bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concussion History and Cognitive Function in a Large Cohort of Adolescent Athletes
Authors: Taylor Kathryn M. , Kioumourtzoglou Marianthi-Anna , Clover Jim , Coull Brent A. , Dennerlein Jack T. , Bellinger David C. , Weisskopf Marc G. 
Published: September 2018

Background: The incidence of reported concussions in the adolescent population is increasing, yet research on the effects of concussions in this population is minimal and inconclusive. Purpose: To assess the association between concussion and performance on a cognitive test battery. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Using multivariate models, the authors assessed the association between concussion and performance on a cognitive test battery among 5616 high school and junior high school athletes. The researchers utilized a global cognitive score and scores for 5 domains: verbal memory, visual memory, visual motor, reaction time, and impulse control. Each cognitive score was converted to a z score with the mean and SD of the nonconcussed population. Results from each model were then interpreted as change in the standardized unit score. In the models, concussion was evaluated as ever having a concussion, number of concussions, time since last concussion, and age at first concussion. Results: Ever having a concussion was associated with a mean decrease of 0.11 standardized units (95% CI, −0.20 to −0.01) on the global cognitive score and lower scores in all cognitive domains. Each additional concussion was associated with lower scores on global cognitive function (effect estimate, −0.06; 95% CI, −0.11 to −0.02), verbal memory, visual memory, and impulse control. Concussion in early childhood was associated with lower global cognition (effect estimate, −0.05; 95% CI, −0.08 to −0.01), visual memory, and motor visual scores as compared with concussions in later childhood. The associations between time since last concussion and cognitive test scores were nonlinear, and on all tests, lower scores were observed even ≥1 year after the concussion. Conclusion: On the basis of objective performance metrics for cognitive function, concussions had a more persistent effect on cognitive function than previously thought. The age at which an individual has his or her first concussion may be an important factor in determining long-lasting cognitive effects.
Clinical Phenomenology and Characteristics of Centenarians in Hospice
Authors: Schoonover Kimberly L. , Lapid Maria I. 
Published: September 2018

Objectives: Little is known about the hospice experience of centenarians. As the population of centenarians is projected to increase, understanding their unique end-of-life needs will be important to inform delivery of quality end-of-life care. Our objective was to characterize the hospice experience of centenarians. Methods: A retrospective single-institution cohort study of centenarians enrolled in hospice from January 1, 2015, to December 31, 2017, was conducted to collect demographic and clinical information. Results: Seventeen centenarians, who comprised 1.4% of hospice admissions, had an average age of 102 years, were mostly female (71%) and widowed (76%), and all caucasian. Upon hospice admission, centenarians resided in nursing (8, 47%) and assisted living (4, 24%) residencies as well as at home (4, 24%) and in senior independent living (1, 6%). Sixty percent of centenarians died in a nursing home. The most common hospice admission diagnosis was dementia (35%). Median length of stay on hospice was 41 days (range: 16-85) for 15 persons who died or discharged live. Conclusions: In this group of centenarians, dementia was the most common condition for hospice enrollment. Slightly less than half resided in nursing homes on admission, although death occurred most frequently in a nursing home. Centenarians were generally able to remain out of the hospital at their time of death.
A device to make the pelvic sagittal plane horizontal and reduce error in cup inclination during total hip arthroplasty: a validation study
Authors: McMahon Samuel E , Magill Paul , Bopf Daniel P , Beverland David E 
Published: September 2018

Introduction: Radiological inclination (RI) is determined in part by operative inclination (OI), which is defined as the angle between the cup axis or handle and the sagittal plane. In lateral decubitus the theatre floor becomes a surrogate for the pelvic sagittal plane. Critically at the time of cup insertion if the pelvic sagittal plane is not parallel to the floor either because the upper hemi pelvis is internally rotated or adducted, RI can be much greater than expected. We have developed a simple Pelvic Orientation Device (POD) to help achieve a horizontal pelvic sagittal plane. Methods: A model representing the posterior aspect of the pelvis was created. This permitted known movement in 2 planes to simulate internal rotation and adduction of the upper hemi pelvis, with 15 known pre-set positions. 20 participants tested the POD in 5 random, blinded position combinations, providing 200 readings. The accuracy was measured by subtracting each reading from the known value. Results: Two statistical outliers were identified and removed from analysis. The mean adduction error was 0.73°. For internal rotation, the mean error was −0.03°. Accuracy within 2.0° was achieved in 176 of 190 (93%) of readings. The maximum error was 3.6° for internal rotation and 3.1° for adduction. Conclusion: In a model pelvis the POD provided an accurate and reproducible method of achieving a horizontal sagittal plane. Applied clinically, this simple tool has the potential to reduce the high values of RI sometimes seen following THA in lateral decubitus.
Multicentre, randomised, blinded, control trial of drug-eluting balloon vs Sham in recurrent native dialysis fistula stenoses
Authors: Swinnen Jan “John” , Hitos Kerry , Kairaitis Lukas , Gruenewald Simon , Larcos George , Farlow David , Huber David , Cassorla Gabriel , Leo Christopher , Villalba Laurencia M , Allen Richard , Niknam Farshid , Burgess David 
Published: September 2018

Background: Endovascular treatment of autogenous arteriovenous haemodialysis fistula stenosis has high reintervention rates. We investigate the effect of drug-eluting balloons in the treatment of recurrent haemodialysis fistula stenosis. Methods: This is a randomised, controlled, investigator-initiated and run, prospective, blinded, multicentre trial. Patients with recurrent autogenous arteriovenous haemodialysis fistula stenosis received standard endovascular treatment plus drug-eluting balloon or standard endovascular treatment plus uncoated balloon (Sham). Primary endpoint was late lumen loss in trial area on ultrasound at 6 weeks, 3, 6 and 12 months. Secondary endpoints were freedom from reintervention to the Index Trial Area and decline in fistula flow (Qa). Interim analysis was performed at 6 months (unblinded due to timeliness). Results: Patients with 132 recurrent stenoses (48% in bare Nitinol stents) were randomised with 70 receiving drug-eluting balloon and 62 Sham. At 6 months, decline in late lumen loss was 0.23 ± 0.03 mm/month for Sham and 0.045 ± 0.03 mm/month for drug-eluting balloon arm, a significant difference (0.18 mm, p = 0.0002). At 12 months, this difference persisted at 0.12 mm (p = 0.0003). At 6 months, significant difference in late lumen loss for instent restenoses (p = 0.0004) was observed, with non-significant difference for unstented restenoses (p = 0.065). Mean time for freedom from reintervention was 10.14 months for Sham versus 42.39 months for drug-eluting balloon (p = 0.001). The same was shown for instent (p = 0.014) and unstented (p = 0.029) restenoses. Qa decline rate at 6 months was 36.89 mL/min/month (Sham) and 0.41 mL/min (drug-eluting balloon). The difference was significant (36.48 mL/min; p = 0.02) and persisted to 12 months (p = 0.44). Conclusion: Paclitaxel drug-eluting balloon significantly delays restenosis after angioplasty for recurrent autogenous arteriovenous haemodialysis fistula stenosis, persisting to 12 months. Drug-eluting balloon significantly increases freedom from reintervention at 12 months with these effects true in stented and unstented fistulas.
Glutamate-sensitive imaging and evaluation of cognitive impairment in multiple sclerosis
Authors: O’Grady Kristin P , Dula Adrienne N , Lyttle Bailey D , Thompson Lindsey M , Conrad Benjamin N , Box Bailey A , McKeithan Lydia J , Pawate Siddharama , Bagnato Francesca , Landman Bennett A , Newhouse Paul , Smith Seth A 
Published: September 2018

Background: Cognitive impairment (CI) profoundly impacts quality of life for patients with multiple sclerosis (MS). Dysfunctional regulation of glutamate in gray matter (GM) has been implicated in the pathogenesis of MS by post-mortem pathological studies and in CI by in vivo magnetic resonance spectroscopy, yet GM pathology is subtle and difficult to detect using conventional T1- and T2-weighted magnetic resonance imaging (MRI). There is a need for high-resolution, clinically accessible imaging techniques that probe molecular changes in GM. Objective: To study cortical GM pathology related to CI in MS using glutamate-sensitive chemical exchange saturation transfer (GluCEST) MRI at 7.0 Tesla (7T). Methods: A total of 20 patients with relapsing-remitting MS and 20 healthy controls underwent cognitive testing, anatomical imaging, and GluCEST imaging. Glutamate-sensitive image contrast was quantified for cortical GM, compared between cohorts, and correlated with clinical measures of CI. Results and Conclusion: Glutamate-sensitive contrast was significantly increased in the prefrontal cortex of MS patients with accumulated disability ( p < 0.05). In addition, glutamate-sensitive contrast in the prefrontal cortex was significantly correlated with symbol digit modality test ( rS = −0.814) and choice reaction time ( rS = 0.772) scores in patients ( p < 0.05), suggesting that GluCEST MRI may have utility as a marker for GM pathology and CI.
Liver injury with drugs used for multiple sclerosis: A contemporary analysis of the FDA Adverse Event Reporting System
Authors: Antonazzo Ippazio Cosimo , Poluzzi Elisabetta , Forcesi Emanuele , Riise Trond , Bjornevik Kjetil , Baldin Elisa , Muratori Luigi , De Ponti Fabrizio , Raschi Emanuel 
Published: September 2018

Background: Drug-induced liver injury (DILI) has been observed in patients with multiple sclerosis (MS), raising concerns on the liver safety of MS drugs. Objective: To describe DILI events with MS drugs by analyzing the FDA Adverse Event Reporting System. Methods: DILI reports were extracted and classified in overall liver injury (OLI), including asymptomatic elevation of liver enzymes, and severe liver injury (SLI). We performed disproportionality analysis by calculating adjusted reporting odds ratios (RORs) with 95% confidence interval (CI) and case-by-case evaluation for concomitant drugs with hepatotoxic potential. Results: Fampridine showed statistically significant ROR for both OLI and SLI, whereas teriflunomide and fingolimod generated solid disproportionality (ROR > 2) only for OLI (ROR, 2.31; 95% CI, 2.12–2.52; and 2.53; 2.40–2.66, respectively). Among monoclonal antibodies, only alemtuzumab generated higher-than-expected ROR for OLI (1.34; 1.09–1.65). We also detected the expected hepatotoxic potential of beta interferon and mitoxantrone. Concomitant reporting of hepatotoxic drugs ranged from 26% (dimethyl fumarate) to 90% (mitoxantrone). Conclusion: These real-world pharmacovigilance findings suggest that DILI might be a common feature of MS drugs and call for (1) formal population-based study to verify the risk of fampridine and (2) awareness by clinicians, who should assess the possible responsibility of MS drugs when they diagnose DILI.
Trends in African Americans’ Attitudes and Behaviors About Living Donor Kidney Transplantation
Authors: Vilme Helene , Davenport Clemontina A. , Pendergast Jane , Boulware L. Ebony 
Published: September 2018

Background: Due to marginal efforts to increase living donor kidney transplantation, it is unclear whether interventions to improve African Americans’ interest and pursuit of living donation should be tailored to address patients’ exposure to or familiarity with dialysis or transplant settings. Design, Setting, and Participants: We conducted a cross-sectional secondary analysis of baseline data from 3 separate randomized clinical trials among African Americans with varying degrees of experience with dialysis or transplantation (predialysis, on dialysis but not on transplant list, and on transplant wait-list) settings. Methods: Interest in living donation was described using a 0 to 10 scale and pursuit of living donor kidney transplantation by achievement of at least 1 pursuant behavior. In multivariable logistic regression analyses, we assessed the association of knowledge, health literacy, and trust in health care with interest in or pursuit of living donation. Results: Interest among the 3 study cohorts was high (predialysis, 62.9%; dialysis, 67.4%; and transplant wait-list, 74.2%). The dialysis and transplant wait-list study cohorts pursued living donation more readily than those not on dialysis (73%, 92%, and 45%, respectively). Interest and pursuit were not statistically significantly associated with knowledge, health literacy, or the 3 factors reflecting medical mistrust. Conclusion: Interest and pursuit of living donation were greater among study participants with greater exposure to dialysis or transplant settings. Efforts to promote patients’ early interest and pursuit of living donor transplants may consider novel strategies to educate patients with less experience about the benefits of living donor kidney transplantation.
Effect of a participatory patient education programme (

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ucation) in group-based patient education among Danes with type 2 diabetes
Authors: Christoffersen Lea AN , Hansen Anne K , Pals Regitze AS , Willaing Ingrid , Siersma Volkert , Olesen Kasper 
Published: September 2018

Objective To assess the effect of a participatory group-based education programme for individuals with type 2 diabetes, Next Education. Method In a quasi-experimental study, individuals with type 2 diabetes were recruited from 14 Danish municipalities with a patient education programme. Eight municipalities using Next Education were intervention sites; six control sites used usual group-based education programmes. Data were collected through questionnaires at baseline and at 3 and 12 months after programmes ended. Changes in quality of life (EQ-5D-5L), diabetes-related emotional distress (PAID-5), physical activity, diet, foot care and sense of coherence (SOC-13) were assessed in generalised linear mixed models. Results At baseline, 310 participants (52.6% females, mean age 62.5 years [SD = 10.7] and a mean duration of type 2 diabetes of 6.9 years [SD = 8.4]) participated in Next Education ( n = 234) or group-based education ( n = 76) at control sites. Compared with participants at control sites, participants at intervention sites had significantly larger sense of coherence scores at 3 (9.4%, p = 0.03) and 12 (9.8%, p = 0.02) months of follow-up. Other measures did not differ significantly between groups. Discussion It is likely that person-centeredness and high degrees of user participation at the intervention sites improved sense of coherence among Danes with type 2 diabetes.
Impact of preoperative elevated serum creatinine on long-term outcome of patients undergoing aortic repair with Stanford A dissection: a retrospective matched pair analysis
Authors: Eghbalzadeh Kaveh , Sabashnikov Anton , Weber Carolyn , Zeriouh Mohamed , Djordjevic Ilija , Merkle Julia , Shostak Olga , Saenko Sergey , Majd Payman , Liakopoulos Oliver , Rahmanian Parwis B. , Madershahian Navid , Choi Yeong-Hoon , Kuhn-Régnier Ferdinand , Wippermann Jens , Wahlers Thorsten 
Published: September 2018

Background: The aim of the present study was to determine whether raised preoperative serum creatinine affected the long-term outcome in patients undergoing surgical aortic repair for Stanford A acute aortic dissection (AAD). Methods: A total of 240 patients diagnosed with Stanford A AAD underwent surgical repair from January 2006 to April 2015. A propensity score matching was applied, resulting in 73 pairs consisting of one group with normal and one group with preoperative elevated creatinine levels. The cohorts were well balanced for baseline and preoperative clinical characteristics. Both groups were compared regarding their early postoperative variables, as well as estimated survival with up to 9-year follow up. Also, the impact of acute postoperative kidney injury and its severity on long-term survival was analyzed. Results: The proportion of patients suffering Stanford A AAD with raised creatinine levels was 31.3% ( n = 75). After propensity matching, there were no statistically significant differences regarding demographics, comorbidities, preoperative baseline and clinical characteristics. Postoperatively matched patients with elevated creatinine had longer intensive care unit ( p < 0.001) and total hospital stay ( p = 0.002), prolonged intubation times ( p = 0.014), higher need for hemofiltration ( p < 0.001), higher incidence of temporary neurological disorders ( p = 0.16), infection ( p = 0.005), and trend toward higher incidence of sepsis ( p = 0.097). However, there were no significant differences regarding 30-day mortality (20.5% versus 20.5%, p = 1.000) and long-term overall survival. Further, neither the incidence nor the different stages of acute kidney injury according to the Acute Kidney Injury Network showed any statistically significant differences in terms of long-term survival for both groups [log rank p = 0.636, Breslow (generalized Wilcoxon) p = 0.470, Tarone–Ware p = 0.558]. Conclusions: Patients with elevated creatinine levels undergoing surgical repair for Stanford A AAD demonstrate higher rate of early postoperative complications. However, 30-day mortality and long-term survival in this patient cohort is not significantly impaired.
Perceptions of preparedness and intimate partner violence screening practices amongst hand therapists
Authors: Sivagurunathan Marudan , Packham Tara , Dimopoulos Lindsay , Murray Robyn , Madden Kim , Bhandari Mohit , MacDermid Joy C 
Published: September 2018

Introduction While hand injuries are reported as common sequelae of intimate partner violence, there is limited attention to hand therapist’s screening practices and perceived preparedness to deal with intimate partner violence in hand therapy setting. The primary aim of the current study is to describe the intimate partner violence training, knowledge of referrals, perceived preparedness, and screening practices of hand therapists. Methods An online survey investigating the perceptions regarding issues pertaining to intimate partner violence was completed by a sample of 189 hand therapists. Areas addressed included intimate partner violence training, perceived preparedness to deal with intimate partner violence-related responsibilities, screening practices and knowledge of resources for referrals. Data were analyzed using descriptive statistics while comparisons of groups used non-parametric analyses to evaluate the impact of training, intimate partner violence experience and knowledge of referrals on preparedness and screening practices. Results Hand therapists reported low perceived preparedness scores (median = 2.1/7) and screening practices. The majority (73%) of hand therapists indicated having received no intimate partner violence training. Additionally, intimate partner violence training, intimate partner violence experience, and knowledge of referrals had significant impact on hand therapists’ perceived preparedness and screening practices. Conclusion Training is significantly related to perceived preparedness and screening practices. Intimate partner violence screening may result in clients receiving appropriate referrals leading to improved quality of life. Future research should seek out ideal methods for offering intimate partner violence training for hand therapists so that they can meet the needs of clients with intimate partner violence experience.
The use of high-dose intrathecal diamorphine in laparoscopic bariatric surgery: a single-centre retrospective cohort study
Authors: Wojcikiewicz Thomas G , Jeans John , Karmali Anil , Nkhoma Jackline , Cousins Jonathan , Kynoch Michael 
Published: September 2018

Introduction: The use of intrathecal diamorphine is not commonplace in laparoscopic bariatric surgery. At our institution, a major UK bariatric centre, high-dose intrathecal diamorphine is routinely utilised. Methods: Data were analysed retrospectively. Fifty-three patients who had a spinal anaesthetic were matched against age, sex, body mass index and surgical procedure type to generate controls. Pain scores were recorded in the post-anaesthetic care unit on arrival, after 1 hour and on discharge to the ward. Post-operative nausea and vomiting; post-operative hypertension; pruritus; 24-hour morphine consumption and length of stay were measured. Results: Pain scores were better in the spinal anaesthetic group in all measured categories (p = 0.033, p < 0.01, p < 0.01); post-operative nausea and vomiting was less common in the spinal anaesthetic group (p < 0.01); post-operative hypertension was less common in the spinal anaesthetic group (p = 0.25); pruritus was more common in the spinal anaesthetic group (p < 0.01); morphine consumption was less common in the spinal anaesthetic group (p = 0.037). Length of hospital stay was reduced by 12.4 hours (p = 0.025). Conclusion: We propose that this is a practical and safe technique to adopt. A randomised-control trial will need to be conducted in order to find the most efficacious volume of local anaesthetic and dose of diamorphine
Audit of computed tomography brain findings in HIV-infected patients with space occupying infective lesions at a regional level hospital in KwaZulu-Natal
Authors: Pillay Somasundram , Ramchandre Kaveer 
Published: September 2018

Background: With the increased prevalence of HIV pandemic, more focus is placed on pathology involving the central nervous system secondary to HIV infection. Medical computerised tomography scans have become an integral investigation at a regional hospital level. Objective: To provide a description of central nervous system space occupying infective lesion found within this cohort of patients. Setting: Edendale Hospital, Pietermaritzburg, KwaZulu-Natal. Methods: This was a retrospective study in which the charts of all HIV-infected medical patients with findings of a space occupying infective lesion on computerised tomography brain seen for the time period 1 January 2015 up to and including 31 December 2015 were analysed. A total of 110 patient files were evaluated. Results: Most patients were in the third to fourth decade of life with mean cluster of differentiation 4 of 125 cells/mm3. A differential comprising toxoplasmosis or tuberculoma (80.9%) was the leading aetiology described. Most frequent clinical features in these patients included seizures (41.8%), confusion or altered mental state (38.2%), headaches (33.6%), hemiparesis (48.2%) and cranial nerve abnormality (22.7%). The most common central nervous system sites involved were, in order of decreasing prevalence was parietal, basal ganglia, frontal cortex (31.8% vs 31.8% vs 26.4%, respectively). Early initiation of co-trimoxazole and anti-tuberculosis treatment yielded better outcomes compared to the group who received delayed or no treatment with p-values (Pearson’s χ2) of 0.0002 and <0.0001, respectively. Conclusion: Computerised tomography scans to detect space-occupying infective lesion of the brain are invaluable for rapid diagnosis and to reduce morbidity and mortality.