bluuebunny/crossref_metadata_2025_split huggingface dataset:
Short-term Changes After Corticosteroid Injections Into the Normal Tendons of Rabbits: A Controlled Randomized Study
Authors: Dinhane Kandir Genesio Innocenti , Godoy-Santos Alexandre Leme , Fabro Alexandre Todorovic , Moretto Maria Regina , Deprá Igor , Yoshida Winston Bonetti 
Published: January 2019

Background: Corticosteroid injections in or around tendons for the treatment of athletic injuries are a common practice among orthopaedic surgeons and are apparently efficacious in the short term, although controversies persist related to local complications. Purpose: This study evaluated short-term (48 hours) biomechanical, biochemical, and histological alterations after a single injection of betamethasone into the normal tendons of rabbits. Study Design: Controlled laboratory study. Methods: A total of 72 New Zealand White rabbits were randomly divided into 2 groups: the test group—in which 36 animals underwent 1 intratendinous injection of betamethasone (1.4 mg / 0.2 mL) in the right calcaneal tendon; the control group—in which the right calcaneal tendon of 36 animals was injected with saline (placebo control group) and the left calcaneal tendon was left untreated for normal standards (normal control). Forty-eight hours later, animals were euthanized and tendons were harvested. Metalloproteinase (MMP1 and MMP2) and interleukin (IL1 and IL6) expression levels, biomechanical resistance (load × elongation parameters), and histomorphometry (hematoxylin and eosin and picrosirius red stains for collagen fibers, tenocytes, and inflammatory cells) were analyzed in the tendons. Results: The test group had a significant reduction in MMP2 expression as compared with the control groups ( P = .027). Regarding the other parameters, there were no additional significant differences between the groups. Conclusion: A single injection of corticosteroid into normal calcaneal tendons did not trigger acute local morphological, structural, or biomechanical injuries at 48 hours, but it did promote a significant decrease in MMP2 levels. Additional studies are needed with increased duration of follow-up, various doses, and multiple injections and in tendinopathic models. Clinical Relevance: Some previous studies demonstrated early structural changes in tendons after a single corticosteroid injection, which was not corroborated by the present study. Metalloproteinase decrease is usually associated with a reduction in collagen degradation, which would be protective for the healing process. More studies are necessary to confirm the possible beneficial effect of these results in the long term and for tendinopathies.
A pilot study investigating the effect of pedalling exercise during dialysis on 6-min walking test and hand grip and pinch strength
Authors: Desai Manasi , Mohamed Ahmed , Davenport Andrew 
Published: January 2019

Introduction: Haemodialysis patients are at an increased risk of sarcopenia. Physical inactivity is now recognised as a major cause of muscle wasting in haemodialysis patients. It is unclear as to what and how much exercise is required to show benefit. We therefore performed a pilot study of cycling during haemodialysis. Methods: Patients underwent a progressive submaximal individualised cycling exercise, 3× a week during haemodialysis for 4 months using bed-cycle ergometers. Body composition was measured by multifrequency segmental bioimpedance and muscle function by 6-min walking test, and hand grip strength and pinch strength. Results: In total, 56% of patients in a dialysis centre fulfilled exercise study inclusion criteria and 13 (72.2%) of 18 patients completed the exercise programme, with the mean age of 64.0 ± 16.6 years and 76.9% being male. The 6-min walking test increased following exercise from 349 ± 105 to 398 ± 94.2 m, p < 0.05, as did both hand grip strength and pinch strength, with 20.4 ± 9.1 versus 23.4 ± 9.9 kg, p < 0.01, and 4.3 ± 1.8 versus 5.9 ± 2.4 kg, p < 0.05, respectively. There were no changes in appendicular muscle mass or other body composition detected with bioimpedance in either the exercise group, or 21 control patients, propensity matched for body composition, comorbidity and frailty. Muscle strength did not change in the control group. Haemodialysis sessional Kt/Vurea was greater at the end of the exercise programme compared to controls (1.63 ± 0.63 vs 1.21 ± 0.12, p < 0.01). Conclusion: The majority of dialysis centre patients met our exercise study entry criteria and could potentially benefit from cycling during haemodialysis. We found that muscle function and strength improved after a 4-month, thrice weekly cycling exercise programme.
Emergency at sea. Wading through the chaos of emotions
Authors: Del Bono Diletta 
Published: January 2019

This article draws attention to the advantages of applying the theoretical model of the experiential group in particularly critical conditions, such as those dictated by a state of emergency, as a means of addressing an urgent need by putting up a sort of decompression chamber for emotional residues derived from the difficult and sometimes extreme work situations experienced by the participants. The shared participation in the unwholesome experience unites and creates familial bonds, and is infectious, giving back a universal language for the encounter with other cultures that are unknown to us. Not only that, the state of emergency gives rise to another form of language, the language of meaningful action, where doing as an institutional practice—acting together to save human lives—allows the structuring and consolidation of a sense of identity to which the strong ‘esprit de corps’ emerges, also told by the crew as the experiential groups bears witness.
Clinical Trial Assessment of Intermittent and Continuous Infusion Dose of N-Acetylcysteine on Redox Status of the Body in Patients with Sepsis Admitted to the ICU
Authors: Peivandi Yazdi Arash , Razavi Majid , Sheikh Shahrzad , Boroumand Nadia , Salehi Maryam , Hashemy Seyed Isaac 
Published: January 2019

Purpose: Conflicting results exist regarding the efficacy of N-acetyl cysteine (NAC) in sepsis treatment. A pivotal factor affecting the therapeutic potency of NAC in sepsis is timing and dosing of its infusion. We aimed to assess the effect of NAC on redox status of patients with sepsis and to compare its efficacy in intermittent and continuous infusion with the objective of developing the infusion regimen and optimizing the timing. Materials and Methods: A prospective, randomized clinical trial was designed to compare the antioxidative effect of NAC in intermittent infusion group (IV: 25 mg/kg bolus and then 25 mg/kg/8 hours 3 times) and continuous infusion group (IV: 25 mg/kg bolus and then 75 mg/kg over 24 hours) in 60 critically ill patients with sepsis (20 patients in each group). Blood samples were collected immediately before and after intervention for total antioxidant capacity (TAC) and malondialdehyde (MDA) assessment. Results: N-acetyl cysteine considerably increased TAC levels in both intermittent (0.68 ± 0.60; P value = .036) and continuous (0.69 ± 0.64; P value = .015) infusion groups when compared to placebo (0.61 ± 0.10); however, the difference in TAC levels between the intermittent and the continuous infusion did not reach statistical significance ( P value = .942). Likewise, NAC treatment decreased MDA levels in both intermittent (19.45 ± 4.18; P value = 0.001) and continuous (22.47 ± 6.68; P value = .002) infusion groups when compared to placebo (31.76 ± 11.06), while the difference in MDA levels between the intermittent and the continuous infusion did not reach statistical significance ( P value = .481). Conclusion: Our data confirmed the antioxidative effect of NAC treatment in patients with sepsis, with no significant difference in intermittent and continuous infusion.
The Clinical Utility of the TYM and RBANS in a One-Stop Memory Clinic in Singapore: A Pilot Study
Authors: Dong YanHong , Ling Melissa Tan Yi , Ng Kelly Ee Teng , Wang Aijing , Wan Esther Yee Shuang , Merchant Reshma A. , Venketasubramanian Narayanaswamy , Chen Christopher Li-Hsian , Mahendran Rathi , Collinson Simon Lowes 
Published: January 2019

Background: We aimed to examine the discriminant validity of a brief self-administered cognitive screening test, the Test Your Memory (TYM) and a brief neuropsychological test, the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), supplemented with executive and language tests (Color Trail Test [CTT] and modified Boston Naming Test [mBNT], respectively), in detecting cognitive impairment (CI) in a one-stop memory clinic in Singapore. Methods: Ninety patients ≥50 years old with a diagnosis of no cognitive impairment, mild cognitive impairment, and mild Alzheimer disease were recruited from memory clinic. They received the TYM, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), RBANS, CTT, mBNT, and a gold-standard formal neuropsychological test battery. Results: The TYM had a significantly larger area under the curve (AUC) than MMSE (0.96 vs 0.88, P = .03) and was equivalent to MoCA in detecting CI (0.96 vs 0.95, P = .80). At the optimal cutoff points, the TYM (<38) was significantly more sensitive than the MMSE (<24) and MoCA (<20; P < .001). The RBANS had an AUC equivalent to the RBANS supplemented with CTT and mBNT (0.92 vs 0.86, P = .22) in detecting CI. The RBANS supplemented with CTT and mBNT was more sensitive than RBANS alone in detecting CI (sensitivity: 0.98 vs 0.93, P = .016) among patients screened negative using TYM. Conclusion: The self-administered TYM is superior to MMSE and equivalent to MoCA in detecting CI and could be implemented routinely. The RBANS supplemented with CTT and mBNT is more sensitive in detecting CI than RBANS alone therefore could be used for diagnostic purposes.
Implementation of an Advanced Pharmacy Practice Model in the Emergency Department
Authors: Sin Billy , Ciaramella Christine , Stein Greg , Butel Shalom , Thompson Holly , de Souza Sylvie , DiGregorio Robert 
Published: January 2019

Study Objective The objective of this retrospective descriptive study was to quantify clinical activities performed by pharmacists in an advanced pharmacy practice model in the emergency department (ED). Methods Data from January 2015 to August 2017 extracted from the department of pharmacy’s electronic documentation system and the hospital’s electronic medical record were collected and reviewed. Cost savings was derived from the system with adaptation from the previous literature and had been validated by our institution’s administration as an acceptable reflection of the impact for activity. Results The ED pharmacy team participated in a total of 4106 clinical activities that resulted in a cumulative cost avoidance of $5 387 679. Overall, the most common clinical activities that the pharmacy team provided included pharmacotherapy consult (63.3%) and response to medical emergencies (20.7%). A total of 16 219 medication orders placed by ED clinicians were prospectively reviewed and 379 interventions were accepted by ED clinicians. Turnaround times for medication verification in median (interquartile range [IQR]) for 2015, 2016, and 2017 were 2 minutes (1-6 minutes), 3 minutes (1-6 minutes), and 2 minutes (1-5 minutes), respectively. A total of 14 peer-reviewed publications, primarily based on pharmacy practice or use of pharmacotherapy for acute pain, were published by a research program led by the ED pharmacotherapist. Conclusion We created and implemented an advanced practice model tailored to our institution’s needs. The model maximized opportunities for pharmacists to provide direct patient care, practice at the top of their license, and encouraged the safe and effective use of medications.
Engaging the Dog Owner Community in the Design of an Effective Koala Aversion Program
Authors: David Patricia , Rundle-Thiele Sharyn , Pang Bo , Knox Kathy , Parkinson Joy , Hussenoeder Felix 
Published: January 2019

Introduction: This article outlines a dog owner–focused social marketing pilot program implemented in 2017, which aimed to reduce koala and domestic dog interactions in one local city council in Australia. Literature: Dog attacks and predation are the third most common cause of death in koalas after habitat loss and vehicle strikes. Programs aiming to reduce wildlife and domestic pet interactions frequently neglect human dimensions, and social sciences have been called upon to complement conservation efforts. Methods: Developed in consultation with dog training experts and the local regional council Leave It was based on input from 41 dog owners. Leave It was a 4-week training program priced at AUD$150 that was delivered by local dog trainers who had previously received specialized koala aversion training. Findings: Co-design results indicated that the social marketing pilot program needed to emphasize training, be positive, and be dog and not koala-focused. A fun, positive dog-focused event, supported by dog retailers, entertainers, and food service providers, was held in June 2017 to launch the Leave It program. Outcome evaluations for Leave It indicated a statistically significant increase in wildlife aversion–related behaviors (stay, come back every time/some of the time, and stay quiet on command). Process evaluation indicated that people enjoyed the dog-focused event and the opportunity to seek training and obedience advice. Conclusions: Co-designing the program with dog owners in the local council area engaged community members, making them contributors rather than program participants. The program had a dog focus rather than wildlife focus as recommended by dog owners.
The Multidimensional Benefits of an Employee Recreation Program
Authors: Gaskins David A. 
Published: January 2019

Employee Recreation represents a unique departmentally sponsored program designed to improve recruitment, retention, enjoyment, enthusiasm and commitment among student employees. It is popular and fun for employees but also has personal management advantages, strong marketing implications, and administrative benefits. The rationale for the program centers upon its effectiveness as a medium to positively impact programs and personnel. The opportunity to separately assemble employees in a setting which combines sports/ recreation with social ingredients has the potential to stimulate some exceptional staff dynamics. When blended properly, these components can increase excitement, motivation, and personal investment in the department as an employee while also improving camaraderie, teamwork, and morale. Positive word-of-mouth through one-on-one interaction between student staff and peers is extremely pertinent to recruitment and retention of staff but has even greater worth for promoting the program to participants. It also affords a strategic opportunity to expose, educate, and energize this group concerning activities which may be chosen. Administratively, employee recreation establishes a forum for empowering student personnel to exercise organizational and planning skills while also supplying a laboratory environment to field test various activities and gather evaluative feedback to assist in their refinement. The format and structuring of the program should contain a number of fundamental components and address several important issues. After goals, objectives, and outcomes have been determined, a committee of student employees should be assembled to advise, recommend, select, plan, organize, promote, and administer the events. Commitment is another major factor necessary for success and includes allocating staff time, providing marketing support, and establishing a scheduling system which is convenient and does not adversely conflict with normal staffing times for activities and lor facilities. Financing options include departmental sponsorship and subsidy, support by the employees themselves, or by generating money through the formation of a campus organization. Ultimately it is the actual selection and composition of the activity calendar which will make or break the program. Events should be chosen because their appeal, affordability, appropriateness, potential for return benefit, contribution to diversification, and ease of administration. Employee recreation is an exceptional innovation which captures many of the values and principles integral to the essence of recreational sports, represents a wise investment in the most important resource of the program-the student staff, and establishes a win-win environment for everyone involved.
What Are Diabetes Patients Versus Health Care Personnel Discussing on Social Media?
Authors: Årsand Eirik , Bradway Meghan , Gabarron Elia 
Published: January 2019

Background: Use of social media is increasing rapidly, also in health care and diabetes. However, patients, health care personnel, and patient organizations discuss diabetes on social media very differently. This has led to a lack of common ground when these stakeholders communicate about diabetes and a gap in understanding one another’s point of view. Social media have a potential for improved communication if each stakeholder group knows about, acknowledges, and accepts one another’s perspective. Method: We extracted and analyzed posts from three Norwegian Facebook groups representing patients, patients’ organization, and health care personnel. Qualitative content analysis was done to find the distribution of main categories, followed by a thematic analysis of subcategories that were posted and discussed. Results: The patient organization’s posts are the most equally distributed over the four main identified categories: scientific content, health care services, self-management, and diabetes awareness. The closed patient group’s posts were dominated by self-management; the open diabetes nurses’ group was dominated by diabetes awareness. The three social media groups differed substantially in what and how they posted and discussed within the main topics. The nurses’ open group had percentage-wise both the most liked and commented post, and the posts on self-management had the highest average number of comments. Conclusions: There is a big discrepancy in posted information and discussions on social media, between patient closed group, patient organization open group, and health care personnel open group. To reach the aim of using social media for better health, there is a need for more information of what is posted and discussed in the other groups, to harmonize and ensure safe and accurate dissemination of information.
Return to Sport Activity After Meniscal Allograft Transplantation: At What Level and at What Cost? A Systematic Review and Meta-analysis
Authors: Grassi Alberto , Bailey James R. , Filardo Giuseppe , Samuelsson Kristian , Zaffagnini Stefano , Amendola Annunziato 
Published: January 2019

Context: Meniscal injuries are common among both sport- and non–sport-related injuries, with over 1.7 million meniscal surgeries performed worldwide every year. As meniscal surgeries become more common, so does meniscal allograft transplantation (MAT). However, little is known about the outcomes of MAT in active patients who desire to go back to preinjury activities. Objective: The purpose of this systematic review and meta-analysis was to evaluate return to sport, clinical outcome, and complications after MAT in sport-active patients. Data Sources: A systematic search of MEDLINE, EMBASE, and CINAHL electronic databases was performed on February 25, 2018. Study Selection: Studies of level 1 through 4 evidence looking at MAT in physically active patients with reported return to activity outcomes and at least 2-year follow-up were included. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 4. Data Extraction: Details of sport-related outcomes and reoperations were extracted and pooled in a meta-analysis. Results: Nine studies were included in this systematic review. A majority (77%) of athletes and physically active patients were able to return to sport after MAT; two-thirds were able to perform at preinjury levels. Graft-related reoperations were reported in 13% of patients, while the joint replacement rate with partial or total knee prosthesis was 1.2%. Conclusion: Physical activity after MAT appears possible, especially for low-impact sports. However, because of the limited number of studies, their low quality, and the short-term follow-up, the participation recommendation for high-impact and strenuous activities should be considered with caution until high-quality evidence of long-term safety becomes available.
Preserving right ventricular function in patients with pulmonary arterial hypertension: Single centre experience with a cardiac magnetic resonance imaging‐guided treatment strategy
Authors: Huis in ’t Veld Anna E. , Van de Veerdonk Mariëlle C. , Spruijt Onno A. , Groeneveldt Joanne A. , Marcus J. Tim , Westerhof Nico , Jan Bogaard Harm , Noordegraaf Anton Vonk 
Published: January 2019

The feasibility and usefulness of routine cardiac magnetic resonance imaging (CMR) in the management of idiopathic pulmonary arterial hypertension (IPAH) is unknown. The aims of the study were: 1) to study whether a decrease in CMR‐derived right ventricular ejection fraction (RVEF) coincides with clinical deterioration; 2) to determine whether RVEF is responsive to early escalation of pulmonary arterial hypertension (PAH)‐specific therapy. This was a prospective study including 30 incident IPAH patients. Patients underwent right heart catheterization and CMR at regular follow‐up visits (baseline, four, eight, 12, 24 months; no right heart catheterization at eight months). New York Heart Association (NYHA) functional class II patients started with monotherapy (endothelin receptor antagonist or phosphodiesterase‐5‐inhibitor) and NYHA III patients with combination therapy (endothelin receptor antagonist plus phosphodiesterase‐5‐inhibitor). In the case of a deterioration in RVEF of more than 3% compared with the previous measurement, PAH‐specific therapy was added (i.e. treatment escalation). In 11 patients without signs of clinical deterioration, a greater than 3% decrease in RVEF occurred. After treatment escalation, RVEF significantly improved (average improvement of 7%, p = 0.009) whereas right ventricle volumes, N‐terminal pro‐brain natriuretic peptide and six‐minute walking distance remained stable. Clinical worsening did not occur after escalating therapy. Throughout the study, four patients presented with clinical worsening, despite a stable RVEF. Three of these four patients had a baseline RVEF <35%. In IPAH patients presenting with an early decrease in RVEF but otherwise stable disease, progressive right ventricle failure and subsequent clinical worsening did not occur when therapy was escalated. Nevertheless, clinical worsening did occur in patients with a low baseline RVEF.