bluuebunny/crossref_metadata_2025_split huggingface dataset:
Psychometric properties of the Spanish version of the Engagement in Meaningful Activities Survey in people with serious mental illness
Authors: Prat Gemma , Ribot Arantxa , Recoder Sílvia , Muñoz Francisco 
Published: June 2019

Introduction Facilitating engagement in meaningful activities is a key intervention in the recovery process of people with serious mental illness. This study validates the use of the Engagement in Meaningful Activities Survey in the Spanish mental health population for the purposes of measuring such engagement. Method Two hundred and ninety-five people with serious mental illness (68.3% were male; M = 47.5, SD = 9.7 years) participated voluntarily and anonymously in the study. All gave written informed consent. A translation into Spanish and back-translation to English was made. Reliability and validity of the Engagement in Meaningful Activities Survey was assessed by the internal consistency, temporal stability and dimensionality of the scale. Results The Cronbach’s alpha of the Engagement in Meaningful Activities Survey scale was 0.91 and the intraclass correlation coefficient was 0.76. Confirmatory factor analysis revealed a two-factor structure of the scale (χ2 = 93.906, p < .001; comparative fit index = .96, Tucker–Lewis index = .95, root-mean-square error of approximation (90% confidence interval) = .05 (.03–.07) and standardized root mean square residual = .04). All the items showed significant standardized factor loadings above .59. Correlation between the two factors was .97 ( p < .001). Conclusion The instrument could be useful for assessing engagement in meaningful activities and helpful for recovery process interventions focused on enhancing community adjustment in people with serious mental illness.
Frontal Plane Loading Characteristics of Medial Collateral Ligament Strain Concurrent With Anterior Cruciate Ligament Failure
Authors: Schilaty Nathan D. , Bates Nathaniel A. , Krych Aaron J. , Hewett Timothy E. 
Published: June 2019

Background: Both the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) bear load during athletic tasks of landing, cutting, pivoting, and twisting. As dynamic knee valgus is a purported mechanism for ACL injury, the MCL should bear significant strain load with valgus force. Hypothesis: The intact MCL will demonstrate a significant increase in strain upon failure of the ACL at 25° of knee flexion. Study Design: Controlled laboratory study. Methods: In vivo kinetics/kinematics of 44 healthy athletic participants were measured to determine stratification of injury risk (ie, low, medium, and high) in 3 degrees of knee forces/moments (knee abduction moment, anterior tibial shear, and internal tibial rotation). These stratified kinetic values were input into a cadaveric impact simulator to assess ligamentous strain during a simulated landing task. Uniaxial and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect mechanical data for analysis. Conditions of external loads applied to the cadaveric limbs were varied and randomized. Results: ACL strain increased with increased dynamic knee abduction moment (χ2[5] = 14.123, P = .0148). The most extreme dynamic knee abduction moment condition demonstrated significantly higher ACL strain compared with lower loaded trials ( P≤ .0203). Similarly, MCL strain increased with dynamic knee abduction moment (χ2[5] = 36.578, P < .0001). Matched-pairs analysis compared ACL strain with MCL strain (maximum ACL strain – maximum MCL strain) and demonstrated high strain for the ACL versus the MCL ( S177 = 6223.5, P < .0001). Conclusion: Although significant, MCL strain had minimal increase with increased dynamic knee abduction moment, and the event of ACL failure did not significantly increase MCL strain when compared with high dynamic knee abduction moment conditions in the cadaveric model. The ACL bears more strain than the MCL at increasing amounts of dynamic knee abduction moment at 25° of knee flexion, which may explain the limited concomitant MCL injury rate that can occur during a dynamic valgus collapse of the knee. Clinical Relevance: These characteristics of ACL and MCL strain are important to understand the mechanisms that drive these injuries at the knee and will improve rehabilitation and injury prevention techniques.
Statin Effects on Incidence, Treatment Success, and Mortality of Clostridium difficile Infections
Authors: Gaviola Marian L. , Scribe Emily C. , Leverett Haley N. , Howard Meredith L. 
Published: June 2019

Purpose To review the effects of statin use in patients at risk for or diagnosed with Clostridium difficile infection (CDI) on CDI incidence, treatment success, and mortality. Methods A literature search was performed through January 2019 using the following terms: statins, HMG-CoA inhibitors, Clostridium difficile, Clostridium difficile associated diarrhea, and Clostridium difficile infection. Additional references were identified from a review of literature citations. Studies evaluating statin effects on C difficile-related outcomes were included. Results A total of 8 studies were identified for inclusion in this review. All studies were retrospective. Five studies reported the association between statin use and the development of CDI, suggesting that statins may decrease risk of CDI development in patients already on statin. In one study, there was an improved treatment response against CDI with the use of statin. Three retrospective studies evaluated statin use and mortality from CDI and only one study found significant mortality benefit in statin users. Conclusions Statin use may have a protective effect against the development of CDI and improve CDI treatment success; however, it is unclear if use confers a mortality benefit. Current data remain sparse and larger, prospective studies are needed to confirm current results and identify the specific population that may benefit the most from this intervention.
Evaluation of the Two-Bag System in Adult Diabetic Ketoacidosis Patients
Authors: Cho Nam , Bushell Tommy , Choi Mia , Moussavi Kayvan 
Published: June 2019

Purpose: Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus (DM). This study was designed to assess if the two-bag (TB) system, which utilizes 2 intravenous (IV) fluid bags, one containing sodium chloride and the other containing sodium chloride and dextrose, is an effective and safe alternative to the traditional one-bag (OB) system in adults with DKA. Methods: A retrospective review was performed at an academic medical center. Adults with DKA were included if treated with the OB or TB system. The primary outcome was time to anion gap closure. Secondary outcomes included duration of insulin infusion, time to serum bicarbonate correction, number of continuous IV fluid orders, intensive care unit (ICU) and hospital length of stay (LOS), and rates of hypoglycemia and hypokalemia. Results: One hundred twenty-two patients were included. Sixty-eight were treated with the OB system and 54 with the TB system. There were no differences in time to anion gap closure, duration of insulin infusion, ICU LOS, or hospital LOS. Time to bicarbonate correction was shorter in the OB group (13.5 [IQR: 7-29] vs 25 [IQR: 11-50] hours; P = .03). There were no differences in rates of hypoglycemia or hypokalemia between groups. Conclusion: The TB system had similar efficacy and safety when compared to the OB system. Both approaches can be considered in adults with DKA.
Fluoxetine in progressive multiple sclerosis: The FLUOX-PMS trial
Authors: Cambron Melissa , Mostert Jop , D’Hooghe Marie , Nagels Guy , Willekens Barbara , Debruyne Jan , Algoed Luc , Verhagen Wim , Hupperts Raymond , Heersema Dorothea , De Keyser Jacques , De Groot Liesbeth , De Bruyne Jan , Foselle Erwin , Guillaume Daniel , Merckx Henri , Vanopdenbosch Ludo , Vokaer Mathieu , Klippel Nina De , Nuytten Dirk , Van Remoortel Ann , Symons Anoek , D’haeseleer Miguel , Bissay Veronique , Van Merhaegen-Wieleman Annick , Van Lint Michel , Michiels Veronique , Haentjens Patrick , Van Wijmeersch Bart , Tillemans Bart , Van Hecke Wim , Hengstman Gerald 
Published: June 2019

Background: Preclinical studies suggest that fluoxetine has neuroprotective properties that might reduce axonal degeneration in multiple sclerosis (MS). Objective: To determine whether fluoxetine slows accumulation of disability in progressive MS. Methods: In a double-blind multicenter phase 2 trial, patients with primary or secondary progressive MS were randomized to fluoxetine 40 mg/day or placebo for a period of 108 weeks. Clinical assessments were performed every 12 weeks by trained study nurses who visited the patients at their home. The primary outcome was the time to a 12-week confirmed 20% increase in the Timed 25 Foot Walk or 9-Hole Peg test. Secondary outcomes included the Hauser ambulation index, cognitive tests, fatigue, and brain magnetic resonance imaging (MRI). Results: In the efficacy analysis, 69 patients received fluoxetine and 68 patients received placebo. Using the log-rank test ( p = 0.258) and Cox regression analysis ( p = 0.253), we found no significant difference in the primary outcome between the two groups. Due to an unexpected slow rate of progression in the placebo group, there was insufficient statistical power to detect a potential benefit of fluoxetine. We found no differences between the two groups for secondary outcomes. Conclusion: The trial failed to demonstrate a neuroprotective effect of fluoxetine in patients with progressive MS.
Outcomes of Triggering the Emergency Response Team at a High-Volume Arthroplasty Center
Authors: Saku S. A. , Linko R. , Madanat R. 
Published: June 2019

Background and Aims: Emergency Response Teams have been employed by hospitals to evaluate and manage patients whose condition is rapidly deteriorating. In this study, we aimed to assess the outcomes of triggering the Emergency Response Teams at a high-volume arthroplasty center, determine which factors trigger the Emergency Response Teams, and investigate the main reasons for an unplanned intensive care unit admission following Emergency Response Team intervention. Material and Methods: We gathered data by evaluating all Emergency Response Team forms filled out during a 4-year period (2014–2017), and by assessing the medical records. The collected data included age, gender, time of and reason for the Emergency Response Teams call, and interventions performed during the Emergency Response Teams intervention. The results are reported as percentages, mean ± standard deviation, or median (interquartile range), where appropriate. All patients were monitored for 30 days to identify possible intensive care unit admissions, surgeries, and death. Results: The mean patient age was 72 (46–92) years and 40 patients (62%) were female. The Emergency Response Teams was triggered a total of 65 times (61 patients). The most common Emergency Response Team call criteria were low oxygen saturation, loss or reduction of consciousness, and hypotension. Following the Emergency Response Team call, 36 patients (55%) could be treated in the ward, and 29 patients (45%) were transferred to the intensive care unit. The emergency that triggered the Emergency Response Teams was most commonly caused by drug-related side effects (12%), pneumonia (8%), pulmonary embolism (8%), and sepsis (6%). Seven patients (11%) died during the first 30 days after the Emergency Response Teams call. Conclusion: Although all 65 patients met the Emergency Response Teams call criteria, potentially having severe emergencies, half of the patients could be treated in the arthroplasty ward. Emergency Response Team intervention appears useful in addressing concerns that can potentially lead to unplanned intensive care unit admission, and the Emergency Response Teams trigger threshold seems appropriate as only 3% of the Emergency Response Teams calls required no intervention.
Iterative CT reconstruction in abdominal low-dose CT used for hybrid SPECT-CT applications: effect on image quality, image noise, detectability, and reader’s confidence
Authors: Grosser Oliver S , Ruf Juri , Kupitz Dennis , Czuczwara Damian , Loewenthal David , Thormann Markus , Furth Christian , Ricke Jens , Denecke Timm , Pech Maciej , Kreissl Michael C , Amthauer Holger 
Published: June 2019

Background Iterative computed tomography (CT) image reconstruction shows high potential for the preservation of image quality in diagnostic CT while reducing patients’ exposure; it has become available for low-dose CT (LD-CT) in high-end hybrid imaging systems (e.g. single-photon emission computed tomography [SPECT]-CT). Purpose To examine the effect of an iterative CT reconstruction algorithm on image quality, image noise, detectability, and the reader’s confidence for LD-CT data by a subjective assessment. Material and Methods The LD-CT data were validated for 40 patients examined by an abdominal hybrid SPECT-CT (U = 120 kV, I = 40 mA, pitch = 1.375). LD-CT was reconstructed using either filtered back projection (FBP) or an iterative image reconstruction algorithm (Adaptive Statistical Iterative Reconstruction [ASIR]®) with different parameters (ASIR levels 50% and 100%). The data were validated by two independent blinded readers using a scoring system for image quality, image noise, detectability, and reader confidence, for a predefined set of 16 anatomic substructures. Results The image quality was significantly improved by iterative reconstruction of the LD-CT data compared with FBP ( P ≤ 0.0001). While detectability increased in only 2/16 structures ( P ≤ 0.03), the reader’s confidence increased significantly due to iterative reconstruction ( P ≤ 0.002). Meanwhile, at the ASIR level of 100%, the detectability in bone structure was highly reduced ( P = 0.003). Conclusion An ASIR level of 50% represents a good compromise in abdominal LD-CT image reconstruction. The specific ASIR level improved image quality (reduced image noise) and reader confidence, while preserving detectability of bone structure.
Venous Thromboprophylaxis in Spine Surgery
Authors: Alvarado Anthony M. , Porto Guilherme B. F. , Wessell Jeffrey , Buchholz Avery L. , Arnold Paul M. 
Published: June 2019

Study Design: Review article. Objective: A review of the literature on postoperative initiation of thrombophylactic agents following spine surgery. Methods: A review of the literature and synthesis of the data to provide an update on venous thromboprophylaxis following spine surgery. Results: Postoperative regimens of venous thromboprophylaxis measures following spine surgery remain a controversial issue. Recommendations regarding mechanical versus chemical prophylaxis vary greatly among institutions. Conclusion: Postoperative spine surgery initiation of thromboprophylaxis remains controversial regarding optimal timing and agent selection. The benefits of deep vein thrombosis/pulmonary embolism prophylaxis must be weighed against the possible postoperative complications associated with spine surgery.
Prevalence and phenotypes of JAK2 V617F and calreticulin mutations in a Danish general population
Authors: Cordua Sabrina , Kjaer Lasse , Skov Vibe , Pallisgaard Niels , Hasselbalch Hans C. , Ellervik Christina 
Published: June 2019

AbstractThe JAK2 V617F and calreticulin mutations (CALR) are frequent within myeloproliferative neoplasms (MPNs). JAK2 V617F has been detected in the general population, but no studies have previously investigated the CALR prevalence. Thus, we aimed to determine the CALR and JAK2 V617F population prevalence and assess the biochemical profile and lifestyle factors in mutation-positive individuals with and without MPN. 19 958 eligible participants, enrolled from 2010-2013, from the Danish General Suburban Population Study were screened for JAK2 V617F and CALR by droplet digital polymerase chain reaction with (3.2%) mutation positives of which 16 (2.5%) had MPN at baseline. Of 645 participants, 613 were JAK2 V617F positive, and 32 were CALR positive, corresponding to a population prevalence of 3.1% (confidence interval [CI], 2.8-3.3) and 0.16% (CI, 0.11-0.23), respectively. Increasing age, smoking, and alcohol were risk factors for the mutations. JAK2 V617F positives with and without MPN presented elevated odds for prevalent venous thromboembolism. The odds ratio for a diagnosis of MPN per percentage allele burden was 1.14 (95% CI, 1.09-1.18; P = 1.6 × 10−10). Mutation positives displayed higher blood cell counts than nonmutated participants, and 42% of mutation positives without MPN presented elevation of ≥1 blood cell counts; 80 (13%) even presented blood cell counts in accordance with current MPN diagnostic criteria. In conclusion, we present a novel population prevalence of CALR and a JAK2 V617F prevalence that is 3 to 30 times higher compared with less sensitive methods. Mutation-positive non-MPNs with elevated blood cell counts raise concerns of MPN underdiagnosis in the population.
Machine learning techniques for personalized breast cancer risk prediction: comparison with the BCRAT and BOADICEA models
Authors: Ming Chang , Viassolo Valeria , Probst-Hensch Nicole , Chappuis Pierre O. , Dinov Ivo D. , Katapodi Maria C. 
Published: June 2019

Abstract
Background
Comprehensive breast cancer risk prediction models enable identifying and targeting women at high-risk, while reducing interventions in those at low-risk. Breast cancer risk prediction models used in clinical practice have low discriminatory accuracy (0.53–0.64). Machine learning (ML) offers an alternative approach to standard prediction modeling that may address current limitations and improve accuracy of those tools. The purpose of this study was to compare the discriminatory accuracy of ML-based estimates against a pair of established methods—the Breast Cancer Risk Assessment Tool (BCRAT) and Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) models.

Methods
We quantified and compared the performance of eight different ML methods to the performance of BCRAT and BOADICEA using eight simulated datasets and two retrospective samples: a random population-based sample of U.S. breast cancer patients and their cancer-free female relatives (N = 1143), and a clinical sample of Swiss breast cancer patients and cancer-free women seeking genetic evaluation and/or testing (N = 2481).

Results
Predictive accuracy (AU-ROC curve) reached 88.28% using ML-Adaptive Boosting and 88.89% using ML-random forest versus 62.40% with BCRAT for the U.S. population-based sample. Predictive accuracy reached 90.17% using ML-adaptive boosting and 89.32% using ML-Markov chain Monte Carlo generalized linear mixed model versus 59.31% with BOADICEA for the Swiss clinic-based sample.

Conclusions
There was a striking improvement in the accuracy of classification of women with and without breast cancer achieved with ML algorithms compared to the state-of-the-art model-based approaches. High-accuracy prediction techniques are important in personalized medicine because they facilitate stratification of prevention strategies and individualized clinical management.
Androgens Enhance Adult Hippocampal Neurogenesis in Males but Not Females in an Age-Dependent Manner
Authors: Duarte-Guterman Paula , Lieblich Stephanie E , Wainwright Steven R , Chow Carmen , Chaiton Jessica A , Watson Neil V , Galea Liisa A M 
Published: June 2019

AbstractAndrogens (testosterone and DHT) increase adult hippocampal neurogenesis by increasing survival of new neurons in male rats and mice via an androgen receptor pathway, but it is not known whether androgens regulate neurogenesis in female rats and whether the effect is age-dependent. We investigated the effects of DHT, a potent androgen, on neurogenesis in young adult and middle-aged male and female rats. Rats were gonadectomized and injected with the DNA synthesis marker bromodeoxyuridine (BrdU). The following day, rats began receiving daily injections of oil or DHT for 30 days. We evaluated cell proliferation (Ki67) and survival of new neurons (BrdU and BrdU/NeuN) in the hippocampus of male and female rats by using immunohistochemistry. As expected, DHT increased the number of BrdU+ cells in young males but surprisingly not in middle-aged males or in young and middle-aged females. In middle age, DHT increased the proportion of BrdU/NeuN cells, an effect driven by females. Androgen receptor expression also increased with aging in both female and male rats, which may contribute to a lack of DHT neurogenic effect in middle age. Our results indicate that DHT regulates adult hippocampal neurogenesis in a sex- and age-dependent manner.
Macronutrient-Mediated Inflammation and Oxidative Stress: Relevance to Insulin Resistance, Obesity, and Atherogenesis
Authors: Biobaku Fatimo , Ghanim Husam , Batra Manav , Dandona Paresh 
Published: June 2019

AbstractContextThe intake of macronutrients as components of a Western dietary pattern leads to oxidative stress and inflammation.Evidence AcquisitionData were largely retrieved from our previous and most recent work. PubMed and Google Scholar were searched for recent articles on the effect of macronutrients/dietary intake on inflammation, insulin resistance, obesity, and atherogenesis. The most relevant, high-quality articles were included in our review.Evidence SynthesisOur previous work has demonstrated the molecular mechanisms of macronutrient-mediated oxidative stress and inflammation. With the induction of inflammation, proinflammatory molecules potentially interfere with insulin signal transduction, thus causing insulin resistance. In addition, other molecules promote atherogenic inflammation. More recently, our work has also shown that certain foods are noninflammatory or anti-inflammatory and thus, do not interfere with insulin signaling. Finally, as obesity is induced by chronic excessive caloric intake, it is characterized by an increase in the expression of proinflammatory molecules, which are induced acutely by a Western diet. Caloric restriction, including fasting, is associated with a reduction in oxidative and inflammatory stress.ConclusionsThis review summarizes and attempts to provide an up-to-date profile of the molecular mechanisms involved in macronutrient-mediated oxidative/inflammatory stress and its potential consequences. An understanding of these underlying mechanisms is crucial for making appropriate dietary choices.