bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Tablet-Based Volunteer-Mediated Intervention for Cognitively Impaired Older People: A Pretest–Posttest
Authors: Chen Ke , Lou Vivian Wei Qun , Lo Selina Siu Ching 
Published: July 2019

Purpose: This study evaluated the potential effectiveness of a tablet-based, volunteer-led intervention (Lok Chi In-home Training) for cognitively impaired older people in improving cognitive and emotional health. Method: A one-group pretest and posttest design was adopted, involving 57 community-dwelling older people with cognitive impairments (Montreal Cognitive Score between 13 and 22, without neuropsychiatric behavioral problem). Trained volunteers performed eight in-home training sessions using a tablet to facilitate. Outcome measures include cognitive function, depression, activity of daily living, and instrumental activity of daily living. Results: A paired sample t test indicated that after receiving Lok Chi In-home Training, participants showed significantly large improvements on cognitive ability, moderate improvements on depression, and small improvements on instrumental activity of daily living. Conclusions: This study demonstrated the feasibility and potential benefits of Lok Chi intervention for improving cognition and emotion.
Depression Reduction Among Acupuncture Patients in an Interprofessional Study
Authors: Leung Patrick , Cheung Monit , Hou Liwen , Webb Ann E. , Chen Xin , Hune Nikki 
Published: July 2019

Purpose: Acupuncture as a sole treatment was tested for patients with depressive symptoms when seeking treatment in an interprofessional project. This study aims to test the relative effects of depression-specific acupuncture treatment (DSAT) versus nondepression-specific acupuncture treatment (Non-DSAT) on depression scores of patients seeking acupuncture care. Method: In this chart-review quasi-experimental study, former patient charts were randomly selected from a 3-year record at two college-operated acupuncture clinics in Houston. Among them, 62 charts contained depression data measured by the Hopkins Symptoms Checklist-25 (HSCL-25). Results: Data show that 39 patients received DSAT and 23 patients received Non-DSAT, but none of them indicated depression as a reason for treatment. After treatment, although the prevalence rate was lower, the average depression score was higher in both groups. Further analysis with the mixed between-within-subjects analysis of variance showed insignificant group interactive effects on the depression score change. Discussion: Depression outcomes between the two groups were not conclusive. Acupuncture as a depression treatment method should be further tested with a longitudinal research design focusing on patients with depressive symptoms. The role of social workers is essential so that depression screening can be accurately conducted.
Cone-Beam Computed Tomography Evaluation of Skeletal Deformities and Pharyngeal Airway in Chinese Han Individuals With Nonsyndromic Unilateral Cleft Lip and Palate
Authors: Zhang Yuan , Wang Yuhua , Zhang Yaoyuan , Li Sheng , Wang Lin , Qian Yajing 
Published: July 2019

Objective: This study examined the relationships between skeletal deformities and the pharyngeal airway of patients with nonsyndromic unilateral cleft lip and palate (UCLP). Design: Retrospective study. Setting: Orthodontics and Oral and Maxillofacial Surgery Departments in the Affiliated Hospital of Stomatology, Nanjing Medical University, China. Patients, Participants: The sample comprised 30 nonsyndromic UCLP patients and 30 healthy controls. Each group has 23 males and 7 females. Interventions: All cone-beam computed tomography images were obtained with the participant in the standard supine position and asked to bite with intercuspal position without swallowing or moving their heads and tongues during scanning. Main Outcome Measure(s): SNA, SNB, ANB, anterior cranial base, Wits appraisal, maxillary length (PTM-ANS || FH), maxillary position (S-PTM || FH), mandibular length (Go-Pog || MP), FMA, posterior face height, anterior face height, Posterior-Anterior face height, lower face height, pharyngeal airway volumes, and areas were evaluated by Dolphin imaging software. Results: The UCLP group showed significantly decreased SNA, SNB, ANB, PTM-ANS || FH, S-PTM || FH, P-A Face Height compared with the controls. However, the airway volumes and areas showed no significant difference between 2 groups. The total airway volume and minimum cross-sectional area in UCLP patients were related to the Go-Pog || MP and FMA. Conclusions: Patients with UCLP have both the maxillary and mandibular deficiencies in the sagittal dimension. Both the sagittal and vertical relationships of the jaw might affect the airway volume and area. However, no significant difference was detected in airway volume and area in UCLP patients when compared with the controls.
Controlling Nutritional Status (CONUT) Score as a Predictor of All-Cause Mortality at 3 Months in Stroke Patients
Authors: López Espuela Fidel , Roncero-Martín Raúl , Zamorano Juan Diego Pedrera , Rey-Sanchez Purificación , Aliaga-Vera Ignacio , Portilla Cuenca Juan Carlos , Naranjo Ignacio Casado , Morán-García José María , Lavado-García Jesús María 
Published: July 2019

Malnutrition is frequently observed in patients after stroke and is associated with poor outcomes. Patients at risk of malnutrition may be identified with several nutrition screening tools, but no nutritional screening tool has been validated for use with stroke patients. The aim of this study was to explore the ability of the Controlling Nutritional Status (CONUT) score to predict 3-month mortality in stroke patients. Method: Patients were recruited from consecutive admissions at a hyperacute stroke unit and were screened for risk of malnutrition (light, moderate, or severe) using CONUT scores. At the next visit, 3-month outcomes were obtained. Results: Of the 164 recruited patients, 51.2% were male. Mean patient age was 77.7 ( SD = 7.0) years, and 85.8% of patients had an ischemic stroke. There was a significant difference in the survival rate ( p < .001) at 3 months between patients with moderate risk for malnourishment compared to the other patients. The multivariate regression Cox model showed that moderate risk of malnourishment, according to the CONUT score, increased the risk for death at 3 months (hazard ratio = 1.086; 95% CI [1.057, 8.305]; p < .039). Conclusion: The CONUT score has predictive validity for all-cause mortality in stroke patients after 3 months, both in hospital and after discharge. Further prospective multicenter studies with larger samples are needed to clarify the usefulness of the CONUT score in the prognosis of all-cause mortality in stroke patients.
Effects of Nocturnal Sleep Quality on Diurnal Cortisol Profiles and Attention in Nurses: A Cross-Sectional Study
Authors: Tsai Jui-Chen , Chou Kuei-Ru , Tsai Hsiu-Ting , Yen Yu-Chun , Niu Shu-Fen 
Published: July 2019

Objective: Low sleep quality (LSQ) activates the hypothalamic–pituitary–adrenal (HPA) axis and is related to arousal. Nursing staff, who work in shifts, tend to exhibit LSQ, which affects the level of vigor after awakening. This study investigated the effects of nocturnal sleep quality on diurnal cortisol profiles and sustained attention in day-shift nurses. Method: This study adopted a prospective cross-sectional design. Participants were recruited from a university-affiliated hospital in northern Taiwan. In the initial stage of this study, the Chinese Pittsburgh Sleep Quality Index (PSQI) Questionnaire was administered to 199 participants to categorize them as either LSQ (PSQI > 5) or high sleep quality (HSQ; PSQI ≤ 5). Participants were then randomly sampled from the two groups. Nocturnal sleep data and four diurnal saliva samples were collected for each participant. Sustained attention was measured before they started work. A total of 32 and 29 participants in the HSQ and LSQ groups, respectively, completed the data collection process. Results: Compared with the HSQ group, the LSQ group exhibited earlier wake-up times ( p = .02), a flatter cortisol awakening response (CAR) slope ( p < .01), a flatter morning-to-evening slope ( p < .01), and prolonged reaction speed and mean reaction time before starting work ( p < .01). Conclusion: Compared with the HSQ group, the LSQ group exhibited impaired HPA-axis regulation, with a flatter CAR and diurnal cortisol slope and poor sustained attention in the morning. Nursing staff are advised to achieve HSQ to improve attention and performance levels and maintain optimum work safety.
Large head ceramic-on-ceramic bearing in primary total hip arthroplasty: average 3-year follow-up of a multicentre study
Authors: Lavigne Martin , Vendittoli Pascal-André , Virolainen Petri , Corten Kristoff , Martinez Mariano , Zicat Bernard , Peter Viju , Bloem Rolf , Miazzolo Nicolas , Remes Ville 
Published: July 2019

Background: Surgeons are increasingly using larger femoral head sizes in total hip arthroplasty (THA) to improve stability and reduce the rate of dislocation, 1 of the leading causes of revision surgery. Large ceramic head sizes up to 48 mm can now be used with monoblock acetabular components. National registries have shown promising results at short-term with large diameter ceramic-on-ceramic THA, with very low revision rates. This study reports on the average 3-year follow up of a press-fit monoblock large diameter acetabular shell with a pre-assembled ceramic liner, with emphasis on the radiographic outcome, complications related to the implantation of the cup, and the patient’s clinical outcome. Methods: 170 hips in 169 patients were reviewed at an average 38 ± 5.8 months following surgery. Results: The radiographic review revealed no acetabular cup loosening, no osteolysis and no cup migration. 1 acetabular cup was revised for malposition. The patient clinical outcome and the satisfaction rate were excellent. At 3 years, 7.1% of patients complained of groin pain and 3.5% spontaneously reported hip joint generated noise. 1 patient sustained a non-recurrent traumatic hip dislocation 2 years post surgery. Conclusions: New technology should be introduced cautiously on the market. This is especially true for the large diameter ceramic monoblock acetabular component used in this study since it involves a new acetabular component design. At short term, we have not identified new modes of failure with this implant. Longer follow-up is still needed to assess the safety of large ceramic bearing in THA.
The short external rotators dissection during the posterior approach in total hip arthroplasty did not change the blood flow
Authors: Setoguchi Daisuke , Kinoshita Koichi , Ishimatsu Tetsuro , Ishii Satohiro , Yamamoto Takuaki 
Published: July 2019

Objectives: The posterior approach in total hip arthroplasty (THA) often requires dissection of the short external rotators (SERs), which could increase the postoperative dislocation rate. The reattachment of the dissected SERs has been reported to reduce the dislocation rate, while such repair generally causes progression of muscle atrophy. 1 of the suggested causes of atrophy is reduced blood flow to the repaired SERs. The present study aimed to measure the blood flow of the SERs before dissection (pre-tenotomy) and after reattachment (post-reattachment) during the posterior approach in THA. Methods: This prospective study included 26 patients who underwent THA via the posterior approach. A laser-Doppler rheometer was used to measure the blood flow in the following SERs at the time of pre-tenotomy and post-reattachment: the piriformis muscle (PM), superior gemellus (SG), inferior gemellus (IG), obturator internus (OI), and subcutaneous tissue as a control. Results: The average pre-tenotomy and post-reattachment blood flows (mL/minutes/100 g) were: 1.90 ± 0.28 and 1.92 ± 0.40 in the PM, 1.94 ± 0.20 and 1.99 ± 0.39 in the SG, 1.91 ± 0.21 and 1.94 ± 0.30 in the IG, 1.93 ± 0.22 and 1.98 ± 0.36 in the OI, and 1.94 ± 0.24 and 1.87 ± 0.38 in the subcutaneous tissue. The pre-tenotomy and post-reattachment blood flows did not show significant difference in any muscle. Conclusions: Laser-Doppler blood flow measurements showed that the blood flow is preserved, even when the SERs are dissected and reattached in THA via the posterior approach.
Modern trunnion designs do not affect clinically significant patient-reported outcomes
Authors: Ihekweazu Ugonna N , Lyman Stephen , Chiu Yu-fen , Vaynberg Idelle , Westrich Geoffrey 
Published: July 2019

Introduction: Trunnion geometry is known to vary between hip systems. Trunnionosis and the impact of trunnion design on total hip arthroplasty (THA) survival, has gained attention as a failure mechanism. We sought to report the differences in patient-reported outcome measures (PROMs) between the most commonly utilised modern THA trunnions. Methods: We reviewed primary unilateral THA patients from May 2007 to October 2011. The most frequently used stems were included. LEAS, HOOS subdomains, and SF-12 were obtained pre and post operatively while satisfaction was measured at 2 years after THA. Trunnions were grouped by taper geometry and manufacturer. The 2-year change in PROMs for each trunnion was compared to the pooled 2-year change in HOOS for all other trunnions. Results: 3950 THA patients were studied. 6 trunnion designs were evaluated from 5 manufacturers. The range in differences between the 2-year change in individual PROMs were as follows: HOOS pain (0.6–2.4), HOOS symptoms (0–3.8), HOOS ADL (0.4–4), and HOOS QOL (0.5–3.6). None of the differences in the 2-year change in PROMs reached a minimal clinically important change (MCIC), which we previously determined to be a minimum of 9 points for all HOOS domains. Conclusion: All of the trunnions designs utilised in our study cohort demonstrated excellent clinical results. Small differences were well below the known MCIC; and were not clinically relevant. The findings of this study should prompt further investigations into the long-term impact of trunnion design on clinical patient-reported outcomes.
The Frequency of Sexual Perpetration in College Men: A Systematic Review of Reported Prevalence Rates From 2000 to 2017
Authors: Anderson RaeAnn E. , Silver Kristin E. , Ciampaglia Alyssa M. , Vitale Amanda M. , Delahanty Douglas L. 
Published: July 2019

Background: The prevalence of sexual perpetration in college men is unknown. Prior reviews of sexual violence prevalence rates have produced wide-ranging estimates, likely due to wide variation in measurement strategies. Objectives: This article systematically reviewed research findings (from 2000 to 2017) regarding prevalence rates of sexual perpetration in college men and measurement strategies. Data Sources: PsycINFO and Web of Science databases. Eligibility Criteria: Empirical reports published between 2000 and 2017 that included male participants, available in English, and reported lifetime prevalence findings in Canadian or American college students. Participants: Data from 78 independent samples including 25,524 college men. Results: The average prevalence rate of any sexual perpetration was 29.3% ( SD = 16.8), and the average rate of rape was 6.5% ( SD = 6.3). Studies that used non-Sexual Experiences Survey (SES)–based questionnaires recorded higher prevalence rates (41.5%) than SES-using studies (26.2%). At least 16 different sexual perpetration questionnaires were identified. Modifying standardized questionnaires was extremely common; this was reported in over half of the studies. Studies using modified standardized questionnaires found higher prevalence rates of sexual perpetration than studies using nonmodified standardized questionnaires. Limitations: This report focused exclusively on college men in the United States and Canada. Conclusions and Implications: On average, 29% of college males report engaging in behaviors defined as sexual perpetration; however, there was a strong influence of measurement strategy on reported rates.
Angiographic assessment of the efficacy of flow diverter treatment for cerebral aneurysms
Authors: Sadasivan Chander , Dholakia Ronak , Peeling Lissa , Gölitz Philipp , Doerfler Arnd , Lieber Baruch B , Fiorella David J , Woo Henry H 
Published: July 2019

Background The recent growth of neuro-endovascular treatment has rekindled interest in the use of angiographic techniques for flow assessment. Aneurysm treatment with flow diverters is particularly amenable to such analysis. We analyze contrast time–density curves — recorded within aneurysms before (pre) and immediately after (post) flow diverter implantation to estimate six-month treatment outcomes. Methods Fifty-six patients with 65 aneurysms were treated with flow diverters at two institutions. A region of interest was drawn around the aneurysm perimeter in image sequences taken both pre and post angiography, and the temporal variation in grayscale intensity within the aneurysm (time–density curve) was recorded. Eleven parameters were quantified from each time–density curve. Aneurysm occlusion status was recorded six months post treatment. The change in parameters from pre to post treatment was statistically evaluated between aneurysm occluded and non-occluded groups. Results Of the 11 parameters, eight were significantly different before and immediately after flow diversion. Considering the entire data set, none of the parameters was statistically different between the occluded and non-occluded groups. However, subgroup analyses showed that four variables were significantly different between the aneurysm occluded and non-occluded groups. The sensitivity of these variables to predict aneurysm occlusion at six months ranged from 60% to 89%, while the specificity ranged from 55% to 70%. Conclusions Device-induced intra-aneurysmal flow alterations quantified by simple aneurysmal time–density curves can potentially be used to predict long-term outcomes of flow diversion. Large multi-center studies will be required to confirm these findings. Patient-to-patient variability in coagulation may need to be incorporated for clinically relevant predictive values.
Cardiac valve replacement for infective endocarditis in patients with end stage renal disease on hemodialysis — A single institution experience
Authors: Medicherla Ratna C , Phair John , Carnevale Matthew , Jakobleff William , Lipsitz Evan , Scher Larry 
Published: July 2019

Complications from vascular access are the leading cause of morbidity in the hemodialysis population. The use of tunneled catheters is associated with a greater risk of bacteremia and mortality when compared to other types of hemodialysis access. Infective endocarditis is a serious complication occurring in 2–5% of patients undergoing hemodialysis and is likely secondary to transient bacteremia from repetitive vascular access. Objective To review outcomes in hemodialysis-dependent patients requiring cardiac valve replacement for infective endocarditis. Methods A retrospective chart review was conducted to identify all patients who underwent valve replacement within a six-year period (January 2009–December 2014). Inclusion criteria included a diagnosis of infective endocarditis and end stage renal disease on hemodialysis. Relevant clinical information including demographics, comorbidities, valve involvement, causative organisms, and type of hemodialysis access (arteriovenous fistula, arteriovenous graft, or tunneled catheter) was collected. Results A total of 1497 patients underwent cardiac valve replacement within the six-year period. Of these, 167 patients (11.2%) had infective endocarditis and 119 patients (7.9%) had end stage renal disease on hemodialysis. Overall 30-day mortality for valve replacement was 5.0% (75/1497). Mortality for patients with infective endocarditis was 7.2% (12/167) and for patients with end stage renal disease on hemodialysis was 10.1% (12/119). Thirty-three patients (2.2%) had infective endocarditis and end stage renal disease on hemodialysis. Of these, 12 patients were being dialyzed via arteriovenous fistula, 4 via arteriovenous graft, and 17 via tunneled catheter. Mortality occurred in 2 of 12 patients with arteriovenous fistula, 1 of 4 patients with arteriovenous graft, and 2 of 17 patients with tunneled catheter for an overall mortality of 15.2% (5/33). Conclusion Infective endocarditis remains a significant problem in patients with end stage renal disease on hemodialysis, particularly when tunneled catheters are utilized for hemodialysis access. Although appropriate algorithms have been developed to minimize long term use of tunneled catheters, bacteremia remains a significant problem. We reviewed our institutional experience and the medical literature to determine outcomes in hemodialysis-dependent patients with infective endocarditis requiring valve replacement. Despite mortality rates between 42 and 73% reported in the literature, our mortality rate was 15.2%. 1 Care of these critically ill patients must emphasize early diagnosis and aggressive management to optimize outcomes.
The effect of patent expiration on sales of branded competitor drugs in a therapeutic class
Authors: Fujimoto Jeffrey , Tien Daniel M , Snyder Sophie , Hertz Jeppe A , Schweitzer Stuart 
Published: July 2019

Background Generic entry can lower pharmaceutical prices and yield significant cost savings for both patients and health systems. The effect of generic entry has often been measured by sales of the branded drug whose patent has expired, but what is less clear is how branded competitors within the same therapeutic class respond. Methods We analyzed the effect of patent expiration of the first innovative drug in a therapeutic class on competitor sales within the same therapeutic class for five major therapeutic classes using data obtained from IMS Health. Results Composite quantity sales decreased by 49%, 65%, and 67% in the first three years, respectively, following patent expiration. However, the effect of patent expiration was not uniformly negative; competitors were often able to obtain dominant market share. Additionally, factors beyond patent expiration may affect the rate and timing of branded market contraction which holds significant implications for drug pricing and sales. Conclusion Patent expiration is a consequential event for not only the drug undergoing patent expiration, but also the therapeutic class in which the drug is contained. Market dynamics change significantly for competitor-branded products which warrant further research.