bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association Between Length of Recovery Following Sport-Related Concussion and Generic and Specific Health-Related Quality of Life in Adolescent Athletes: A Prospective, Longitudinal Study
Authors: Valovich McLeod Tamara , Bay R. Curtis , Lam Kenneth C. , Snyder Valier Alison R. 
Published: June 2018

Objective:
Our purpose was to determine the association between concussion recovery and health-related quality of life (HRQOL).

Setting:
Secondary school athletic training facilities.

Participants:
Patients (N = 122) with a concussion.

Study Design:
Prospective, longitudinal cohort.

Main Measures:
The Pediatric Quality-of-Life Inventory (PedsQL), PedsQL Multidimensional Fatigue Scale (MFS), and Headache Impact Test-6 (HIT-6) were completed at preseason and days 3 (D3), 10 (D10), and 30 (D30) postconcussion. The independent variable was the recovery group.

Results:
Interactions between group and time (P < .001) were noted for all PedsQL subscales, except Social Functioning (P = .75). Significantly lower scores were found among Prolonged than in Short on D3 (P < .05). Significant interactions (P < .001) were also noted for all MFS subscales. Pairwise comparisons for General and Sleep subscales revealed Prolonged had lower scores than Short and Moderate on D3 and D10. A group by time interaction was found for the HIT-6 (P < .001), with scores being higher (P < .01) in Prolonged than in Short on D3 and D10.

Conclusions:
Adolescents with a prolonged recovery demonstrated lower HRQOL in the immediate days postinjury, particularly in physical and school functioning, fatigue, and headache. There was a strong association between recovery length and school functioning. Additional research is needed to understand how to minimize the impact of concussion on HRQOL.
Race/Ethnicity and Retention in Traumatic Brain Injury Outcomes Research: A Traumatic Brain Injury Model Systems National Database Study
Authors: Sander Angelle M. , Lequerica Anthony H. , Ketchum Jessica M. , Hammond Flora M. , Gary Kelli Williams , Pappadis Monique R. , Felix Elizabeth R. , Johnson-Greene Douglas , Bushnik Tamara 
Published: June 2018

Objective:
To investigate the contribution of race/ethnicity to retention in traumatic brain injury (TBI) research at 1 to 2 years postinjury.

Setting:
Community.

Participants:
With dates of injury between October 1, 2002, and March 31, 2013, 5548 whites, 1347 blacks, and 790 Hispanics enrolled in the Traumatic Brain Injury Model Systems National Database.

Design:
Retrospective database analysis.

Main Measure:
Retention, defined as completion of at least 1 question on the follow-up interview by the person with TBI or a proxy.

Results:
Retention rates 1 to 2 years post-TBI were significantly lower for Hispanic (85.2%) than for white (91.8%) or black participants (90.5%) and depended significantly on history of problem drug or alcohol use. Other variables associated with low retention included older age, lower education, violent cause of injury, and discharge to an institution versus private residence.

Conclusions:
The findings emphasize the importance of investigating retention rates separately for blacks and Hispanics rather than combining them or grouping either with other races or ethnicities. The results also suggest the need for implementing procedures to increase retention of Hispanics in longitudinal TBI research.
Traumatic Brain Injury and the Risk for Subsequent Crime Perpetration
Authors: Bonow Robert H. , Wang Jin , Zatzick Douglas F. , Rivara Frederick P. , Rowhani-Rahbar Ali 
Published: June 2018

Objective:
To examine whether patients with traumatic brain injury (TBI) are at higher risk for subsequent crime perpetration compared with injured patients without TBI and those hospitalized for reasons other than injury.

Setting and Participants:
Patients hospitalized in Washington State from 2006-2007.

Design:
A retrospective cohort study using linked statewide datasets.

Main measures:
Primary outcomes were arrest for any violent or nonviolent crime within 5 years of discharge. Adjusted subhazard ratios were calculated using regression models incorporating death as a competing risk.

Results:
Compared with uninjured patients (n = 158 247), the adjusted rate of arrest for any crime was greater among injured patients with TBI (n = 6894; subdistribution hazard ratios [sHR], 1.57; 95% confidence interval [CI], 1.49-1.62) and without TBI (n = 40 035; sHR, 1.55; 95% CI, 1.49-1.62). When patients with TBI were directly compared with injured patients without TBI, no effect of TBI on subsequent arrests was found (sHR, 1.02; 95% CI, 0.94-1.11). TBI did not increase the likelihood of either violent or nonviolent crime when these outcomes were examined separately.

Conclusions:
TBI survivors do not appear to be at increased risk for criminality compared with injured individuals without TBI. However, injured persons with or without TBI may be at elevated risk of crime perpetration compared with those who are uninjured.
Preloaded Descemet Membrane Endothelial Keratoplasty Donor Tissue: Surgical Technique and Early Clinical Results
Authors: Newman Lara R. , DeMill David L. , Zeidenweber Dorian A. , Mayko Zachary M. , Bauer Alex J. , Tran Khoa D. , Straiko Michael D. , Terry Mark A. 
Published: June 2018

Purpose:
To describe the technique, advantages, and early complication rates of using Descemet membrane endothelial keratoplasty (DMEK) donor tissue that is prestained and preloaded into an injector at the eye bank and delivered in a storage medium to the surgeon for transplantation 1 to 2 days later.

Methods:
A total of 111 eyes with endothelial failure underwent DMEK using donors that were prestripped, prestained, S-stamped, and preloaded into a Straiko modified Jones tube and delivered in an Optisol-filled viewing chamber 1 to 2 days later. Scroll tightness, time to unscroll and center the tissue, postoperative rebubble rate, and graft failure rate were recorded. Endothelial cell density was measured at 3 and 6 months.

Results:
All tissues remained well stained with easy visualization at the time of surgery (n = 111). The mean scroll tightness was 2.2 (range: 1–4). The mean time to center and unscroll the tissue was 3.5 minutes (range: 0.5–11.25 min). There was no primary graft failure. There were 16 cases with the placement of another bubble postoperatively (with a 14.4% rebubble rate). Of those 16 cases, 2 required a second rebubble. Endothelial cell loss at 3 and 6 months postoperatively was 26.7% (n = 63 eyes) and 30.9% (n = 67 eyes), respectively.

Conclusions:
This is the first report of the clinical use of prestained, preloaded tissue for DMEK. The characteristics and handling of the tissue were not different from those of surgeon-loaded tissue. Because punching, staining, and loading the graft intraoperatively is not necessary, the surgery time and risk of damaging donor tissue are reduced when using preloaded tissue.
Possible Risk Factors and Clinical Outcomes of Black Areas in Small-Incision Lenticule Extraction
Authors: Ma Jiaonan , Wang Yan , Chan Tommy C. Y. 
Published: June 2018

Purpose:
To investigate the possible risk factors and clinical effects of black areas in small-incision lenticule extraction.

Methods:
Thirty-one cases and 126 controls were enrolled in a case–control study from the database of a single center from September 2012 to July 2017. A retrospective analysis of surgical procedures with video and medical records was performed. Logistic regression analysis was used to assess the possible risk factors for black areas between cases with black areas and controls without black areas.

Results:
In the study, 19 eyes (61.3%) with black areas were associated with the presence of surface debris, 10 of which had repeated suction during docking and centration (P < 0.001). There was a significant difference in the energy of the femtosecond laser used for the cases (133 ± 4.04 nJ) and controls (138 ± 3.26 nJ) (P < 0.001). The odds ratio for the energy of the laser was 0.180 (95% confidence interval, 0.099–0.328, P < 0.001). Eyes with black areas had poorer uncorrected vision at 1 and 7 days and 1 month postoperatively (0.06, 0.01, and 0.00 logMAR, respectively) compared with controls (−0.01, −0.07, and −0.05 logMAR, respectively) (P < 0.005). At month 3, the safety index was lower in the cases (1.14 ± 0.47) compared with controls (1.36 ± 0.28) (P = 0.003). The postoperative spherical equivalent in the cases was more myopic than in controls (P = 0.036), except for month 3 (P = 0.183).

Conclusions:
Black areas in small-incision lenticule extraction could be caused by repeated suction, presence of surface debris, and a lower energy of the femtosecond laser. These factors could result in rough dissection and slower recovery of visual acuity.
Endothelium-in Versus Endothelium-out Insertion With Descemet Membrane Endothelial Keratoplasty
Authors: Price Marianne O. , Lisek Marek , Kelley Meagan , Feng Matthew T. , Price Francis W. 
Published: June 2018

Purpose:
To determine whether graft orientation during insertion affects Descemet membrane endothelial keratoplasty (DMEK) outcomes.

Methods:
This was a retrospective analysis of 754 consecutive DMEK cases performed by 2 experienced surgeons to treat Fuchs dystrophy. Both surgeons used an intraocular lens insertor. One surgeon always inserted the tissue scrolled endothelium outward (group 1, n = 245). The other surgeon tested 3 methods: endothelium-outward scroll configuration (group 2, n = 161), endothelium-inward trifold configuration (group 3, n = 172), and trifold configuration with concurrent use of an anterior chamber maintainer (group 4, n = 176). The main outcome measures were rebubbling rate, regrafting or failure within 6 months, and 6-month endothelial cell loss. The tissue unfolding time from graft insertion to air fill was measured in a subset of 120 cases by 1 surgeon.

Results:
The rebubbling rates were comparable across groups (ie, 12%, 10%, 10%, and 13% for groups 1, 2, 3, and 4, respectively, P = 0.21). The 6-month graft failure/replacement rates were comparable across groups (ie, 0.8%, 1.2%, 2.3%, and 0.6%, respectively, P = 0.18). Similarly, the 6-month endothelial cell loss did not differ significantly between groups (ie, 28% ± 11%, 30% ± 13%, 28% ± 15%, and 27% ± 13%, respectively, P = 0.019). In the subset analysis, the tissue unfolding time was similar for scroll and trifold configurations (6.0 ± 3.5 vs. 5.4 ± 3.0 minutes, respectively, P = 0.43).

Conclusions:
The outcomes were similar for endothelium-out and endothelium-in (trifold) insertion methods with DMEK, suggesting that the choice is a matter of surgeon preference.
Sensory profiles and skin innervation of patients with painful and painless neuropathies
Authors: Üçeyler Nurcan , Vollert Jan , Broll Barbara , Riediger Nadja , Langjahr Melissa , Saffer Nadine , Schubert Anna-Lena , Siedler Gabriela , Sommer Claudia 
Published: June 2018

Abstract
We assessed pain characteristics and sensory profiles of a large and extensively phenotyped cohort of patients with polyneuropathies (PNPs) and small fiber neuropathy (SFN) using quantitative sensory testing (QST). Our aim was to detect potentially discriminative QST profiles of patient subgroups determined by pain, etiology, or skin innervation. We prospectively recruited 350 patients with painful and painless PNPs and with SFN at 1 neuromuscular center. After neurological work-up, patients underwent QST at the dorsal foot and 5-mm skin punch biopsy at the lower leg and upper thigh for intraepidermal nerve fiber counts. A healthy control group of 273 volunteers was investigated accordingly. Pain was present in 50% of the patients with PNP with a median intensity of 6/10 on a numeric rating scale, and, by definition, in all patients with SFN, with a median intensity of 5/10 numeric rating scale. Axonal PNP was painful more often than demyelinating PNP (P < 0.01). Patients with PNP mostly had loss of function profiles, whereas most patients with SFN belonged to the gain of function (hyperalgesia) phenotype. In healthy controls, skin innervation positively correlated with sensory thresholds, whereas this correlation was lost in patients with PNP and SFN. Quantitative sensory testing did not distinguish between painful and painless neuropathies regarding small fiber function, but revealed higher mechanical pain (P < 0.01) and detection thresholds (P < 0.05) and lower mechanical pain sensitivity in the group of patients with painful neuropathies. Etiological neuropathy subgroups were not distinguished by QST.
Comparison of Uninjured and Concussed Adolescent Athletes on the Concussion Balance Test (COBALT)
Authors: Massingale Shelly , Alexander Amy , Erickson Steven , McQueary Elizabeth , Gerkin Richard , Kisana Haroon , Silvestri Briana , Schodrof Sarah , Nalepa Bryce , Pardini Jamie 
Published: June 2018

Background and Purpose:Dizziness and balance problems are common symptoms following sports-related concussion (SRC). Most sports require high-level balance skills that integrate the sensory inputs used for balance. Thus, a comprehensive assessment of postural control following SRC is recommended as an integral part of evaluation and management of the injury. The purpose of this exploratory study was to examine performance differences between uninjured and concussed athletes on the Concussion Balance Test (COBALT), as well as complete preliminary analyses of criterion-related validity and reliability of COBALT.Methods:COBALT is an 8 condition test developed for both preseason and postinjury assessment using force plate technology to measure sway velocity under dynamic postural conditions that challenge the vestibular system. Retrospective COBALT data obtained through chart review for 132 uninjured athletes and 106 concussed age-matched athletes were compared.Results:All uninjured athletes were able to complete the assessment, compared with only 55% of concussed athletes. Concussed athletes committed significantly more errors than uninjured athletes. Sway velocity for concussed athletes was higher (worse) than that for uninjured athletes on 2 conditions in COBALT.Discussion and Conclusions:By examining an athlete's ability to complete the protocol, error rate, and sway velocity on COBALT postinjury, the clinician can identify balance function impairment, which may help the medical team develop a more targeted treatment plan, and provide objective input regarding recovery of balance function following SRC.Video Abstract availablefor more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A204).
Activity and Exercise Intolerance After Concussion: Identification and Management of Postural Orthostatic Tachycardia Syndrome
Authors: Miranda Nicole A. , Boris Jeffrey R. , Kouvel Kristen M. , Stiles Lauren 
Published: June 2018

Background and Purpose:
Postural orthostatic tachycardia syndrome (POTS) is increasingly recognized as a complication affecting recovery from concussion. Individuals with POTS demonstrate refractory dizziness, lightheadedness, cognitive dysfunction, fatigue, headache, chronic pain, nausea and gastrointestinal dysmotility, activity and exercise intolerance, syncope, and tachycardia. Subtypes of POTS may include hypovolemia, hyperadrenergic states, autonomic neuropathy, and underlying autoimmunity, which may variably impact response to rehabilitation in varying ways. The subtle presentation of POTS postconcussion is often mistaken for underlying anxiety, conversion disorder, or lack of motivation for recovery. This article will present clinical features of POTS that may arise after concussion, and propose a role for physical therapists in the diagnosis and management of POTS during concussion recovery.

Summary of Key Points:
Data recorded and entered into a database during clinic visits from a large pediatric institution indicate that 11.4% of individuals diagnosed with POTS report onset of symptoms within 3 months of sustaining a concussion. Activation of the sympathetic nervous system can result in lightheadedness, shortness of breath, chest pain, tachycardia, palpitations on standing or with exertion, and activity and exercise intolerance. Identified comorbidities in people with POTS such as joint hypermobility and autoimmune disorders can further influence recovery.

Recommendations for Clinical Practice:
Physical therapists may identify signs and symptoms of POTS in a subset of individuals who remain refractory to typical interventions and who exhibit symptom exacerbation with orthostatic activity. Incorporation of an individualized POTS exercise program into current established concussion interventions may be useful, with emphasis on initial recumbent exercises and ongoing physical therapy assessment of exercise tolerance for dosing of activity intensity and duration.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A211).
Do Healthier Meals Cost More?
Authors: Huang Yue , Houser Robert F. , Roberts Susan B. , Lichtenstein Alice H. 
Published: June 2018

One barrier to achieving healthier eating patterns is the perceived higher cost of healthier food. The objective of this cross-sectional study was to investigate the potential association between cost and the nutrition quality among entrées from casual dining restaurants.
Nutrition and price information were collected from 11 restaurants in Boston metropolitan area. A nutrition quality metric (Estimated Nutrition Score [ENS]) was developed based on the 2015-2020 Dietary Guidelines for Americans to allow comparisons between more healthy and less healthy entrées. Associations between entrée price and ENS were assessed as continuous variables and dichotomized based on median ENS, availability of “small,” “half,” and “light” options, and with or without calories as a component of the score.
Of the 11 restaurant chains meeting the inclusion criteria, the association between ENS and price was significant for 6. Of those 6, more healthy options were less expensive at 4 restaurants, and more healthy options were more expensive at 2 restaurants. Eliminating small, half, and light options from the analyses resulted in a null association for 1 restaurant in the former category. Eliminating calories from the score resulted in loss of a significant association between price and ENS for all 6 restaurants, whereas for 2 additional restaurants, significant negative relationships were detected.
There was no consistent association between ENS and entrée price in the sample assessed. Hence, within the category of restaurants evaluated, customers can often choose healthier entrées that are priced less than or equal to less healthy entrées.
FDG PET/CT in a Case of Human African Trypanosomiasis (Sleeping Sickness)
Authors: Xiao Zhengguang , Dong Aisheng , Wang Yang 
Published: June 2018

Abstract
Human African trypanosomiasis imported to nonendemic countries is rare. It is very difficult to establish the correct diagnosis of human African trypanosomiasis in nonendemic areas. We present a case of human African trypanosomiasis with MRI and FDG PET/CT findings. Head MRI showed hyperintense areas in bilateral internal capsules. Abdominal and pelvic MRI showed hepatosplenomegaly and multiple enlarged lymph nodes. FDG PET/CT showed generalized hypermetabolic lymph nodes, diffuse FDG uptake of the spleen, and hepatosplenomegaly mimicking lymphoma. In addition, FDG PET/CT revealed decreased FDG uptake in the medial occipital cortex and cardiomegaly with pericardial effusion.
Total Salvianolic Acid Injection Prevents Ischemia/Reperfusion-Induced Myocardial Injury Via Antioxidant Mechanism Involving Mitochondrial Respiratory Chain Through the Upregulation of Sirtuin1 and Sirtuin3
Authors: Huang Dan-Dan , Wei Xiao-Hong , Mu Hong-Na , Pan Chun-Shui , Li Quan , Hu Bai-He , Chang Xin , Yan Li , Fan Jing-Yu , Liu Yu-Ying , Luo Jian-Yuan , Han Jing-Yan 
Published: June 2018

ABSTRACT
Sirtuin1 (Sirt1) and Sirtuin3 (Sirt3) are known to participate in regulating mitochondrial function. However, whether Total Salvianolic Acid Injection (TSI) protects against myocardial ischemia/reperfusion (I/R) injury through regulating Sirt1, Sirt3, and mitochondrial respiratory chain complexes is unclear. The aim of this study was to explore the effects of TSI on I/R-induced myocardial injury and the underlying mechanism. Male Sprague–Dawley rats were subjected to 30 min occlusion of the left anterior descending coronary artery followed by 90 min reperfusion with or without TSI treatment (8 mg/kg/h). The results demonstrated that TSI attenuated I/R-induced myocardial injury by the reduced infarct size, recovery of myocardial blood flow, and decreased cardiac apoptosis. Moreover, TSI protected heart from oxidative insults, such as elevation of myeloperoxidase, malondialdehyde, hydrogen peroxide, ROS, as well as attenuated I/R-elicited downregulation of Sirt1, Sirt3, NADH dehydrogenase [ubiquinone] 1 alpha subcomplex 10 (NDUFA10), succinate dehydrogenase complex, subunit A, flavoprotein variant (SDHA), and restoring mitochondrial respiratory chain complexes activity. The in vitro study in H9c2 cells using siRNA transfection further confirmed the critical role of Sirt1 and Sirt3 in the effect of TSI on the expression of NDUFA10 and SDHA. These results demonstrated that TSI attenuated I/R-induced myocardial injury via inhibition of oxidative stress, which was related to the activation of NDUFA10 and SDHA through the upregulation of Sirt1 and Sirt3.
Phloem structure and development in Illicium parviflorum, a basal angiosperm shrub
Authors: Losada Juan M. , Holbrook N. Michele 
Published: June 2018

SUMMARYRecent studies in canopy-dominant trees revealed a structure-function scaling of the phloem. However, whether axial scaling is conserved in woody plants of the understory, the environments of most basal-grade angiosperms, remains mysterious. We used seedlings and adult plants of the shrub Illicium parviflorum to explore the anatomy and physiology of the phloem in their aerial parts, and possible changes through ontogeny. Adult plants maintain a similar proportion of phloem tissue across stem diameters, but scaling of conduit dimensions and number decreases the hydraulic resistance towards the base of the plant. Yet, the small sieve plate pores resulted in an overall higher sieve tube hydraulic resistance than has been reported in other woody angiosperms. Sieve elements scaled from minor to major leaf veins, but were shorter and narrower in petioles. The low carbon assimilation rates of seedlings and mature plants contrasted with a three-fold higher phloem sap velocity in seedlings, suggesting that phloem transport velocity is modulated through ontogeny. While the overall architecture of the phloem tissue in basal-angiosperm understory shrubs scales in a manner consistent with trees, modification of conduit connections may have allowed woody angiosperms to extend beyond their understory origins.