , De Keulenaer Gilles , Ector Bavo , Elegeert Ivan , Troisfontaines Pierre , Weytjens Caroline , Mullens Wilfried , Dendale Paul 
Published: May 2018

Aims The TElemonitoring in the MAnagement of Heart Failure (TEMA-HF) 1 long-term follow-up study assessed whether an initial six-month telemonitoring (TM) programme compared with usual care (UC) would result in reduced all-cause mortality, heart failure admissions and healthcare costs in chronic heart failure (CHF) patients at long-term follow-up. Methods Of the 160 patients included in the multi-centre, randomised controlled telemonitoring trial (TEMA-HF 1, time point t0); 142 CHF patients (65% male; age: 76 ± 10 years; EF: 36 ± 15%) were alive and entered the follow-up study (time point: t1) with a final evaluation at 79 months (time point: t2). Both TM and UC group patients received standard heart failure care during the follow-up study (time points: t1 – t2). The primary endpoint was all-cause mortality. Secondary outcomes included days lost due to heart failure readmissions and readmission/patient follow-up related healthcare costs. Results Compared with usual care, the initial six-month TM programme had no significant effect on all-cause mortality (hazard ratio: 0.83; 95% confidence interval, 0.57 to 1.20; p = 0.32). The number of days lost due to heart failure readmissions was significantly lower in the TM group ( p = 0.04). Healthcare costs did not differ significantly between the TM (€ 9140 ± 10580) and UC group (€ 12495 ± 22433) ( p = 0.87). Discussion An initial six-month telemonitoring programme was not associated with reduced all-cause mortality in CHF patients at long-term follow-up but resulted in a reduction in the number of days lost due to heart failure readmissions. This study is registered in the ClinicalTrials.gov registry (NCT03171038) (URL: https://clinicaltrials.gov/ct2/show/NCT03171038 ).
Ultra-protective mechanical ventilation without extra-corporeal carbon dioxide removal for acute respiratory distress syndrome
Authors: Regunath Hariharan , Moulton Nathanial , Woolery Daniel , Alnijoumi Mohammed , Whitacre Troy , Collins Jonathan 
Published: May 2018

Background Tidal hyperinflation can still occur with mechanical ventilation using low tidal volume (LVT) (6 mL/kg predicted body weight (PBW)) in acute respiratory distress syndrome (ARDS), despite a well-demonstrated reduction in mortality. Methods Retrospective chart review from August 2012 to October 2014. Inclusion: Age >18years, PaO2/FiO2<200 with bilateral pulmonary infiltrates, absent heart failure, and ultra-protective mechanical ventilation (UPMV) defined as tidal volume (VT) <6 mL/kg PBW. Exclusion: UPMV use for <24 h. Demographics, admission Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, arterial blood gas, serum bicarbonate, ventilator parameters for pre-, during, and post-UPMV periods including modes, VT, peak inspiratory pressure (PIP), plateau pressure (Pplat), driving pressure, etc. were gathered. We compared lab and ventilator data for pre-, during, and post-UPMV periods. Results Fifteen patients (male:female = 7:8, age 42.13 ± 11.29 years) satisfied criteria, APACHEII 20.6 ± 7.1, mean days in intensive care unit and hospitalization were 18.5 ± 8.85 and 20.81 ± 9.78 days, 9 (60%) received paralysis and 7 (46.67%) required inotropes. Eleven patients had echocardiogram, 7 (63.64%) demonstrated right ventricular volume or pressure overload. Eleven patients (73.33%) survived. During-UPMV, VT ranged 2–5 mL/kg PBW(3.99 ± 0.73), the arterial partial pressure of carbon dioxide (PaCO2) was higher than pre-UPMV values (84.81 ± 18.95 cmH2O vs. 69.16 ± 33.09 cmH2O), but pH was comparable and none received extracorporeal carbon dioxide removal (ECCO2-R). The positive end-expiratory pressure (14.18 ± 7.56 vs. 12.31 ± 6.84 cmH2O), PIP (38.21 ± 12.89 vs. 32.59 ± 9.88), and mean airway pressures (19.98 ± 7.61 vs. 17.48 ± 6.7 cm H2O) were higher during UPMV, but Pplat and PaO2/FiO2 were comparable during- and pre-UPMV. Driving pressure was observed to be higher in those who died than who survived (24.18 ± 12.36 vs. 13.42 ± 3.25). Conclusion UPMV alone may be a safe alternative option for ARDS patients in centers without ECCO2-R.
Association between progestin-only contraceptive use and cardiometabolic outcomes: A systematic review and meta-analysis
Authors: Glisic Marija , Shahzad Sara , Tsoli Stergiani , Chadni Mahmuda , Asllanaj Eralda , Rojas Lyda Z , Brown Elizabeth , Chowdhury Rajiv , Muka Taulant , Franco Oscar H 
Published: May 2018

Aims The association between progestin-only contraceptive (POC) use and the risk of various cardiometabolic outcomes has rarely been studied. We performed a systematic review and meta-analysis to determine the impact of POC use on cardiometabolic outcomes including venous thromboembolism, myocardial infarction, stroke, hypertension and diabetes. Methods and results Nineteen observational studies (seven cohort and 12 case–control) were included in this systematic review. Of those, nine studies reported the risk of venous thromboembolism, six reported the risk of myocardial infarction, six reported the risk of stroke, three reported the risk of hypertension and two studies reported the risk of developing diabetes with POC use. The pooled adjusted relative risks (RRs) for venous thromboembolism, myocardial infarction and stroke for oral POC users versus non-users based on the random effects model were 1.06 (95% confidence interval (CI) 0.70–1.62), 0.98 (95% CI 0.66–1.47) and 1.02 (95% CI 0.72–1.44), respectively. Stratified analysis by route of administration showed that injectable POC with a RR of 2.62 (95% CI 1.74–3.94), but not oral POCs (RR 1.06, 95% CI 0.7–1.62), was associated with an increased risk of venous thromboembolism. A decreased risk of venous thromboembolism in a subgroup of women using an intrauterine levonorgestrel device was observed with a RR of 0.53 (95% CI 0.32–0.89). No effect of POC use on blood pressure was found, but there was an indication for an increased risk of diabetes with injectable POCs, albeit non-significant. Conclusions This systematic review and meta-analysis suggests that oral POC use is not associated with an increased risk of developing various cardiometabolic outcomes, whereas injectable POC use might increase the risk of venous thromboembolism.