bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between migraine and hospital readmission due to pain after surgery: A hospital registry study
Authors: Platzbecker Katharina , Zhang Megan Behua , Kurth Tobias , Rudolph Maira Isabella , Eikermann-Haerter Katharina , Burstein Rami , Eikermann Matthias , Houle Timothy 
Published: July 2018

Background Migraine has been identified as a risk factor of 30-day hospital readmission after surgery. We aimed to further characterize this association examining pain as a potentially migraine-associated, preventable reason for readmission. Hypothesis Compared to patients with no migraine, surgical patients with migraine are at increased risk of 30-day hospital readmission with an admitting diagnosis specifying pain. Methods This hospital registry study examined 150,710 patients aged 18 years and above, who underwent surgery with general anesthesia and mechanical ventilation between 2007 and 2015 at a tertiary care center and two affiliated community hospitals in Massachusetts, USA. Results Migraine was associated with an increased risk of 30-day pain-related readmission after surgery (adjusted odds ratio 1.42 [95% confidence interval 1.15–1.75]). The association was stronger for migraine with aura (compared to migraine without aura: Adjusted odds ratio 1.69 [95% confidence interval 1.06–2.70]; compared to no migraine: Adjusted odds ratio 2.20 [95% confidence interval 1.44–3.37]). The predicted adjusted risk of pain-related 30-day readmissions was 9.1 [95% confidence interval 5.3–13.0] in 1000 surgical patients with migraine with aura and 5.4 [95% confidence interval 4.2–6.6] in 1000 patients with migraine without aura, compared to 4.2 [95% confidence interval 3.8–4.5] in 1000 patients with no migraine. Furthermore, migraine was associated with an increased risk of postsurgical 30-day readmission due to a priori defined migraine-related pain (headache or abdominal pain) (adjusted odds ratio 1.55 [95% confidence interval 1.20–2.00]). Conclusion Patients with migraine undergoing surgery are at increased risk of 30-day hospital readmission due to pain.
Efficacy and safety of erenumab (AMG334) in chronic migraine patients with prior preventive treatment failure: A subgroup analysis of a randomized, double-blind, placebo-controlled study
Authors: Ashina Messoud , Tepper Stewart , Brandes Jan Lewis , Reuter Uwe , Boudreau Guy , Dolezil David , Cheng Sunfa , Zhang Feng , Lenz Robert , Klatt Jan , Mikol Daniel D 
Published: July 2018

Background Erenumab was effective and well tolerated in a pivotal clinical trial of chronic migraine. Here, we evaluated efficacy and safety of monthly erenumab (70 mg or 140 mg) versus placebo in the subgroup of patients who had previously failed preventive treatment(s) (≥ 1, ≥ 2 prior failed medication categories) and in patients who had never failed. Methods Subgroup analyses evaluated change from baseline in monthly migraine days; achievement of ≥ 50% and ≥ 75% reduction in monthly migraine days; and change in monthly acute migraine-specific medication days. Adverse events were evaluated for each subgroup. Results Treatment with both doses of erenumab resulted in greater reductions in monthly migraine days (primary endpoint) at Month 3 (treatment difference [95% CI], never failed subgroup: −2.2 [−4.1, −0.3] for 70 mg and −0.5 [−2.4, 1.5] for 140 mg; ≥ 1 prior failed medication categories subgroup: −2.5 [−3.8, −1.2], for 70 mg and −3.3 [−4.6, −2.1] for 140 mg; ≥ 2 prior failed medication categories subgroup: −2.7 [−4.2, −1.2], for 70 mg and −4.3 [−5.8, −2.8] for 140 mg). Similar results were observed in the monthly acute migraine-specific medication days endpoint, and in the achievement of ≥ 50% and ≥ 75% reduction in monthly migraine days. There were no new or unexpected safety issues. Conclusion Erenumab showed consistent efficacy in chronic migraine patients who had failed prior preventive treatments and was well tolerated across subgroups.
Exponential Technology, Industry 4.0 and Future of Jobs in India
Authors: Mashelkar R. A. 
Published: July 2018

Advance in technology leads to economic growth, and in turn to creation of new jobs, while making some old jobs obsolete. However, the rise of exponential technologies such as mobile internet, internet of things, big data analytics, artificial intelligence, etc. is disrupting this cycle dramatically, affecting jobs that used brawn as well as brain. This article analyses the impact of this shift in the Indian context and suggests several policy measures for government, industry and also institutions to prepare for the future of jobs in India, so that we do not face the grim prospect of jobless Indian growth. JEL: O00, 038, E24.
Can Poly (ADP-Ribose) Polymerase Inhibitors Palliate Paclitaxel-Induced Peripheral Neuropathy in Patients With Cancer?
Authors: Balko Ryan A. , Hendrickson Andrea Wahner , Grudem Megan E. , Klampe Carolyn M. , Jatoi Aminah 
Published: July 2018

Background: Paclitaxel-treated patients can suffer from years of peripheral neuropathy with pain, numbness, and tingling. Promising preclinical data with poly (ADP-ribose) polymerase (PARP) inhibitors led us to explore this class of agents to palliate this neuropathy. Methods: We relied on a completed trial that tested the antineoplastic effects of veliparib (NCT01012817). Data from patients who had been enrolled on NCT01012817, who previously received paclitaxel, and who had completed a validated pain assessment instrument were evaluated for improvement in their pain scores. Results: All 34 eligible patients were women, and all had a metastatic gynecological malignancy. On a 10-point scale (higher numbers indicative of worse pain), the average baseline score was 3.6 (range: 0-7). Seven patients (21%; 95% confidence interval: 9%-38%) manifested a drop in pain score (1 score lower than baseline followed by at least one consecutive value also below baseline). Of note, no patients initiated other therapy for neuropathy while on NCT01012817. Conclusion: The PARP inhibitors merit further study for chemotherapy-induced peripheral neuropathy. For patients suffering from peripheral neuropathy, these putative palliative effects might prompt earlier consideration of a PARP inhibitor as part of cancer treatment.
Nasometric Comparison Between Spanish–English Bilingual and English Monolingual Children
Authors: Perry Jamie L. , Kotlarek Katelyn , Mendez Lucia , Holt Yolanda , Fafulas Stephen , Broadwell Katie 
Published: July 2018

Objective: It is well established in the literature that English diagnostic tests should not be directly applied to speakers whose primary language is Spanish. Normative nasalance data across word and sentence-level stimuli among Spanish–English bilingual children living in the United States have not been provided. The present study aims to (1) compare differences in nasalance between typically developing Spanish–English bilingual children and English-speaking monolingual children and (2) determine whether within-speaker nasalance differences exist in Spanish–English bilingual children when presented with English and Spanish speech stimuli. Design: Thirty-four typically developing children including 17 monolingual English speakers and 17 Spanish–English bilingual speakers with normal velopharyngeal anatomy between 5 and 7 years of age participated in the study. Speakers were recorded using a nasometer producing sets of stimulus items at the word and sentence level in English (English monolinguals) and in both Spanish and English for bilingual children. Results: Results indicated no statistically significant difference between nasalance values across the different stimuli between monolingual and bilingual participants. However, within-subject effects showed statistical significance between English and Spanish word stimuli among the bilingual group. Conclusions: These findings emphasize the importance of using language-specific diagnostic materials for nasalance testing, which would be of importance in the treatment of individuals with cleft palate.
The role of the pharmacist in the multidisciplinary approach to the prevention and resolution of drug-related problems in cancer chemotherapy
Authors: Boşnak Ahmet S , Birand Nevzat , Diker Ömer , Abdi Abdikarim , Başgut Bilgen 
Published: July 2018

Background Clinical pharmacists have important roles in implementing scientifically valid knowledge and advice on safe, reasonable use of pharmaceuticals. Clinical pharmacy services were introduced and evaluated in oncology clinic in a tertiary university hospital. Methods A prospective interventional study was conducted from November 2017 to March 2018. Drug-related problems were classified using the Pharmaceutical Care Network Europe drug-related problem classification tool v8.01. The main outcome measure is the proposed interventions aimed at identification of the drug-related problems, the role of the pharmacists in the resolution, and the rate of acceptance of these recommendations by physicians. Results A total of 102 patients were included in the study, who were treated with at least two cycles of any cancer type and stage. A total of 55 (53.9%) patients had 251 drug-related problems. Drug-related problems mainly involved antihypertensive (31.6%), antidiabetic (17.8%), and herbal agents (31.6%). Treatment effectiveness was the major type of drug-related problems (50.2%) followed by treatment safety (29.1%). A total of 211 (100%) interventions were accepted and regarded as clinically relevant. Prescriber informed only were the most common types of intervention at the prescriber level. Eighty-six point four percent identified drug-related problems were solved, 9.8% of the problems were partially solved, 2.3% problems were unsolved. Conclusion Clinical pharmacy services may have optimized therapy effectiveness, prevent adverse effects and unclear/compliant problems. The pharmacist interventions were highly acknowledged by oncologists and patients; this may indicate the presence of a great convenience and need to implement Clinical pharmacy services in alternative hospitals in Northern Cyprus.
Drug-associated progressive multifocal leukoencephalopathy in multiple sclerosis patients
Authors: Oshima Yasuo , Tanimoto Tetsuya , Yuji Koichiro , Tojo Arinobu 
Published: July 2018

Objective: To investigate characteristics of multifocal leukoencephalopathy (PML) in multiple sclerosis (MS) patients associated with drugs other than natalizumab since our experience in other disease-modifying drugs (DMD) is still limited. Methods: This is a descriptive observational study within the FAERS database, registered between July 2015 and June 2017. Results: The primary cohort for the analysis consisted of 100,921 MS patients (mean (standard deviation (sd)) age, 48.9 (12.8) years, 20.9% male). Among them 786 (0.78%) developed PML. The adjusted odds ratio of PML for each drug was as follows; natalizumab 115.72 (95% CI; 83.83, 159.74), fingolimod 4.98 (3.64, 6.81) followed by dimethyl fumarate 1.77 (1.2, 2.62) and rituximab 3.22 (1.07, 9.72). The median time from the start of suspected drugs to the onset of PML for natalizumab and other agents were 1463 and 178 days, respectively. The proportion of PML appeared higher in Japan (2.4%) compared to that in the United States (0.24%). Conclusion: The reporting proportion of PML was relatively higher in natalizumab followed by fingolimod, dimethyl fumarate and rituximab. Other characteristics of PML associated with DMDs, including the time to onset and differences in reporting among countries, are described.
Impact of mindfulness-based stress reduction for people with multiple sclerosis at 8 weeks and 12 months: A randomized clinical trial
Authors: Senders Angela , Hanes Douglas , Bourdette Dennis , Carson Kimberly , Marshall Lynn M , Shinto Lynne 
Published: July 2018

Background: Mindfulness training is often used as a therapeutic intervention to manage stress and enhance emotional well-being, yet trials for multiple sclerosis (MS) are limited and few have used an active control. Objective: Assess the feasibility of mindfulness-based stress reduction (MBSR) for people with MS and evaluate the efficacy of MBSR compared to an education control. Methods: We conducted a single-blind, randomized trial of MBSR versus education control among 62 adults with MS. Primary outcomes were measures of feasibility. Secondary outcomes included perceived stress, anxiety, depression, fatigue, pain, resilience, and the Paced Auditory Serial Addition Test, assessed at baseline, 8 weeks, and 12 months. Mean scores for secondary outcome measures were compared between groups at each time point and within groups across time by analyses of covariance or paired t-tests, respectively. Results: Successful recruitment and retention demonstrated feasibility. Improvements in several secondary outcomes were observed among both MBSR and control groups. However, differences between the groups were not statistically significant at either 8 weeks or 12 months. Conclusion: Emotional well-being improved with both MBSR and education. Spontaneous improvement cannot be ruled out as an explanation for findings and additional studies that evaluate the impact of mindfulness training to improve emotional health are warranted.
Targeting the ‘right’ patients for integrated care: stakeholder perspectives from a qualitative study
Authors: Stokes Jonathan , Riste Lisa , Cheraghi-Sohi Sudeh 
Published: July 2018

Objective To explore the perceptions of relevant stakeholders in terms of targeting the ‘right’ patients for integrated care. Methods Secondary analysis of qualitative interviews with relevant stakeholders (including programme managers, programme initiators, a representative of the payers, medical and social care professionals and allied health services staff) from two integrated care sites in England. A thematic analysis was conducted of cross-cutting themes. Results Both sites focused on individualized management of ‘high-risk’ patients through multidisciplinary team case management. The data-driven approach to targeting patients, recommended in the policy literature, did not align with stakeholders’ experience of selecting patients in practice. The ‘right’ patients were at lower risk than those recommended by policy, and their complexities were identified as comprising mostly social rather than medical issues. Conclusions These findings raise timely questions about the individualized management approach. They potentially explain why management of high-risk patients has not been found to be effective using quantitative measures, undermining the assumption that this approach will lead to cost savings. There is a need to expand beyond an individually targeted approach to incorporate prevention and to address social issues.
Fecal calprotectin for detection of postoperative endoscopic recurrence in Crohn’s disease: systematic review and meta-analysis
Authors: Tham Yuen Sau , Yung Diana E. , Fay Shmuel , Yamamoto Takayuki , Ben-Horin Shomron , Eliakim Rami , Koulaouzidis Anastasios , Kopylov Uri 
Published: July 2018

Background: Anastomotic recurrence is frequent in patients with Crohn’s disease (CD) following ileocecal resection. The degree of endoscopic recurrence, quantified by the Rutgeerts score (RS), correlates with risk of clinical and surgical recurrence. Several studies demonstrate the accuracy of fecal calprotectin (FC) for detection of endoscopic recurrence, however the optimal threshold FC value remains to be established. The aim of our meta-analysis was to evaluate the accuracy of common FC cut-offs for detection of endoscopic recurrence. Methods: We performed a systematic literature search for studies evaluating postoperative recurrence in CD which reported RS and FC levels. Endoscopic recurrence was defined as RS = 2–4 (or RS ⩾ 2). We calculated pooled diagnostic sensitivity, specificity, diagnostic odds ratio (DOR) and constructed summary receiver operating characteristic (SROC) curves for each available FC cut-off value. Results: A total of 54 studies were retrieved; 9 studies were eligible for analysis. Diagnostic accuracy was calculated for FC values of 50, 100, 150 and 200 µg/g. A significant threshold effect was observed for all FC values. The optimal diagnostic accuracy was obtained for FC value of 150 µg/g, with a pooled sensitivity of 70% [95% confidence interval (CI) 59–81%], specificity 69% (95% CI 61–77%), and DOR 5.92 (95% CI 2.61–12.17). The area under the SROC curve was 0.73. Conclusion: FC is an accurate surrogate marker of postoperative endoscopic recurrence in CD patients. The FC cut-off 150 μg/g appears to have the best overall accuracy. Serial FC evaluations may eliminate or defer the need for colonoscopic evaluation in up to 70% of postoperative CD patients.
Barriers to Healthcare Participation in Persons With Disabilities in Appalachia: A Qualitative Pilot Study
Authors: Kurowski-Burt Amy , Haddox John Christopher 
Published: July 2018

Objectives: A study exploring facility-related barriers to healthcare participation (the level to which an individual is engaged or involved in their own healthcare activities from simply keeping appointments to following treatment regimens) in persons with disabilities in Appalachia from the perspectives of four stakeholder groups, (1) adults with disabilities, (2) caregivers of persons with disabilities, (3) advocates for persons with disabilities, and (4) providers who treat persons with disabilities. Background: Persons with disabilities potentially face additional barriers to healthcare participation than those without disabilities. Understanding and addressing the barriers to participation could assist in improving healthcare outcomes among the disabled population. Methods: A qualitative study was conducted involving scripted focus groups with four stakeholder groups with expertise/experience in disabilities. The objective was to assess perceptions of impacts of clinical design elements on healthcare participation. Results: Participants identified and characterized six major categories of facility- and nonfacility-related barriers they felt impacted healthcare participation, with priority differences reported between each group. Conclusions: The healthcare facility is perhaps the most visible tool the provider has at his or her disposal to deliver effective healthcare. Understanding the interactions persons with different disabilities have with the physical facility and the messages, both intentional and unintentional, the state of the facility sends can provide useful insights into delivering more effective healthcare to this population.
Outcomes of Total Ankle Arthroplasty in Moderate and Severe Valgus Deformity
Authors: Demetracopoulos Constantine A. , Cody Elizabeth A. , Adams Samuel B. , DeOrio James K. , Nunley James A. , Easley Mark E. 
Published: July 2018

Introduction. Failure to correct coronal deformity at the time of total ankle arthroplasty (TAA) can lead to early implant failure. We aimed to determine clinical, radiographic, and patient-reported outcomes of patients with moderate to severe valgus deformity who underwent TAA for end-stage ankle arthritis. Methods. Patients with a valgus deformity of at least 10° who underwent TAA were retrospectively reviewed. The coronal tibiotalar angle was assessed on radiographs preoperatively, at 1 year, and at final follow-up. The visual analog scale (VAS) for pain, Short Form-36 (SF-36), American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot-ankle scale, and Short Musculoskeletal Function Assessment (SMFA) scores were assessed preoperatively and at final follow-up. Results. Mean preoperative valgus deformity was 15.5 ± 5.0°, and was corrected to a mean of 1.2 ± 2.6° of valgus postoperatively. VAS, SF-36, AOFAS, and SMFA scores improved significantly ( P < .001 for all). There was no significant change in tibiotalar angle between 1 year and final follow-up in either group. Reoperation and revision rates did not differ between groups. Conclusion. Correction of coronal alignment was achieved and maintained in patients with both moderate and severe preoperative valgus malalignment. Outcome scores significantly improved for all patients. Levels of Evidence: Therapeutic, Level IV
Assessment of Cell Viability of Fresh Osteochondral Allografts in N-Acetylcysteine-Enriched Medium
Authors: Calvo Rafael , Espinosa Maximiliano , Figueroa David , Pozo Luz María , Conget Paulette 
Published: July 2018

Objective The purpose of this study was to evaluate the effect of N-acetylcysteine (NAC)-enriched storage medium on fresh osteochondral viability at 4°C. Our hypothesis was that the cell viability of chondrocytes obtained from human osteochondral tissue and stored at 4°C significantly improves in the presence of NAC. Design Controlled laboratory study. For this study, 8 samples of femoral condyle osteochondral tissue were obtained from patients undergoing total knee replacement. The samples were stored at either 4°C in phosphate-buffered saline (PBS) or at 3 different concentrations of NAC (NAC 1, 2, and 5 mM). Cell viability was analyzed at time 0 and 4 weeks by flow cytometry. The results of cell viability (median) were analyzed statistically using analysis of variance and Tukey’s post hoc test. P values <0.05 were considered statistically significant. Results The viability at time 0 was 95.5% ± 3.7%. At 4 weeks, the cell viability was 56.8% ± 20.1% in the control group (PBS), 83.8% ± 11.9% in the group stored with NAC 1 mM, 73.4% ± 13.6% in the group stored with NAC 2 mM, and 66.4% ± 27.7% in the group stored with NAC 5 mM. A statistically significant difference from the baseline viability (time 0) was observed in the PBS control group ( P = 0.0018) but not in the other groups. A statistically significant difference was observed in the NAC 1 mM group compared with the PBS group ( P = 0.0255). Conclusion The use of NAC at 1 mM concentration improves cell viability after 4 weeks of storage in chondrocytes obtained from human osteochondral tissue.
Objective and subjective measures of dalfampridine efficacy in clinical practice
Authors: Klineova Sylvia , Farber Rebecca , Friedman Joshua , Farrell Colleen , Lublin Fred D , Krieger Stephen 
Published: July 2018

Background Multiple sclerosis affects mobility in over 80% of patients. Dalfampridine is the only approved treatment for walking impairment in multiple sclerosis. We assessed dalfampridine utilization in our practice and investigated response using timed 25 foot walk (T25FW) improvement and a patient-reported ambulation inventory. Methods Chart review identified patients with multiple sclerosis for whom dalfampridine was prescribed. T25FW data were extracted from medical records. Participants completed a dalfampridine-specific version of the multiple sclerosis walking scale (dMSWS-12) to assess the qualitative impact of dalfampridine on ambulation. We evaluated two responder categories: liberally defined as any improvement in T25FW; and over 20% T25FW improvement. Results The dMSWS-12 questionnaire was completed by 39 patients. Eighteen patients (46%) did not show any T25FW improvement. Of the 21 patients (54%) with T25FW improvement, four patients (11%) showed improvement greater than 20%. Analysis of dMSWS-12 scores showed a median score of 40 (range 12–60). Eleven patients (28%) showed no improvement (dMSWS-12 score ≤36). In contrast to objective T25FW improvement (54%), 28 patients (72%) reported improvement in walking ability (dMSWS-12 score ≥37). Conclusion Our results suggest that T25FW alone might not be sufficient for response characterization and that adding patient-reported measures may further elucidate the therapeutic response.