bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial navigation ability and gaze switching in older drivers: A driving simulator study
Authors: Kunishige Masafumi , Fukuda Hiroshi , Iida Tadayuki , Kawabata Nami , Ishizuki Chinami , MIyaguchi Hideki 
Published: February 2019

Objective Driving ability in older people is affected by declining motor, cognitive and visual functions. We compared perceptual and cognitive skills and driving behaviour in a Japanese population. Methods We used a driving simulator to measure the effects of spatial navigation skills and eye movements on driving ability. Participants were 34 older and 20 young adults who completed a simulated driving task involving a lane change and a right turn at an intersection. We used an eye tracker to measure gaze. We measured visual recognition (Benton Judgment of Line Orientation Test (BJLO)), spatial navigation (Card-Placing Test (CPT A & B)), visual perception (Raven’s Colored Progressive Matrices (RCPM)) and driving ability (Stroke Drivers’ Screening Assessment). Results Older participants scored significantly lower on the BJLO, CPT-A & B and RCPM, showed a significant correlation between gaze time and CPT-A & B scores (both p < .01) and had a longer gaze time. There were significant between-group differences in saccade switching (p < .01 right turn), distance per saccade (p < .05 for right turn and lane change) and saccade total distance (p < .05 right turn; p < .01 lane change). There was an association between age and rate of gaze at the right door mirror (p = 0.04). Conclusion The findings indicate that older drivers have poorer eye movement control and spatial navigation. This is likely to result in delayed responses and difficulties in predicting the on-coming driving environment. Driving simulation could help older drivers in their driving abilities.
Validation and iteration of CT perfusion defined malignant profile thresholds for acute ischemic stroke
Authors: Keenan Kevin J , Christensen Soren , Inoue Manabu , Mlynash Michael , Albers Gregory W , Smith Wade S 
Published: February 2019

Background Malignant profile computed tomography perfusion (CTP) lesions are associated with poor outcomes after administration of intravenous tissue-plasminogen activator (IV-tPA) for ischemic stroke. Aims To determine whether published CTP-based lesion thresholds predictive of poor outcomes in a predominantly 8 cm of CTP anatomic coverage cohort would predict poor outcomes in an independent 4 cm of CTP anatomic coverage cohort and to generate optimized 4 cm CTP thresholds. Methods Ischemic stroke patients with baseline CTP imaging with 4 cm of anatomic coverage before receiving IV-tPA at a single institution were retrospectively studied. Perfusion lesion time to maximum of tissue residue function (Tmax) and cerebral blood flow (CBF) volumes were determined using RAPID automated software. Fisher's exact tests assessed associations between lesion thresholds and outcomes. Receiver operating characteristic (ROC) curves generated optimized thresholds for 4 cm of CTP coverage. Results Sixty-three patients were included. Poor outcomes were associated with published thresholds of Tmax >6 s > 103 mL, Tmax > 8 s > 86 mL, and Tmax > 10 s > 78 mL but not CBF core >53 mL. Thresholds optimized for 4 cm of CTP coverage and associated with poor outcomes were Tmax > 6 s > 100 mL, Tmax > 8 s > 65 mL, Tmax >10 s > 46 mL, and CBF core >39 mL. Conclusions We validated the ability of published CTP Tmax lesion volume thresholds to predict poor outcomes despite IV-tPA in an independent cohort using only 4 cm of CTP anatomical coverage. A CBF > 39 mL threshold, rather than the predominantly 8 cm CTP coverage derived CBF threshold of >53 mL, was associated with poor outcomes in this 4 cm CTP coverage cohort.
Recrudescence of Old Stroke Deficits Among Transient Neurological Attacks
Authors: Jun-O’connell Adalia H. , Henninger Nils , Moonis Majaz , Silver Brian , Ionete Carolina , Goddeau Richard P. 
Published: February 2019

Background: Recrudescence of old stroke deficits (ROSD) is a reported cause of transient neurological symptoms, but it is not well characterized. Objective: We sought to determine the prevalence, potential triggers, and clinical outcome of ROSD in a cohort of patients presenting with acute transient neurological attack (TNA) and absent acute pathology on brain imaging. Methods: We retrospectively analyzed 340 consecutive patients who presented with TNA and no acute pathology on brain imaging that were included in an institutional stroke registry between February 2013 and April 2015. The presumed TNA cause was categorized as transient ischemic attack (TIA), ROSD, and other cause. Baseline characteristics, triggers, cardiovascular complications within 90 days, and death were recorded. Results: The prevalence of ROSD in the studied cohort was 10% (34/340). Infectious stressors and acute metabolite derangements were more common in ROSD compared to TIA ( P < .05, each). Compared to TIA and the other TNA, ROSD was more likely to have more than 1 acute stressor ( P < .001). Patients with ROSD had similar vascular risk factors compared to TIA ( P > .05), including hypertension, diabetes mellitus, peripheral vascular disease, hyperlipidemia, and similarly used HMG-CoA reductase inhibitor, antihypertensive, and antiplatelet medications. Among the patients with an available 90-day follow-up (n = 233), cardiovascular events were more frequent in the TIA group as compared to other TNA ( P < .05). Conclusion: ROSD is common and distinct from TIA and is associated with a triggering physiologic reaction leading to transient reemergence of prior neurologic deficits. Further study of the mechanism of this phenomenon is needed to help better identify these patients.
Rates and Trends of Endotracheal Intubation in Patients With Status Epilepticus
Authors: Alkhachroum Ayham M. , Rubinos Clio , Chatterjee Abhinaba , Chen Monica L. , Martin Andrew , Claassen Jan , Murthy Santosh B. , Merkler Alexander E. 
Published: February 2019

Objective: Among patients with status epilepticus, we sought to determine the rate of endotracheal intubation, identify the physician specialties responsible for endotracheal intubation, and characterize the trend in use of endotracheal intubation over the last 20 years. Methods: We performed a cross-sectional study using data from 2 sources. First, we used inpatient claims between 2009 and 2015 from a nationally representative 5% sample of Medicare beneficiaries. Patients with status epilepticus were identified using International Classification of Diseases, 9th Revision, Clinical Modification ( ICD-9-CM) codes, and those who underwent endotracheal intubation were identified based on Current Procedural Terminology codes. Medical specialties of providers performing intubation were identified based on Healthcare Provider Taxonomy Codes. Second, we used claims data from the National Inpatient Sample (NIS) to estimate the annual rates and trends of endotracheal intubation and tracheostomy among patients with status epilepticus from 1995 to 2014. Results: Among 1971 Medicare beneficiaries with status epilepticus, 566 (29%) patients underwent endotracheal intubation. 375 (66%) patients were intubated on admission. The most common medical providers performing intubation in patients with status epilepticus were emergency medicine physicians (50.4%), anesthesiologists (16.4%), and pulmonary medicine physicians (10.1%). Neurologists accounted for 1.7% of all intubations. Among individuals with status epilepticus identified in the NIS, 248 681 (41.7%) were intubated. The proportion of patients intubated increased from 29.5% (95% confidence interval [CI]: 27.8%-31.3%, P = .018) in 1995 to 50.8% (95% CI: 49.6%-52%, P = .012) in 2014. The proportion of patients with status epilepticus who underwent tracheostomy increased from 2.2% (95% CI: 1.7%-2.7%, P = .005) in 1995 to 3.4% (95% CI: 3%-3.9%, P = .004) in 2014. Significance: Approximately 1 in 3 patients with status epilepticus undergo endotracheal intubation. Over the last 20 years, the proportion of patients with status epilepticus undergoing endotracheal intubation has almost doubled. Neurologists perform a small percentage of these intubations.
Body fat estimates from bioelectrical impedance equations in cardiovascular risk assessment: The PREVEND cohort study
Authors: Byambasukh Oyuntugs , Eisenga Michele F , Gansevoort Ron T , Bakker Stephan JL , Corpeleijn Eva 
Published: February 2019

AbstractAimsTo investigate prospectively the association of body fat percentage (BF%) estimates using various equations from bioelectrical impedance analysis (BIA) with cardiovascular events, compared with body mass index (BMI) and waist circumference.Methods and resultsWe used data of 34 BIA-BF%-equations that were used for estimation of BF% in 6486 (men = 3194, women = 3294) subjects. During a median follow-up of 8.3 years, 510 (7.9%) cardiovascular events (363 in men; 147 in women) occurred. In men, the crude hazard ratio (95% confidence interval) for BF% from the best predicting BIA-BF%-equation was 3.97 (3.30–4.78) against 2.13 (1.85–2.45) for BF% from the BIA device's BIA-BF%-equation, 1.34 (1.20–1.49) for BMI and 1.49 (1.40–1.73) for waist circumference per log-1-SD increase of all. In women, the hazard ratios for best predicting BIA-BF%-equation, BIA device estimation, BMI and waist circumference were 3.80 (2.85–4.99), 1.89 (1.57–2.28), 1.35 (1.21–1.51) and 1.52 (1.31–1.75), respectively. After adjustments for age, Framingham cardiovascular disease risk score and creatinine excretion – a marker of muscle mass – BF%s and BMI remained independently associated with cardiovascular events in both men and women, while waist circumference was independently associated with cardiovascular events in men, but not in women. According to discrimination ability (C-index) and additive predictive value (net reclassification index and integrated discrimination index) on obesity measures to the Framingham cardiovascular disease risk score, BF% was superior to BMI and waist circumference in both men and women.ConclusionsBF% was independently associated with future cardiovascular events. Body fat estimates from the best-predicting BIA-BF%-equations can be a more predictive measurement in cardiovascular risk assessment than BMI or waist circumference.
Five-Strand Hamstring Autografts for Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Smith John-Rudolph H. , Houck Darby A. , Hart Jessica A. , Vidal Armando F. , Frank Rachel M. , Bravman Jonathan T. , McCarty Eric C. 
Published: February 2019

Background: Recent studies have described surgical techniques to increase the hamstring graft diameter for anterior cruciate ligament reconstruction (ACLR), particularly for 5-strand hamstring (5HS) autografts. Purpose: To review the literature examining the biomechanical and clinical outcomes of 5HS autografts for ACLR. Study Design: Systematic review; Level of evidence, 3. Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic Meta-Analyses) guidelines was performed by searching PubMed, Embase, and the Cochrane Library for studies reporting the biomechanical and clinical outcomes of 5HS autografts. All English-language literature published from 2012 to 2018 that reported the biomechanical properties of 5HS grafts and/or clinical outcomes after ACLR with 5HS autografts with a minimum 1-year follow-up was reviewed by 2 independent reviewers. Graft diameter, stiffness, displacement, strength, failure rates, anteroposterior knee laxity, and patient-reported outcome scores were collected. The study methodology was evaluated using the modified Coleman Methodology Score. Results: Two biomechanical and 3 clinical studies (1 with level 2 evidence, 2 with level 3 evidence) were included. The biomechanical studies compared the results of fourteen 4-strand hamstring (4HS) and fourteen 5HS graft specimens for ACLR (ovine grafts, n = 12; cadaveric grafts, n = 16) and found no significant differences in ultimate load, stiffness, displacement, and stress relaxation ( P > .05), likely attributed to insufficient incorporation of the fifth strand. The mean 5HS cadaveric graft diameter (8.2 mm) was significantly greater than that of 4HS grafts (6.8 mm) ( P = .002), whereas the mean ovine graft diameters were not significantly different (4HS, 5.2 mm; 5HS, 5.3 mm) ( P > .05). Two clinical studies compared the outcomes after ACLR of 53 patients with a 4HS autograft versus 62 patients with a 5HS autograft, while 1 clinical study reported the outcomes of 25 patients after ACLR with a 5HS autograft (mean age, 28.7 years; mean follow-up, 24.8 months). The overall mean diameter for 4HS and 5HS autografts was 8.4 and 9.1 mm, respectively. There was no significant difference in failure rates between 4HS and 5HS autografts ( P = .82). None of the comparative studies reported significant differences in any clinical outcomes ( P > .05 for all). Conclusion: The available literature on traditional 4HS and 5HS autografts for ACLR is limited. Of the available data, clinical and biomechanical studies suggest no difference in outcomes after ACLR with either graft construct. Additional research is needed to determine whether creating a 5HS graft is beneficial.
Improving Emergency Department Patient Experience Through Implementation of an Informational Pamphlet
Authors: Sangal Rohit B , Orloski Clinton J , Shofer Frances S , Mills Angela M 
Published: February 2019

Objective: Patient satisfaction is emerging as a new health-care metric. We hypothesized that an emergency department (ED) informational pamphlet would significantly improve patient understanding of ED operations and ultimately improve patient satisfaction. Methods: We performed a prospective study of patients presenting to a single tertiary care center ED from April to July 2017. All patients were given a pamphlet on alternating weeks with regular care on opposite weeks and were surveyed upon ED discharge. The primary outcome was patient satisfaction with ED care. Secondary outcomes included patient understanding of various wait times (test results, consultants), discharge process, who was on the care team and what to expect during the ED visit. Results: Four hundred ninety-four patients were included in this study and 266 (54%) were in the control group. Of 228 (46%) patients who were given the pamphlet, 116 (51%) were unaware they received it. Of the remaining 112 (49%) patients who remembered receiving the pamphlet, 43 (38%) stated they read it. Among those reading the pamphlet, only two statements were significant: knowing what to expect during the ED visit (88% vs 71%; P = 0.012) and waiting time for test results (95% vs 75%; P = 0.003) when compared to those who did not receive or read the pamphlet. Conclusion: An ED informational pamphlet, when utilized by patients, does improve patient understanding of some aspects of the ED visit but does not appear to be the best tool to convey all information. Ultimately, sustained improvement in patient satisfaction is a complex and dynamic issue necessitating a multifactorial approach and other methods should be explored.
Calling on the Client’s Perceptions About the Contributions of Physiotherapists Working in Occupational Health Services
Authors: Chetty Laran 
Published: February 2019

Background: Clients are the recipients of occupational health care. To date, little is known about the perceptions of clients about the contribution of physiotherapists working in occupational health services. Gathering this information is imperative to understanding and responding to clients’ needs. Methods: An interpretative qualitative study was undertaken and face-to-face interviews were conducted with clients from 2 occupational health services situated within the National Health Service in the United Kingdom. Data were tape-recorded and transcribed verbatim in full. Data were analyzed using thematic analysis. Results: There were 9 clients interviewed, predominantly comprising secretaries, staff nurses, and care assistants. Thematic analysis revealed 2 main themes: vocational rehabilitation and health promotion. Clients revealed distinct subcomponents of the contribution of physiotherapists in occupational health services such as functional capacity evaluations, job demand analysis, and work-specific rehabilitation. Promoting staff health was another pertinent issue reported by clients. Conclusions: Clients clearly felt that physiotherapists made a contribution to occupational health services. This information lays the groundwork for the development of physiotherapists within occupational health services, which in turn will help clients achieve better care and health outcomes.
New arsenate minerals from the Arsenatnaya fumarole, Tolbachik volcano, Kamchatka, Russia. XI. Anatolyite, Na6(Ca,Na)(Mg,Fe3+)3Al(AsO4)6
Authors: Pekov Igor V. , Lykova Inna S. , Yapaskurt Vasiliy O. , Belakovskiy Dmitry I. , Turchkova Anna G. , Britvin Sergey N. , Sidorov Evgeny G. , Scheidl Katharina S. 
Published: February 2019

AbstractThe new mineral anatolyite Na6(Ca,Na)(Mg,Fe3+)3Al(AsO4)6 was found in the Arsenatnaya fumarole, Tolbachik volcano, Kamchatka, Russia. It is associated with potassic feldspar, hematite, tenorite, cassiterite, johillerite, tilasite, ericlaxmanite, lammerite, arsmirandite, sylvite, halite, aphthitalite, langbeinite, anhydrite, wulffite, krasheninnikovite, fluoborite, pseudobrookite and fluorophlogopite. Anatolyite occurs as aggregates (up to 2 mm across) of rhombohedral–prismatic, equant or slightly elongated along [001] crystals up to 0.2 mm. The mineral is transparent, pale brownish–pinkish, with vitreous lustre. It is brittle, cleavage was not observed and the fracture is uneven. The Mohs’ hardness is ca 4½. Dcalc is 3.872 g cm–3. Anatolyite is optically uniaxial (–), ω = 1.703(4) and ε = 1.675(3). Chemical composition (wt.%, electron microprobe) is: Na2O 16.55, K2O 0.43, CaO 2.49, MgO 5.80, MnO 0.16, CuO 0.69, ZnO 0.55, Al2O3 5.01, Fe2O3 7.94, TiO2 0.18, SnO2 0.17, SiO2 0.04, P2O5 0.55, As2O5 60.75, SO3 0.03, total 101.34. The empirical formula based on 24 O apfu is (Na5.90K0.10)Σ6.00(Ca0.50Na0.13Zn0.08Mn0.03)Σ0.74(Mg1.63Fe3+1.12Al0.15Cu0.10)Σ3.00(Al0.96Ti0.03Sn0.01)Σ1.00(As5.97P0.09Si0.01)Σ6.07O24. Anatolyite is trigonal, R$\bar{3}$c, a = 13.6574(10), c = 18.2349(17) Å, V = 2945.6(4) Å3 and Z = 6. The strongest reflections of the powder XRD pattern [d,Å(I)(hkl)] are: 7.21(33)(012), 4.539(16)(113), 4.347(27)(211), 3.421(20)(220), 3.196(31)(214), 2.981(17)(223), 2.827(100)(125) and 2.589(18)(410). The crystal structure was solved from single-crystal XRD data to R = 4.77%. The structure is based on a 3D heteropolyhedral framework formed by M4O18 clusters [M1 = Al and M2 = (Mg,Fe3+)] linked with AsO4 tetrahedra. (Ca,Na) and Na cations centre A1O6 and A2O8 polyhedra in voids of the framework. Anatolyite is isostructural with yurmarinite. The new mineral is named in honour of the outstanding Russian crystallographer, mineralogist and mathematician Anatoly Kapitonovich Boldyrev (1883–1946).
Sensitization of nociceptors by prostaglandin E2–glycerol contributes to hyperalgesia in mice with sickle cell disease
Authors: Khasabova Iryna A. , Uhelski Megan , Khasabov Sergey G. , Gupta Kalpna , Seybold Virginia S. , Simone Donald A. 
Published: February 2019

Abstract
Pain is a characteristic feature of sickle cell disease (SCD), 1 of the most common inherited diseases. Patients may experience acute painful crises as well as chronic pain. In the Berkley transgenic murine model of SCD, HbSS-BERK mice express only human hemoglobin S. These mice share many features of SCD patients, including persistent inflammation and hyperalgesia. Cyclooxygenase-2 (COX-2) is elevated in skin, dorsal root ganglia (DRG), and spinal cord in HbSS-BERK mice. In addition to arachidonic acid, COX-2 oxidizes the endocannabinoid 2-arachidonoylglycerol (2-AG) to produce prostaglandin E2 (PGE2)–glycerol (PGE2-G); PGE2-G is known to produce hyperalgesia. We tested the hypotheses that PGE2-G is increased in DRGs of HbSS-BERK mice and sensitizes nociceptors (sensory neurons that respond to noxious stimuli), and that blocking its synthesis would decrease hyperalgesia in HbSS-BERK mice. Systemic administration of R-flurbiprofen preferentially reduced production of PGE2-G over that of PGE2 in DRGs, decreased mechanical and thermal hyperalgesia, and decreased sensitization of nociceptors in HbSS-BERK mice. The same dose of R-flurbiprofen had no behavioral effect in HbAA-BERK mice (the transgenic control), but local injection of PGE2-G into the hind paw of HbAA-BERK mice produced sensitization of nociceptors and hyperalgesia. Coadministration of a P2Y6 receptor antagonist blocked the effect of PGE2-G, indicating that this receptor is a mediator of pain in SCD. The ability of R-flurbiprofen to block the synthesis of PGE2-G and to normalize levels of 2-AG suggests that R-flurbiprofen may be beneficial to treat pain in SCD, thereby reducing the use of opioids to relieve pain.
Gamification: focus on the strategies being implemented in interventions: a systematic review protocol
Authors: Lopes Sílvia , Pereira Armanda , Magalhães Paula , Oliveira André , Rosário Pedro 
Published: February 2019

Abstract
Objective
Gamification broadly refers to the use of game design elements in non-game contexts with the goal of promoting users’ engagement. Gamification strategies appear as an advantageous tool to increase the motivation and involvement of users. The purpose of this systematic review is to identify studies using gamification strategies in distinct intervention contexts and to describe their impact in each type of intervention. Thus, the focus is on the construct (gamification) rather than on a particular area or population.

Results
To achieve this goal, Scopus, IEEE, Web of Science, MEDLINE, ERIC, and PsycINFO databases will be used to gather data for the systematic review. Both the research and report of results will be based on Cochrane’s recommendations and PRISMA guidelines. Data, including the assessment on the quality of the articles, will be conducted by two members of the team independently. Findings will be reported narratively. The ethical approval is not required as the research does not involve data collection. Findings will be submitted to a peer-review journal and the results will be presented on international congresses. Future reviews could consider investigating particular areas of intervention in which gamification strategies are being employed.
Trial registration Systematic Review Registration: PROSPERO CRD42017070508
Attacking convolutional neural network using differential evolution
Authors: Su Jiawei , Vargas Danilo Vasconcellos , Sakurai Kouichi 
Published: February 2019

Abstract
The output of convolutional neural networks (CNNs) has been shown to be discontinuous which can make the CNN image classifier vulnerable to small well-tuned artificial perturbation. That is, images modified by conducting such alteration (i.e., adversarial perturbation) that make little difference to the human eyes can completely change the CNN classification results. In this paper, we propose a practical attack using differential evolution (DE) for generating effective adversarial perturbations. We comprehensively evaluate the effectiveness of different types of DEs for conducting the attack on different network structures. The proposed method only modifies five pixels (i.e., few-pixel attack), and it is a black-box attack which only requires the miracle feedback of the target CNN systems. The results show that under strict constraints which simultaneously control the number of pixels changed and overall perturbation strength, attacking can achieve 72.29%, 72.30%, and 61.28% non-targeted attack success rates, with 88.68%, 83.63%, and 73.07% confidence on average, on three common types of CNNs. The attack only requires modifying five pixels with 20.44, 14.28, and 22.98 pixel value distortion. Thus, we show that current deep neural networks are also vulnerable to such simpler black-box attacks even under very limited attack conditions.