bluuebunny/crossref_metadata_2025_split huggingface dataset:
A targeted assessment and intervention at the time of discharge reduced the risk of readmissions for short-term hospitalized older patients: a randomized controlled study
Authors: Lindhardt Tove , Loevgreen Susan Mai , Bang Brigitte , Bigum Catja , Klausen Tobias W 
Published: April 2019

Objective: The aim of this study was to test and compare the effect of (1) a systematic discharge assessment with targeted advice and (2) a motivational interview followed by a home visit. Design: This was a three-armed randomized controlled study. Setting: This study was conducted in the Medical department in a university hospital. Subjects: Patients ⩾65 years of age with health problems at discharge participated in the study. Interventions: Group A ( n = 117): patients were informed of health problems and self-care interventions; Group B ( n = 116): a motivational conversation targeting activities of daily living with a home care nurse and a home visit. Main measures: The main measures of this study were readmissions, handgrip strength, chair-to-stand test, health-related quality of life, depression signs, mortality, and call on municipality services. Results: Risk of readmission was reduced for intervention groups by 30% (A; P = 0.26) and 22 % (B; P = 0.46). Mean number of days to first readmission was 49.5 (±51.0) days for the control group ( n = 116) and 57.9 (±53.6) and 67.2 (±58.1) days for the intervention groups A ( P  = 0.43) and B ( P  = 0.10), respectively. Mean loss of handgrip strength was 10.6 (±16.6) kg for men in the control group and 7 (±19.2) and 1.4 (±17.1) kg for the intervention groups A ( P  = 0.38) and B ( P  = 0.01), respectively. Health-related quality of life improved with 0.3 (±23.7) points in the control group and 7.4 (±24.4) and 3.2 (±22.3) points in the intervention groups A ( P = 0.04) and B ( P  = 0.37), respectively. In total, 17 (16.3%) in the control group were provided with assistive devices after three months and 8 (7.3%) and 19 (17.6%) in the intervention groups A ( P = 0.04) and B ( P  = 0.81), respectively. Conclusion: The interventions reduced the risk of readmission and improved handgrip strength, quality of life, and use of assistive devices.
Characterization of Growth Factors, Cytokines, and Chemokines in Bone Marrow Concentrate and Platelet-Rich Plasma: A Prospective Analysis
Authors: Ziegler Connor G. , Van Sloun Rachel , Gonzalez Sabrina , Whitney Kaitlyn E. , DePhillipo Nicholas N. , Kennedy Mitchell I. , Dornan Grant J. , Evans Thos A. , Huard Johnny , LaPrade Robert F. 
Published: April 2019

Background:Platelet-rich plasma (PRP) and bone marrow concentrate (BMC) are orthobiologic therapies with numerous growth factors and other bioactive molecules. Before the clinical utility of PRP and BMC is optimized as a combined therapy or monotherapy, an improved understanding of the components and respective concentrations is necessary.Purpose:To prospectively measure and compare anabolic, anti-inflammatory, and proinflammatory growth factors, cytokines, and chemokines in bone marrow aspirate (BMA), BMC, whole blood, leukocyte-poor PRP (LP-PRP), and leukocyte-rich PRP (LR-PRP) from samples collected and processed concurrently on the same day from patients presenting for elective knee surgery.Study Design:Cross-sectional study; Level of evidence, 3.Methods:Patients presenting for elective knee surgery were prospectively enrolled over a 3-week period. Whole blood from peripheral venous draw and BMA from the posterior iliac crest were immediately processed via centrifugation and manual extraction methods to prepare LR-PRP, LP-PRP, and BMC samples, respectively. BMA, BMC, whole blood, LR-PRP, and LP-PRP samples were immediately assayed and analyzed to measure protein concentrations.Results:BMC had a significantly higher interleukin 1 receptor antagonist (IL-1Ra) concentration than all other preparations (all P < .0009). LR-PRP also had a significantly higher IL-1Ra concentration than LP-PRP ( P = .0006). There were no significant differences in IL-1Ra concentration based on age, sex, body mass index, or chronicity of injury in all preparations. LR-PRP had significantly higher concentrations of platelet-derived growth factor AA (PDGF-AA) and PDGF-AB/BB than all other preparations (all P < .0006). LR-PRP also had significantly higher concentrations of matrix metalloproteinase 1 (MMP-1) and soluble CD40 ligand than all other preparations (all P < .004). LP-PRP had significantly higher concentrations of MMPs, namely MMP-2, MMP-3, and MMP-12, than all other preparations (all P < .007).Conclusion:BMC is a clinically relevant source of anti-inflammatory biologic therapy that may be more effective in treating osteoarthritis and for use as an intra-articular biologic source for augmented healing in the postsurgical inflammatory and healing phases, owing to its significantly higher concentration of IL-1Ra as compared with LR-PRP and LP-PRP. Additionally, LR-PRP had a significantly higher concentration of IL-1Ra than LP-PRP. In cases where increased vascularity and healing are desired for pathological or injured tissues, including muscle and tendon, LR-PRP may be optimal given its higher overall concentrations of PDGF, TGF-β, EGF, VEGF, and soluble CD40 ligand.
Acupuncture treatment and the risk of urinary tract infection in stroke patients: a nationwide matched cohort study
Authors: Yang Jen-Lin , Chen Ta-Liang , Yeh Chun-Chieh , Hu Chaur-Jong , Liao Chien-Chang , Lane Hsin-Long , Shih Chun-Chuan 
Published: April 2019

Background: The association between acupuncture treatment and post-stroke urinary tract infection (UTI) remains incompletely understood. Objective: To compare the long-term risks of UTI among stroke patients treated with or without acupuncture treatment. Methods: This retrospective cohort study was based on data from the National Health Insurance Research Database in Taiwan that included hospitalized stroke patients. We identified 19,286 patients aged 30 years and older who were hospitalized for newly diagnosed stroke between 1 January 2000 and 31 December 2004. Considering immortal time bias, we compared the incidence of UTI during the follow-up period until the end of 2009 in patients with stroke who did and did not receive acupuncture. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of UTI associated with acupuncture were calculated using multivariate Cox proportional hazard regression analysis. Results: Stroke patients who received acupuncture treatment experienced a lower incidence of UTI than those who were not treated with acupuncture (95.4 vs 110.0 per 1000 person-years) with an HR of 0.76 (95% CI: 0.73–0.80). The association between acupuncture treatment and UTI was significant for both sexes and for patients older than 40 years of age, particularly for patients who had no history of medical conditions. Conclusions: In this nationwide retrospective cohort study, we raised the possibility that acupuncture treatment may be associated with a reduced risk of UTI among stroke patients. However, the protective effect associated with acupuncture treatment requires further validation using randomized clinical trials.
Understanding MRI in clinical psychiatry: perspectives from neuroimaging psychiatry registrars
Authors: Wibawa Pierre , Rego Thomas , Velakoulis Dennis , Gaillard Frank 
Published: April 2019

Objective: Based on the experiences of neuroimaging psychiatry registrars, we describe several reflections on improving the understanding and integration of magnetic resonance imaging in clinical psychiatry. Conclusion: Better integration of magnetic resonance imaging into clinical psychiatry can be highly productive when our investments are focused on understanding the gaps in clinical knowledge and the systemic barriers involving the patient and relevant clinicians.
The Real-Life Effectiveness and Safety of Omalizumab Updosing in Patients With Chronic Spontaneous Urticaria
Authors: Salman Andac , Comert Elif 
Published: April 2019

Background: Omalizumab is a third-line treatment for chronic spontaneous urticaria (CSU). Studies investigating the use of higher doses of omalizumab in patients unresponsive to regular doses are limited. Objectives: This study aims to investigate the effectiveness and safety of omalizumab 450 mg in CSU. Methods: A retrospective cohort study was conducted. The response to therapy was evaluated using the Urticaria Activity Score over 7 days (UAS7) and the Urticaria Control Test (UCT). Patients showing complete response (CR) (UAS7: 0-1) to omalizumab 300 mg (Group 1) and patients receiving at least 3 doses of omalizumab 450 mg (Group 2) between 2016 and 2018 were included. Results: A total of 72 patients (Group 1: 59; Group 2: 13) were included. In Group 2, the mean UAS7 score decreased from 18.6 to 5.1 and the mean UCT score increased from 8.6 to 12 after a mean 4.3 courses of 450 mg omalizumab treatment. Of the 13 patients in Group 2, 6 had CR and 3 had good disease control (UAS7: 2-6). The rate of patients with low baseline IgE levels (< 43 IU/mL) was significantly higher in Group 2. Conclusions: Higher doses of omalizumab are effective and safe in patients with CSU that is unresponsive to omalizumab 300 mg. Lower baseline total IgE levels might be used as a predictor of nonresponse to omalizumab and the need for higher doses.
How many calories do nurses burn at work? A real-time study of nurses’ energy expenditure
Authors: Allan Julia , Sadko Klaudia , Bell Cheryl , Johnston Derek 
Published: April 2019

Background Nurses have high rates of overweight and obesity, and physical inactivity is one key determinant of weight gain. Aims The present study aims to quantify nurses’ energy expenditure over a standard 12-hour shift to establish whether activity levels at work are too low to maintain a healthy body weight. Methods Ward-based nurses ( n = 96, 90 female, mean age = 36 years, mean experience = 10 years, mean body mass index = 26.6) wore heart rate and physical activity monitors for the duration of one full working shift. Heart rate and activity data were used in combination with demographic information to estimate each nurse’s energy expenditure over 12 hours. Results On average, nurses burned 2.12 kcals per minute while at work, equating to 1521 kcals/6364 kJ ( SD = 403 kcals/1686 kJ) per 12-hour shift. Energy expenditure over 12 hours varied markedly between nurses (from 812 kcals/3397 kJ to 3005 kcals/12,573 kJ) but was sufficient in 72% of participants (assuming minimal resting levels of energy expenditure for the 12 hours not at work) to burn off a daily calorie intake of 2000 kcals. Conclusions Three-quarters of nurses expend more energy on working days than is required to maintain a healthy body weight if dietary intake does not exceed recommended levels.
Engaging Patient and Family Advisors in Health-Care System Planning: Experiences and Recommendations
Authors: Wheeler Sarah , MacKay Jenna , Moody Lesley , D’Souza Junell , Gilbert Julie 
Published: April 2019

Background: Patient and family advisors (PFAs) contributed to the development of the Ontario Cancer Plan IV (OCP IV), a 4-year strategic plan for Ontario, Canada’s cancer system produced by Cancer Care Ontario. Objective: To understand the barriers and facilitators PFAs experience when they are engaged in health-care system planning and provide recommendations for future engagement. Method: Patient and family advisors who had an ongoing involvement in the development of the OCP IV were invited to take part in an interview. Qualitative data were analyzed for emergent themes and recommendations were generated. Results: Key emergent themes highlighted necessary elements for effective engagement of PFAs. These included rapport (feeling valued, included as an equal and having supportive interpersonal relationships), communication (clarity and transparency, shared language and understanding, feeling heard, and effective teleconferencing), and leadership (from PFAs and staff). Recommendations for optimizing PFA engagement in health-care system planning were generated. Conclusion: Patient and family advisors can be effectively engaged in system-level strategic planning by building reciprocal rapport, effective communication, and strong leadership. Notably, developing “systems literacy” in PFAs is key to ensuring the voices of patients and their families are heard and reflected in health-care system plans.
Acute Annular Outer Retinopathy: Literature Review and a Report of 2 Cases
Authors: Gupta R. Rishi , Iaboni Douglas S.M. , Seamone Mark E. , Archambault Cyril , Lederer David E. 
Published: April 2019

Purpose: Acute annular outer retinopathy (AAOR) is an uncommon disease. We present 2 illustrative cases and demonstrate disease evolution using multimodal imaging. The 18 previously reported cases in the peer-reviewed English literature are also reviewed. Methods: We conducted a case series and literature review. Results: We observed complete structural resolution by spectral-domain optical coherence tomography (SD-OCT) and ultra-widefield fundus autofluorescence in 1 case. In the literature review, 20 cases of AAOR were identified, including the 2 we have presented. Fifteen cases were unilateral and 5 bilateral, resulting in a total of 25 eyes with AAOR. Presenting symptoms included visual field defects (72%), decreased vision (48%), and photopsia (36%). Sixty-eight percent had a final visual acuity better than or equal to 20/40, while a minority (14%) were 20/200 or worse. Clinically, all eyes had a peripapillary annular band of gray-white opacification of the deep retina. Conclusions: We have reviewed and summarized the 18 previously reported cases of AAOR in the English literature and have shown for the first time that AAOR may undergo complete recovery of the external limiting membrane and ellipsoid zone on SD-OCT with resolution of disease. There is still much to be understood regarding the pathogenesis of and optimal management of AAOR.
Evaluating Costs of Biologic Drugs for the Treatment of Moderate-to-Severe Psoriasis in the United States
Authors: Feldman Steven R. , Wu Jashin J. , Armstrong April W. , Lebwohl Mark , Jacobson Abby A. , Lingohr-Smith Melissa , Lin Jay 
Published: April 2019

Objective: To provide a contemporary comparative assessment of biologic drug costs and cost effectiveness for treating moderate-to-severe psoriasis in the United States. Methods: A literature search was conducted in PubMed on October 4, 2018 with the search terms of “psoriasis,” “biologic,” and “cost” with a filter of publication dates within the last 5 years (2014-2018). Studies included in this review were required to be conducted from a United States perspective. Results: Of the 16 studies retrieved, the costs associated with use of biologic drugs for the treatment of moderate-to-severe psoriasis were relatively high, with some drugs exhibiting sustained lower costs than others. Some comparative findings on the cost-effectiveness of biologic drugs based on the annual treatment cost per Psoriasis Area and Severity Index (PASI) 75 responder concluded that the annual treatment cost was lowest for brodalumab 210 mg at US$48 782; the cost was highest for ustekinumab 45/90 mg (US$87 243), followed by adalimumab 40 mg (US$82 655), ixekizumab 160 mg (US$77 957), and secukinumab 300 mg (US$75 671). The annual treatment cost per PASI 100 responder was also lowest for brodalumab at US$87 585. This pattern remained consistent in other cost studies, with brodalumab being the treatment with the lowest treatment costs when compared to other biologic drugs. Conclusion: Brodalumab was consistently observed to be the least costly treatment option among biologic drugs used to treat moderate-to-severe psoriasis in the United States, which is largely the result of its low-drug cost and high-PASI response rate.
Two cases of long-lasting, sub-microscopic Plasmodium malariae infections in adults from coastal Tanzania
Authors: Schindler Tobias , Jongo Said , Studer Fabian , Mpina Maximilian , Mwangoka Grace , Mswata Sarah , Ramadhani Kamaka , Sax Julian , Church L. W. Preston , Richie Thomas L. , Tanner Marcel , Hoffman Stephen L. , Abdulla Salim , Daubenberger Claudia 
Published: April 2019

Abstract
Background
Malaria is endemic in Tanzania with majority of clinical cases caused by Plasmodium falciparum. Additionally, Plasmodium malariae and Plasmodium ovale spp. are also present and clinical manifestations caused by these infections are not well described. Clinical episodes caused by P. malariae infections are often characterized by a relatively mild illness with a low number of parasites, which can persist for long periods. In this report, two cases of P. malariae infections that were identified during a clinical trial evaluating the P. falciparum malaria vaccine candidate, PfSPZ Vaccine are described. The two participants were followed up and monitored for clinical and laboratory parameters to assess vaccine safety providing the opportunity to study clinical manifestations of P. malariae over 4 months.

Case presentation
Two young, healthy Tanzanian men infected with low density asexual blood stage P. malariae diagnosed by quantitative polymerase chain reaction (qPCR) are described. Retrospective analysis of collected and stored blood samples revealed that the two volunteers had constant asexual blood stage parasitaemia for more than 4 months. During the 132 days of infection, the volunteers’ vital signs, body temperature and serum biochemistry all remained within normal ranges. Haematological abnormalities, which were transiently outside normal ranges, were regarded as not clinically significant. During this time period, four consecutive evaluations of blood samples by thick blood smear microscopy conducted by an experienced microscopist were all negative, indicating the presence of low-density sub-microscopic infections.

Conclusions
The two cases of P. malariae infections presented here confirm the ability of this Plasmodium species to persist at low density in the human host for extended time periods without causing clinical symptoms. The presented data also demonstrate that clinical study sites in malaria endemic regions need to have a strong malaria diagnostic infrastructure, including the ability of capturing sub-microscopic parasitaemia and differentiation of Plasmodium species.
Trial registration ClinicalTrials.gov: NCT02613520, https://clinicaltrials.gov/ct2/show/NCT02613520, Registered: November 24th 2015, Enrolment of the first participant to the trial: December 15th 2015, Trial was registered before the first participant was enrolled
Amyotrophic lateral sclerosis mutant TDP-43 may cause synaptic dysfunction through altered dendritic spine function
Authors: Jiang Tongcui , Handley Emily , Brizuela Mariana , Dawkins Edgar , Lewis Katherine E. A. , Clark Rosemary M. , Dickson Tracey C. , Blizzard Catherine A. 
Published: April 2019

ABSTRACT
Altered cortical excitability and synapse dysfunction are early pathogenic events in amyotrophic lateral sclerosis (ALS) patients and animal models. Recent studies propose an important role for TAR DNA-binding protein 43 (TDP-43), the mislocalization and aggregation of which are key pathological features of ALS. However, the relationship between ALS-linked TDP-43 mutations, excitability and synaptic function is not fully understood. Here, we investigate the role of ALS-linked mutant TDP-43 in synapse formation by examining the morphological, immunocytochemical and excitability profile of transgenic mouse primary cortical pyramidal neurons that over-express human TDP-43A315T. In TDP-43A315T cortical neurons, dendritic spine density was significantly reduced compared to wild-type controls. TDP-43A315T over-expression increased the total levels of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropinionic acid (AMPA) glutamate receptor subunit GluR1, yet the localization of GluR1 to the dendritic spine was reduced. These postsynaptic changes were coupled with a decrease in the amount of the presynaptic marker synaptophysin that colocalized with dendritic spines. Interestingly, action potential generation was reduced in TDP-43A315T pyramidal neurons. This work reveals a crucial effect of the over-expression mutation TDP-43A315T on the formation of synaptic structures and the recruitment of GluR1 to the synaptic membrane. This pathogenic effect may be mediated by cytoplasmic mislocalization of TDP-43A315T. Loss of synaptic GluR1, and reduced excitability within pyramidal neurons, implicates hypoexcitability and attenuated synaptic function in the pathogenic decline of neuronal function in TDP-43-associated ALS. Further studies into the mechanisms underlying AMPA receptor-mediated excitability changes within the ALS cortical circuitry may yield novel therapeutic targets for treatment of this devastating disease.
Cost-effectiveness of glaucoma screening in cataract camps versus opportunistic and passive screening in urban India: A study protocol
Authors: Sabherwal Shalinder , John Denny , Dubey Suneeta , Mukherjee Saptarshi , Menon Geetha R. , Majumdar Atanu 
Published: April 2019

India has an estimated 12 million people affected with glaucoma; however, no organised screening programme exists. Cases are usually detected opportunistically. This study documents the protocol for detecting glaucoma in suspects in cataract camps conducted by Shroff Charity Eye Hospital in North India. We report a cost-effectiveness alongside prospective study design of patients attending cataract camps where glaucoma screening will be integrated. The eligible population for glaucoma screening is non-cataract patients. Patients will undergo glaucoma screening by a trained optometrist using a pre-determined glaucoma screening algorithm. Specific diagnostic cut-off points will be used to identify glaucoma suspects. Suspected patients will be referred to the main hospital for confirmatory diagnosis and treatment. This group will be compared to a cohort of patients arriving from cataract camps conducted by the institute in similar areas and undergoing examination in the hospital. The third arm of the study includes patients arriving directly to the hospital for the first time. Cost data will be captured from both the screening components of cataract-only and glaucoma screening-integrated camps for screening invitation and screening costs. For all three arms, examination and treatment costs will be captured using bottom-up costing methods at the hospital. Detection rates will be calculated by dividing the number of new cases identified during the study by total number of cases examined. Median, average and range of costs across the three arms will be calculated for cost comparisons. Finally, cost-effectiveness analysis will be conducted comparing cost per case detected across the three arms from a quasi-societal perspective with a time horizon of 1 year. Ethics approval for the study has been obtained from the institutional ethics committee of the hospital. The study protocol will be useful for researchers and practitioners for conducting similar economic evaluation studies in their context.