bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Efficacy of Jump Training Augmented With Body Weight Support After ACL Reconstruction: A Randomized Controlled Trial
Authors: Elias Audrey R.C. , Harris Kari J. , LaStayo Paul C. , Mizner Ryan L. 
Published: March 2018

Background: Limited knee flexion and increased muscle co-contraction during jump landing are believed to diminish outcomes after anterior cruciate ligament (ACL) reconstruction. The efficacy of jump training to improve patients’ mechanical and neuromuscular deficits is understudied. Hypothesis: Jump training will improve functional, mechanical, and neuromuscular outcomes and higher repetition training augmented by body weight support will result in better retention of gains. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Thirty athletes (18 months after surgery) were screened, and 19 with mechanical deficits and limited clinical outcomes were enrolled in the trial. Testing included the International Knee Documentation Committee (IKDC) questionnaire, leg landing mechanics via motion analysis, knee joint effusion using a stroke test, and a surface electromyography–generated co-contraction index during a single-legged landing. Participants were randomly assigned to 1 of 2 groups: jump training with normal body weight (JTBW) and high-repetition jump training with body weight support (JTBWS). Knee effusion grading throughout training was used to assess joint tolerance. Changes in outcomes over time were analyzed with mixed-effects modeling. Immediate outcomes were compared with retention testing at 8 weeks after training by use of 2-way analyses of variance with effects of time and group. Results: Significant effects of time were found during the training phase for all outcome measures, but no effects of group or sex were found. IKDC score (pooled; mean ± SD) increased from 76 ± 12 to 87 ± 8 ( P < .001). Knee flexion during single-legged landing increased from 57° ± 11° to 73° ± 9° ( P < .001). Average co-contraction index decreased from 37 ± 15 to 19 ± 6 ( P < .001). All measures were retained over the retention period in both groups. The relative risk of knee effusion of the JTBW group versus the JTBWS group was 4.2 (95% CI, 2.25-7.71; P < .001). Conclusion: Jump training mitigated some risk factors for second injury and osteoarthritis in patients after ACL reconstruction. Training made lasting improvements in physical function measures as well as mechanical and neuromuscular coordination deficits. Higher repetitions used with body weight support did not improve retention but substantially reduced risk for effusion. Clinical Relevance: Jump training is an efficacious intervention for athletes with poor outcomes after ACL reconstruction, and training with body weight support lessens the risk for excessive joint stress during practice. Registration: NCT02148172 ( ClinicalTrials.gov identifier)
Evaluation of Acid-base Balance and pO2 with Acetate Dialysis in Non-uremic Patients
Authors: Taccone-Gallucci M. , Mazzarella V. , Morosetti M. , Verardi S. , Meloni C. , Verardi V. , Matteucci M.C. , Boffo V. , Torregrossa G. , Casciani C.U. 
Published: March 2018

The aim of our work was to evaluate the immediate effects of acetate-dialysis in patients with normal renal and respiratory function. For this purpose pH, pO2, pCO2 and HCO3− were monitored in arterial blood before dialysis, after 60, 120, 180 mns and at the end of each treatment in two groups of patients on chronic hemodialysis, a first group of schizophrenic patients and a second group of uremic patients. In the first group of patients the predialytic values were in the normal range. After hemodialysis HCO3− and pCO2 significantly decreased, both these changes were associated with a stable pH. The pO2 significantly decreased after 60 mns of dialysis. At the end of dialysis the pO2 increased without significant variation compared to predialytic values. In conclusion in non-uremic hemodialysis patients metabolic acidosis due to the loss of bicarbonate through the membrane is compensated by respiratory alkalosis. This respiratory alkalosis is not due to hypoventilation secondary to respiratory centre inhibition, but is mainly due to the pCO2 loss through the dialysis membranes.
Non-invasive Assessment of Regional Myocardial Function at Rest and during Exercise after Aorto-coronary Bypass Operation
Authors: Reichart B. , Schad N. , Hartmann A. , Kemkes B.M. , Kreuzer E. , Alber G. 
Published: March 2018

Fifty patients (mean age 53.9 years) with persistent severe ang na pectoris underwent aorto-coronary bypass surgery receiving an overall of 161 anastomosis. On an average 8.6 ± 1.3 months p.o. first pass radionuclide ventriculograms with 99 m Technetium-Pertechnetate were performed at rest and after maximum exercise. Regional ejection fractions (REF) was assessed defining REF as motion of a left ventricular piece of myocardium which is supplied by one main coronary artery and its branches. All regions were classified using preoperative coronary angiograms and operative reports. Six groups evolved: Group 1: (normally perfused areas; n = 14): Total group's REF increased after exercise by 11.6 percentage points. Group 2 (completely revascularized regions without previous myocardial infarction (M.I.); (n=55): On an average REF improved by 11.0 points. Group 3 (completely revascularized regions with previous M.I.; n=25): After exercise REF still rose by 4.1 percentage points. The results deteriorated further in the remaining three groups: Group 4 (incompletely revascularized territories without previous M.I.; n=19), decrease of REF by —4.9 points, Group 5 (incompletely revascularized territories with previous M.I.; n=8) deterioration by —8.1 points. Group 6 (no revascularization but significant disease with or without previous M.I.; n=14) did not differ from group 5; REF deteriorated by —9.0 percentage points. The findings show that complete revascularization improves REF significantly (p < 0.05). Areas without previous M.I. respond to exercise like normally perfused territories. Angina pain relief subsequently to aorto-coronary bypass surgery is undisputed. Yet, up till now, improvement of left ventricular function seemed questionable. One reason for the ineptitude might be the global access to left ventricular function. Since coronary artery disease has segmental nature, global left ventricular parameters, like global ejection fraction e.g., may hide regional changes achieved by revascularization. Therefore, evidence of functional improvement should be done regionally. In the presented study regional ejection fraction was applied, defining that term as motion of a left ventricular portion, which is supplied by one main coronary artery and its branches.
Assessment of Mechanical Properties and Biocompatibility of Pellethane®
Authors: Biester F.D. , Behrend D.M. , Klinkmann H. 
Published: March 2018

Pellethane® CPR 2363-80A nonreinforced (PUR), nonreinforced and twice sterilized (PUR F2), reinforced with Dacron® (Dm), Grisuten® (DG) and glassfibre (PUG) and fabricated under different conditions have been examinated. Tests included uniaxial tension at 310 K, torsional movement from 293 to 319 K, X-ray structure, SEM, visual surface clotting, thrombocyte adhesion and degree of albumenisation. Typical in vitro results were: modulus of elasticity E [MPa] (PUR: 1.33, Dm: 4.22, DG: 1.86, PUG: 622.5), tensile strength δB [MPa] (43.4, 12.5, 21.7, 24.9), elongation at break δ [%] (1122, 109, 660, 479), dynamic modulus of sliding G', G” [MPa] at 293 K (8.7, 0.4/ 15.9, 0.9/ 12.1, 1.3/ 17.1, 1.5), damping tanδ (0.13, 0.1, 0.16, 0.12), orientational degree at 5% elongation fx [%] (PUR: 0.5), low thrombogenicity and high degree of albumenisation. The results indicate a strong dependency of mechanical and biocompatibility properties on membrane and housing fabrication. The most effective combination is a thin PUR membrane and a PUG housing fabricated under special conditions.
The Effect of Hematocrit on the Clearance of Small Molecules during Hemodialysis
Authors: Woffindin C. , Hoenich N.A. , Kerr D.N.S. 
Published: March 2018

Data collected during the evaluation of a series of hemodialysers were analysed to see the effect of hematocrit on the clearance of urea and creatinine. All evaluations were performed on patients with a range of hematocrits with a mean close to 20%. The urea clearance of those in the upper half of the distribution curve (mean hematocrit 29.4%) was not significantly different from that of patients in the lower half of the distribution curve (mean hematocrit 16.9%) whether the clearance was studied at high or low blood flow rates and with hollow fibre or flat plate disposable hemodialysers. Likewise, there was no correlation between hematocrit and urea clearance by regression analysis. In contrast, the clearance of creatinine was affected by hematocrit being greater at lower hematocrit values. This difference was independent of blood flow rate and dialyser type and was confirmed by regression analysis.
Global sensitivity analysis of clinical trials with missing patient-reported outcomes
Authors: Scharfstein Daniel O , McDermott Aidan 
Published: March 2018

Randomized trials with patient-reported outcomes are commonly plagued by missing data. The analysis of such trials relies on untestable assumptions about the missing data mechanism. To address this issue, it has been recommended that the sensitivity of the trial results to assumptions should be a mandatory reporting requirement. In this paper, we discuss a recently developed methodology (Scharfstein et al., Biometrics, 2018) for conducting sensitivity analysis of randomized trials in which outcomes are scheduled to be measured at fixed points in time after randomization and some subjects prematurely withdraw from study participation. The methodology is explicated in the context of a placebo-controlled randomized trial designed to evaluate a treatment for bipolar disorder. We present a comprehensive data analysis and a simulation study to evaluate the performance of the method. A software package entitled SAMON (R and SAS versions) that implements our methods is available at www.missingdatamatters.org .
Early glycaemic control for maintaining visual function in type 1 diabetes: The Oulu cohort study of diabetic retinopathy
Authors: Hautala Nina , Siiskonen Mira , Hannula Virva , Järvinen Kaisu , Falck Aura 
Published: March 2018

Purpose: The purpose of this study was to evaluate the visual function and the ophthalmic status of young Finnish adults with long duration of type 1 diabetes in relation to the history of the metabolic control. Methods: A population-based cohort of children with type 1 diabetes examined in the Northern Ostrobothnia hospital district in 1989 (n = 216) was re-examined 18 years later. High-contrast visual acuity (best-corrected visual acuity), contrast sensitivity, refractive error, lens status, intraocular pressure, stage of diabetic retinopathy and received treatments were evaluated. The metabolic control was reflected by the mean of glycated haemoglobin A1 or glycated haemoglobin A1c values of the years 1983–1989 and 1992–2007, respectively. Results: In all, 96 men and 76 women age 30 ± 3 years with type 1 diabetes duration of 23 ± 4 years attended the re-evaluation. About 60% (103/172) had normal best-corrected visual acuity and 3% had low vision. Contrast sensitivity was abnormal in two-thirds. Half had myopia. Four patients had cataract surgery. Low childhood glycated haemoglobin A1 was indicative, and favourable glycated haemoglobin A1c during youth was a significant predictor of better contrast sensitivity and ocular state in adulthood. Conclusion: The majority of the patients have useful vision, although minor functional impairments are commonly detectable. Long duration of type 1 diabetes in association with non-optimal glycaemic control threatens visual function already at young adulthood. Thus, strong emphasis to control diabetes from onset is important in maintaining good visual function.
Diagnostic capability of optic nerve head rim width and retinal nerve fiber thickness in open-angle glaucoma
Authors: Di Staso Silvio , Agnifili Luca , Di Staso Federico , Climastone Hilary , Ciancaglini Marco , Scuderi Gian Luca 
Published: March 2018

Purpose: This study was performed to test the diagnostic capability of the minimum rim width compared to peripapillary retinal nerve fiber layer thickness in patients with glaucoma. Methods: A case control, observer masked study, was conducted. Minimum rim width and retinal nerve fiber layer thickness were assessed using the patient-specific axis traced between fovea-to-Bruch’s membrane opening center axis. For both minimum rim width and retinal nerve fiber layer thickness, the regionalization in six sectors (nasal, superior-nasal, superior-temporal, temporal, inferior-temporal, and inferior-nasal) was analyzed. Eyes with at least one sector with value below the 5% or 1% normative limit of the optical coherence tomography normative database were classified as glaucomatous. The area under the receiver operator characteristic curve, the accuracy, sensitivity, specificity, and predictive positive and negative values were calculated for both minimum rim width and retinal nerve fiber layer thickness. Results: A total of 118 eyes of 118 Caucasian subjects (80 eyes with open-angle glaucoma and 38 control eyes) were enrolled in the study. Accuracy, sensitivity, and specificity were 79.7%, 77.5%, and 84.2%, respectively, for minimum rim width and 84.7%, 82.5%, and 89.5% for retinal nerve fiber layer thickness. The positive predictive values were 0.91% and 0.94% for minimum rim width and retinal nerve fiber layer thickness, respectively, whereas the negative predictive values were 0.64% and 0.70%. The area under the receiver operator characteristic curve was 0.892 for minimum rim width and 0.938 for retinal nerve fiber layer thickness. Conclusion: Our results indicated that the sector analysis based on Bruch’s membrane opening and fovea to disk alignment is able to detect glaucomatous defects, and that Bruch’s membrane opening minimum rim width and retinal nerve fiber layer thickness showed equivalent diagnostic ability.
Discontinuation of disease-modifying therapy in patients with multiple sclerosis over age 60
Authors: Hua Le H , Fan Tracey H , Conway Devon , Thompson Nicolas , Kinzy Tyler G 
Published: March 2018

Background: The risk–benefit ratio of continuing immunomodulating disease-modifying therapy (DMT) in older multiple sclerosis (MS) patients is unknown. Objective: To evaluate clinical and patient-reported outcomes after stopping DMT in older MS patients. Methods: Retrospective, observational study identifying patients from our MS clinics who were aged over 60 and on DMT > 2 years. Cause-specific Cox proportional hazards regression modeled time to discontinuation and time to reinitiation of therapy. Pre- and post-discontinuation comparisons of Performance Scales (PS), Timed 25-Foot Walk, and Patient Health Questionnaire-9 (PHQ9) were analyzed using linear mixed models. Results: A total of 600 patients were included, with 178 (29.7%) discontinuing. Discontinuers were 2.2 years older, had 3.2 years longer disease duration, and 1.6 years lesser treatment exposure. Providers initiated discontinuation more than patients (68.0%). Only one clinical relapse occurred in discontinuers. A proportion (10.7%) reinitiated DMT. Provider-initiated discontinuers restarted less often (hazard ratio (HR): 0.34; 95% confidence interval (CI): 0.12–0.9). In discontinuers, relapsing-remitting patients had lower PS on average than primary progressive. Provider-initiated discontinuation was associated with lower PS than patient- initiated discontinuation. PHQ9 scores appeared higher in those stopping intravenous (IV) therapies than interferons. Lower PS and PHQ9 indicate better outcomes. Conclusion: Most patients over age 60, who discontinued DMT, remained off DMT. This study provides real-world data that may guide clinicians considering discontinuing DMT.
Managing behavioural and psychological symptoms in community dwelling older people with dementia: 2. A systematic review of qualitative studies
Authors: Braun Andreas , Trivedi Daksha P , Dickinson Angela , Hamilton Laura , Goodman Claire , Gage Heather , Ashaye Kunle , Iliffe Steve , Manthorpe Jill 
Published: March 2018

Background People living with dementia often develop distressing behavioural and psychological symptoms (BPSD) that can affect their quality of life and the capacity of family carers and staff providing support at home. This systematic review of qualitative studies considers the views and experiences of people living with dementia and care providers about these symptoms and what helps to reduce their impact. Methods The two-stage review involved (a) An initial mapping of the literature to understand the range of BPSD, and how it is operationalised by different groups, to develop a search strategy; (b) A search of electronic databases from January 2000 to March 2015, updated in October 2016. Included studies focused on people living in their own homes. Data extraction and thematic analysis were structured to provide a narrative synthesis of the evidence. Results We retrieved 17, 871 records and included relevant qualitative papers (n = 58) targeting community-dwelling people with dementia and family carers around the management of BPSD. Five key themes were identified: (1) Helpful interventions/support for BPSD management, (2) Barriers to support services for BPSD management, (3) Challenges around recognition/diagnosis of BPSD, (4) Difficulties in responding to aggression and other BPSD, and (5) Impact of BPSD on family carers and people living with dementia. Conclusions Family carers sometimes feel that their experiences of BPSD may not be evident to professionals until a crisis point is reached. Some helpful services exist but access to support, lack of knowledge and skills, and limited information are consistently identified as barriers to their uptake. The lack of common terminology to identify and monitor the range of BPSD that people with dementia living at home may experience means that closer attention should be paid to family carer accounts. Future research should include qualitative studies to evaluate the relevance of interventions.
Variation of Traditional Biomarkers of Liver Injury After an Ultramarathon at Altitude
Authors: Tirabassi Jill N. , Olewinski Lucianne , Khodaee Morteza 
Published: March 2018

Background: Significant elevations of traditional biomarkers of liver injury can occur as a result of running an ultramarathon. Hypothesis: Traditional serum biomarker levels of liver injury will significantly increase as the result of participating in this 161-km race at altitude. Study Design: Prospective cross-sectional study. Level of Evidence: Level 3. Methods: A total of 64 (before) and 83 (after) volunteer runners participated in a prospective observational field-based study at the Leadville 100 ultramarathon race. Changes in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), creatine kinase (CK), and bilirubin levels were measured. Results: Of 669 athletes who started the race, 352 successfully completed the race within the 30-hour cutoff (53%). Of 36 runners who had pre- and postrace blood samples taken, the mean ALT, AST, and bilirubin levels were increased from 23 ± 10 U/L, 23 ± 5 U/L, and 0.60 ± 0.29 mg/dL to 117 ± 106 U/L, 485 ± 500 U/L, and 1.60 ± 0.61 mg/dL, respectively (all P < 0.001). There was no change in the mean ALP level ( P = 0.11). There were no significant correlations between postrace ALT, AST, ALP, lactate dehydrogenase (LDH), and bilirubin levels and athletes’ age, sex, body mass index, or finishing time. Significant positive linear correlations between AST, ALT, and LDH with CK were seen. Athletes in this study did not seek medical attention after the race based on an electronic survey (92% response rate). Conclusion: Significant elevations of traditional biomarkers of liver injury occurred as a result of running an ultramarathon at altitude. These correlated with CK, a marker of muscle injury. Clinical Relevance: When reviewing laboratory studies of traditional biomarkers of liver injury in athletes after an ultramarathon, significant elevations may be seen from baseline but are likely to be of no clinical consequence.
A qualitative exploration of psychosocial specialists’ experiences of providing support in UK burn care services
Authors: Guest Ella , Griffiths Catrin , Harcourt Diana 
Published: March 2018

Introduction: A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Methods: Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Results and Discussion: Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Conclusion: Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.
Cannabis and psychosis: what do we know and what should we do?
Authors: Colizzi Marco , Murray Robin 
Published: March 2018

SummaryIt is now incontrovertible that heavy use of cannabis increases the risk of psychosis. There is a dose–response relationship and high potency preparations and synthetic cannabinoids carry the greatest risk. It would be wise to await the outcome of the different models of legalisation that are being introduced in North America, before deciding whether or not to follow suit.Declaration of interestNone.