bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sports interest mediating exercise and compulsive internet use among undergraduates
Authors: Ting J , Chien K P , Dhir A , Chen S 
Published: June 2018

Summary
With the massive growth in Internet technologies, people have become wary of excessive Internet usage, known as compulsive Internet usage or Internet addiction. This study looks into how exercise is related to compulsive Internet usage. Previous research showed varying results regarding the relationship between sports habit and Internet usage; this project clarifies the relationship by investigating mediating variables in terms of interest in different aspects of sports, such as physical education, mastering sport skills, sports participation, and watching sports. Two survey studies were conducted. The participants were 232 male and 107 female Taiwanese undergraduate students in the first survey, totaling 339 students. The second survey had 233 males, 98 female students, and 2 who did not disclose their gender, with a final total of 333. The results reveal that interest in physical education (IPE) mediates sports habit and compulsive Internet usage. As long as the student had a habit of doing sports that increased IPE, this would in turn decrease compulsive Internet use. The importance of igniting students’ IPE is discussed.
Determinants of health behavior inequalities: a cross-sectional study from Israel
Authors: Bayram Tevfik , Donchin Milka 
Published: June 2018

Summary
Health behaviors are shaped by the opportunities people have; and the choices they make according to these opportunities. Inequality in economic, cultural and social resources causes disparities in health and health behaviors. Jerusalem has a multiethnic structure, mainly made up of Jews and Arabs. Arabs and Ultra-Orthodox Jews are disadvantaged in terms of socio-economic and health indicators. The purpose of this study is to determine the factors associated with three health behaviors: physical activity (PA), fruit and vegetable consumption, and smoking. This cross-sectional study was conducted among 1682 adults from a stratified sample by age, sex and neighborhood from 2011 to 2015, in accordance with the Healthy Cities project. Univariate analyses were conducted by Chi-square test of independence; and multivariate analyses by logistic regression models. Of the total population, 12% do adequate amounts of PA; 17.6% consume adequate amounts of fruits/vegetables; and 19.4% are current smokers. Multivariate analyses indicates for both genders: ethnicity/religion and education level is associated with doing PA; ethnicity/religion, education and income level is associated with fruit/vegetable consumption; and ethnicity/religion, and age is associated with smoking. However, gender significantly modifies the effect of ethnicity/religion for all the three health behaviors. Gender disparities regarding health behaviors are higher among Arabs and Ultra-Orthodox Jews. In similar economic, cultural and social circumstances, men and women have similar health behaviors; and unequal opportunity to education and income creates a vicious gender inequality cycle. Therefore, to reduce health behavior inequalities, besides economic and cultural inequalities, social and gender inequalities should also be reduced.
Apparent stability of a low-density Diadema antillarum regime for Puerto Rican coral reefs
Authors: Rodríguez-Barreras Ruber , Montañez-Acuña Alfredo , Otaño-Cruz Abimarie , Ling Scott D 
Published: June 2018

Abstract
Caribbean reefs have suffered decline in coral cover in recent decades due to recurrent anthropogenic and natural stressors. The regional collapse of the sea urchin Diadema antillarum, combined with overfishing, has contributed to a phase-shift of coral reef communities towards fleshy macroalgal dominance. Here, we examine the population dynamics of D. antillarum at five sites in Puerto Rico from 2011 to 2016 and determine trends between the sea urchin and local benthic habitats. The sea urchin population exhibited low but stable densities (with slight, but non-significant trend of increase), yet showed variability between sites. Large urchins (&gt;60 mm test diam.) were the most abundant across sites and through time, followed by medium urchins (41–60 mm test diam.), whereas small individuals (&lt;40 mm) were rare, indicating recruitment-limitation. Spatial and temporal differences in benthic habitats were not related to local D. antillarum abundances. Macroalgae cover declined at all sites over the 6 years, ranging 5–86%, whereas live coral cover also decreased across all sites (ranging 4–38%). Diadema antillarum populations in Puerto Rico appear stable with limited evidence for recovery trends back to pre-mass mortality densities. Full population recovery may take longer than expected; however, evidence indicates that the contemporary low-density D. antillarum population represents a novel stable regime.
Random permutations fix a worst case for cyclic coordinate descent
Authors: Lee Ching-pei , Wright Stephen J 
Published: June 2018

Abstract
Variants of the coordinate descent approach for minimizing a nonlinear function are distinguished in part by the order in which coordinates are considered for relaxation. Three common orderings are cyclic (CCD), in which we cycle through the components of $x$ in order; randomized (RCD), in which the component to update is selected randomly and independently at each iteration; and random-permutations cyclic (RPCD), which differs from CCD only in that a random permutation is applied to the variables at the start of each cycle. Known convergence guarantees are weaker for CCD and RPCD than for RCD, though in most practical cases, computational performance is similar among all these variants. There is a certain type of quadratic function for which CCD is significantly slower than for RCD; a recent paper by Sun & Ye (2016, Worst-case complexity of cyclic coordinate descent: $O(n^2)$ gap with randomized version. Technical Report. Stanford, CA: Department of Management Science and Engineering, Stanford University. arXiv:1604.07130) has explored the poor behavior of CCD on functions of this type. The RPCD approach performs well on these functions, even better than RCD in a certain regime. This paper explains the good behavior of RPCD with a tight analysis.
Potential Mechanisms of Age Acceleration Caused by Estrogen Deprivation: Do Endocrine Therapies Carry the Same Risks?
Authors: Sehl Mary E , Ganz Patricia A 
Published: June 2018

AbstractLonger duration of endocrine therapy decreases breast cancer recurrence and mortality, but these benefits need to be weighed against potential risks to overall health. Notable side effects of endocrine therapy include cataracts, uterine cancer, thromboembolic events, osteoporosis and fracture risk, chronic musculoskeletal complaints, as well as vaginal dryness and discharge, and vasomotor symptoms. Estrogen deprivation in healthy women younger than 50 years undergoing bilateral oophorectomy has been shown to accelerate the development of diseases related to aging, including coronary artery disease, cardiac arrhythmias, stroke, dementia, and osteoporosis, raising concern that even less dramatic modulation of estrogen homeostasis may adversely affect health outcomes. Diminished available estrogen at the cellular and molecular level may facilitate mechanisms that underlie the aging process, often termed the hallmarks of aging. In this review, we describe estrogen’s role in normal physiology across tissues, review the effects of estrogen deprivation on health outcomes in the setting of both surgical and natural menopause, and examine the hallmarks of aging with attention to the effects of estrogen and estrogen blockade on each molecular mechanism underlying the aging process.
Cerebral Aneurysms in Autosomal Dominant Polycystic Kidney Disease: A Comparison of Management Approaches
Authors: Wilkinson D Andrew , Heung Michael , Deol Amrit , Chaudhary Neeraj , Gemmete Joseph J , Thompson B Gregory , Pandey Aditya S 
Published: June 2018

Abstract

BACKGROUND
Autosomal dominant polycystic kidney disease (ADPKD) is a risk factor for formation of intracranial aneurysms (IAs), though the ideal screening and treatment strategies in this population are unclear.

OBJECTIVE
To report outcomes of observation, open surgical, or endovascular management of ruptured and unruptured aneurysms in patients with ADPKD.

METHODS
We performed a retrospective analysis of all patients with ADPKD and IAs at a single center from 2000 to 2016.

RESULTS
Forty-five patients with ADPKD harboring 71 aneurysms were identified, including 11 patients with subarachnoid hemorrhage (SAH). Of 22 aneurysms managed with observation, none ruptured in 136 yr of clinical follow-up. Thirty-five aneurysms were treated with open surgery and 14 with an endovascular approach. Among treated aneurysms, poor neurologic outcome (modified Rankin scale >2) was seen only in patients presenting with SAH (17% SAH vs 0% elective, P = .06). Acute kidney injury (AKI) was also significantly associated with SAH presentation (22% SAH vs 0% elective, P = .05). Neither procedural complications nor AKI were associated with treatment modality. Among 175 yr of radiographic follow-up in patients with known IAs, 8 de novo aneurysms were found, including 3 that were treated. Of 11 patients with SAH, 7 ruptured in the setting of previously known ADPKD, including 2 with prior angiographic screening and 5 without screening.

CONCLUSION
Poor outcomes occurred only with ruptured presentation but were equivalent between treatment modalities. Screening is performed only selectively, and 64% (7 of 11) of patients presenting with SAH had previously known ADPKD.
Total elbow arthroplasty versus plate fixation for distal humeral fractures in elderly patients: a systematic review and meta-analysis
Authors: Jordan Robert W. , Saithna Adnan , Kimani Peter , Modi Chetan , Drew Stephen , Lawrence Tom 
Published: June 2018

Background:
Distal humeral fractures represent about 1% to 2% of adult fractures. Open reduction and internal fixation (ORIF) has traditionally been the standard treatment; however, fracture comminution and osteoporotic bone may prevent adequate fixation, and total elbow arthroplasty (TEA) is an alternative. The aim of this meta-analysis was to determine which procedure provided superior clinical outcomes for elderly patients with distal humeral fractures.

Methods:
A systematic review of the literature was conducted in accordance with the PRISMA guidelines. Cases series and comparative studies reporting functional outcomes or complications after TEA and ORIF in patients over 60 yr of age with an acute distal humeral fracture were included. The studies were appraised using validated quality assessment scales. Results were pooled from different studies using meta-analysis techniques, and the functional outcomes, complications, and frequency of revision surgery were compared.

Results:
The search strategy identified 27 studies: one randomized controlled trial, four comparative studies, 14 ORIF cases series, and eight TEA case series. TEA was associated with statistically significant and clinically superior Mayo Elbow Performance score (MEPS) and Disability of the Arm, Shoulder and Hand (DASH) scores when compared to ORIF in elderly patients while having a statistically significant lower complication rate.

Conclusions:
Meta-analysis of comparative studies demonstrated that TEA is associated with statistically significant and clinically superior MEPS and DASH scores when compared to ORIF in elderly patients.
Predictors of mortality after isolated proximal humeral fractures in elderly patients
Authors: Hofmann Kurt J. , Prokuski Vanessa C. , Allar Benjamin G. , Tybor David , Ryan Scott P. 
Published: June 2018

Background:
The overall incidence of proximal humeral fractures is steadily growing, but little is known about the mortality rates after these fractures in elderly patients. As life expectancy continues to increase, knowledge of mortality rates and predictors of mortality for these fractures will become progressively more important. The purpose of this study was to present the 30-day and 1-year mortality of elderly patients who sustained isolated proximal humeral fractures and to evaluate potential risk factors for increased mortality.

Methods:
We identified 205 patients older than 60 yr with isolated proximal humeral fractures. Mean age was 74.3 yr (range, 60-99 yr) and mean follow-up was 3.9 yr (range, 5 days-8 yr). Thirty-day and 1-year mortality rates were calculated. Age, gender, fracture classification, patient disposition, initial treatment, Charlson Comorbidity Index (CCI) and van Walraven modified Elixhauser Comorbidity Index (ECI) were analyzed in Cox Proportional Hazards models to estimate effect on mortality.

Results:
Fifty-six percent of patients sustained Orthopaedic Trauma Association (OTA) 11-A fractures, 43% were OTA 11-B, and 1% were OTA 11-C. One hundred and sixty-six patients (81%) were treated nonoperatively. The 30-day mortality rate was 2.0%; 1-year mortality rate was 4.4%. Each additional year of patient age increased mortality 12% (hazard ratio [HR]=1.12, 95% confidence interval [CI]: 1.07, 1.17). Women did not differ from men (HR=1.74, 95% CI: 0.80, 3.77). Controlling for age and gender, there was no increased mortality in those admitted at time of injury (HR=1.89, 95% CI: 0.92, 3.88), or those with operative fixation (HR=0.78, 95% CI: 0.27, 2.29). After adjusting for age, neither CCI (HR=1.07, 95% CI: 0.95, 1.23) nor ECI (HR=1.01, 95% CI: 0.97, 1.06) affected mortality.

Conclusions:
The 1-year mortality for elderly patients with isolated proximal humeral fractures was 4.4%, lower than previously reported. Age increased mortality but comorbidity indices did not.

Level of Evidence:
Level IV, Therapeutic.
Implementation of a Flipped Classroom for Nuclear Medicine Physician CME
Authors: Komarraju Aparna , Bartel Twyla B. , Dickinson Lisa A. , Grant Frederick D. , Yarbrough Tracy L. 
Published: June 2018

Introduction:
Increasingly, emerging technologies are expanding instructional possibilities, with new methods being adopted to improve knowledge acquisition and retention. Within medical education, many new techniques have been employed in the undergraduate setting, with less utilization thus far in the continuing medical education (CME) sphere. This paper discusses the use of a new method for CME—the “flipped classroom,” widely used in undergraduate medical education. This method engages learners by providing content before the live (“in class”) session that aids in preparation and fosters in-class engagement.

Methods:
A flipped classroom method was employed using an online image-rich case-based module and quiz prior to a live CME session at a national nuclear medicine meeting. The preparatory material provided a springboard for in-depth discussion at the live session—a case-based activity utilizing audience response technology. Study participants completed a survey regarding their initial experience with this new instructional method. In addition, focus group interviews were conducted with session attendees who had or had not completed the presession material; transcripts were qualitatively analyzed.

Results:
Quantitative survey data (completed by two-thirds of the session attendees) suggested that the flipped method was highly valuable and met attendee educational objectives. Analysis of focus group data yielded six themes broadly related to two categories—benefits of the flipped method for CME and programmatic considerations for successfully implementing the flipped method in CME.

Discussion:
Data from this study have proven encouraging and support further investigations around the incorporation of this innovative teaching method into CME for nuclear imaging specialists.
Trends in Glaucoma Surgical Procedures in Portugal: A 16-Year Nationwide Study (2000-2015)
Authors: Barbosa-Breda João , Gonçalves-Pinho Manuel , Santos João V. , Rocha-Sousa Amândio , Abegão-Pinto Luís , Stalmans Ingeborg , Freitas Alberto 
Published: June 2018

Purpose:
Glaucoma leads as the first cause of irreversible blindness. The number of patients will greatly increase in upcoming years and changes will have to be accomplished to cope with those numbers. As such, data are important to understand the effect of new policies introduced in glaucoma management. Only few countries have described their glaucoma surgical profile and, in Europe, only the United Kingdom described the last 15 years. The aim of this study is to assess the glaucoma surgical profile and its changes in mainland Portugal from 2000 to 2015.

Methods:
Retrospective database analysis of inpatient and surgical outpatients’ episodes of all public hospitals in mainland Portugal was performed. The annual absolute numbers of ophthalmic procedures, as well as their surgical rate (per 100,000 inhabitants) were calculated.

Results:
Glaucoma patients undergoing glaucoma procedures were 67±14 years old and 50% were female. During the study period there was an increase in the number and surgical rate of glaucoma procedures. Trabeculectomy showed a stable surgical rate (7 per 100,000 inhabitants) despite a reduction in terms of relative weight among glaucoma procedures. At the same time, the surgical rate of glaucoma drainage devices and cyclophotoablation increased, while remaining stable for cyclocryoablation.

Conclusions:
In Portugal, trabeculectomy had a stable surgical rate throughout the study period, being the most performed glaucoma surgical procedure. Other surgeries, like glaucoma drainage devices and cyclophotoablation are gaining ground among glaucoma specialists. Our results match what has been published by other countries worldwide and can be used to achieve a better health planning.
Endophthalmitis Following XEN Stent Exposure
Authors: Karri Bhavani , Gupta Chandni , Mathews Divya 
Published: June 2018

Backround:
XEN45 Gel stents are in their infancy, and clinical expertise with microsurgical glaucoma devices are increasing. The soft flexible nature of the XEN stent together with its malleability under the conjunctival tissue should negate any risk of exposure of the XEN45 stent (XEN). However, we report a case in which sight-threatening endophthalmitis was the presenting feature of this complication.

Case Report:
We present a case of uncomplicated XEN implantation that developed endophthalmitis 4 months after surgery. She gave an 8-day history of diarrhea before presentation. She was noted to have exposure of the XEN stent at the point of entry of the XEN into the subconjunctival space. The stent was removed, pars plana vitrectomy was carried out, and intravitreal antibiotics were administered. Achieving low intraocular pressures, bearing in mind her preservative allergy, became a challenge, as we struggled to manage her advanced glaucoma medically. A CyPass Micro-Stent was subsequently inserted to control the intraocular pressure.

Conclusions:
Episodes of XEN stent exposure may not be so isolated. We postulate that poor handwashing transmitted the causative organism to the exposed stent, which then resulted in endopthalmitis. We would like to highlight a few learning points from this case.
Nasolacrimal Sac Diverticulum: A Case Series and Literature Review
Authors: Enright Nicholas J. , Brown Sebastian J. , Rouse Hannah C. , McNab Alan A. , Hardy Thomas G. 
Published: June 2018

Purpose:
To describe the demographics, presentation, treatment, and outcome in 10 cases of lacrimal sac diverticulum and to review the literature on this topic, and to determine the incidence of diverticula from a series of dacryocystograms.

Methods:
Data were collected for all consecutive patients with lacrimal sac diverticulum seen between 2003 and 2015, including patient demographics, clinical presentation, imaging findings, treatment, and follow-up. A systematic literature review was performed for cases of lacrimal sac diverticulum. A retrospective review of 400 consecutive dacryocystograms was performed to determine the incidence of lacrimal sac diverticulum.

Results:
Ten cases (9 patients) of lacrimal sac diverticulum are described, and a further 36 cases were discovered through a literature review. Epiphora, swelling, and dacryocystitis and/or diverticulitis were the most common presenting complaints. When all 46 cases are combined, lacrimal patency was demonstrated in 50% of cases. Dacryocystography diagnosed only 57% of patients with diverticulum, not helped by the addition of ultrasound or CT. The incidence of diverticulum was 3.2% on review of 400 consecutive dacryocystograms (1.6% per lacrimal system). Surgical management with dacryocystorhinostomy and/or diverticulum excision was effective in all 34 operated cases at resolving symptoms in the case series and literature review.

Conclusions:
Lacrimal sac diverticula present with epiphora, medial canthal swelling, dacryocystitis, and/or diverticulitis. Dacryocystography, despite being the most sensitive radiologic test, is only 59% sensitive, and adjunctive CT and ultrasound have limited use. Surgical management is recommended because conservative management often fails. Dacryocystorhinostomy, diverticulum excision, or a combination thereof appears to be equivalent in achieving resolution of symptoms.
Enhanced External Counterpulsation and Recovery From a Plyometric Exercise Bout
Authors: Valenzuela Pedro L. , Montalvo Zigor , Torrontegi Elaia , Sánchez-Martínez Guillermo , Lucia Alejandro , de la Villa Pedro 
Published: June 2018

Objective:To analyze the effectiveness of enhanced external counterpulsation (EECP) on recovery from exercise-induced muscle damage (EIMD).Design:This study followed a crossover, placebo-controlled, counterbalanced design.Participants:Ten healthy active subjects (7 male; 27 ± 4 years).Interventions:Participants performed a plyometric exercise bout (10 sets of 10 jumps interspersed with 1-minute rests) and were then assigned to recover for 30 minutes with either EECP (cuff pressure = 80 mm Hg) or a Sham intervention (0 mm Hg) immediately after exercise and at 24 hours after exercise. Two weeks later, they repeated the protocol with the other recovery intervention.Main Outcome Measures:Muscle soreness, creatine kinase (CK) activity, jump performance, and tensiomyographic variables were measured before exercise, and 24 and 48 hours after exercise.Results:The mean jump height of the plyometric bout did not differ between EECP and Sham (P> 0.05). Exercise resulted in increased muscle soreness (P< 0.001) and CK levels (P< 0.001), as well as in impaired jump performance (P< 0.05). No changes were observed in tensiomyographic variables. No significant differences were found between interventions for any of the study outcomes.Conclusions:No benefits on recovery from EIMD after a plyometric exercise bout were observed with EECP.