bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary Efficacy of Online Traumatic Brain Injury Professional Development for Educators: An Exploratory Randomized Clinical Trial
Authors: Glang Ann E. , McCart Melissa , Slocumb Jody , Gau Jeff M. , Davies Susan C. , Gomez Doug , Beck Laura 
Published: November 2018

Objective:
To examine the efficacy of an online traumatic brain injury (TBI) professional development intervention, In the Classroom After Concussion: Best Practices for Student Success.

Design:
A randomized controlled trial with a sample of 100 general educators, who were randomly assigned to the In the Classroom Web site (treatment group) or the LEARNet Web site (control group). Participants completed the pretest, accessed the In the Classroom or LEARNet site and the posttest and completed follow-up assessments 60 days after posttest.

Measures:
(1) Knowledge of effective strategies for working with students with TBI; (2) knowledge application; (3) self-efficacy in handling situations presented in text and video scenarios, and (4) a standardized self-efficacy measure.

Results:
On the posttest assessment, In the Classroom educators showed significantly greater gains in knowledge (P < .0001, d = 1.36 [large effect]), TBI knowledge application (P = .0261, d = 0.46), and general self-efficacy (P = .0106, d = 0.39) than the LEARNet controls. In the Classroom educators maintained significant gains in knowledge (P = .001, d = 0.82) and general self-efficacy (P = .018, d = 0.38) but not in TBI knowledge application (P = .921, d = 0.02).

Conclusion:
Given the prevalence of TBI, it is important to develop evidence-based, cost-effective approaches to knowledge transfer and exchange in TBI professional development. In the Classroom is one such approach.
Potential Explanations for Increasing Methylphenidate Use in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder in Germany From 2004 to 2013
Authors: Langner Ingo , Haug Ulrike , Scholle Oliver , Lindemann Christina , Schröder Carsten , Riedel Oliver 
Published: November 2018

Abstract

Background
Despite a decreasing population of children and adolescents, the cumulative total amount of dispensed methylphenidate (MPH), the first-choice treatment of attention-deficit/hyperactivity disorder (ADHD) in this age group, has increased dramatically in Germany. We investigated potential reasons for this increase such as changes in the ADHD prevalence over time and other potential explanations including the cumulative amount of dispensed MPH per person.

Methods
Based on German claims data, we calculated standardized annual ADHD prevalence rates, proportions of ADHD cases treated with MPH and/or psychotherapy, and mean cumulative defined daily doses of ADHD drugs for 3- to 17-year-old children and adolescents from 2004 to 2013.

Results
The ADHD prevalence increased continuously from 2004 to 2011 and remained stable thereafter. In ADHD cases, there was little variation in the proportion of individuals treated with drugs and in the frequency of psychotherapeutic treatment during the whole study period. The annual cumulative mean amount of MPH defined daily doses increased by approximately 30% from 2004 to 2008.

Conclusions
Our analyses suggest that the increase in MPH use in Germany was mainly influenced by an increasing ADHD prevalence and increasing amounts of dispensed MPH per person.
Evaluation of Hospital-wide Readmission Risk Calculator to Predict 30-Day Readmission in Neurocritical Care Patients
Authors: Peacock Sarah , Siegel Jason , Harmer Emily , Alejos David , Freeman W. David 
Published: November 2018

ABSTRACT

Background and Purpose: Thirty-day hospital readmissions have been shown to be a measure of quality and result in higher mortality and increased costs. Readmissions are a target for hospitals and payers; thus, several centers have developed predictive readmission scores to identify high-risk patients. The purpose of this study was to evaluate the current hospital-wide readmission risk calculator and the ability of this tool to predict 30-day readmissions in the neurocritical care population. Methods: A retrospective chart review was performed that included 340 consecutive patients admitted to our neuroscience critical care unit. Data including readmission scores, reason for admission, length of stay, and whether they were readmitted were recorded. Results: After removing patients without readmission scores or who died at the end of the original admission, the records of N = 279 patients were analyzed. Patients were more likely to be readmitted if they were initially emergently hospitalized or if there was a history of malignancy. Readmitted patients had a longer original hospital length of stay. Furthermore, 65.8% of the patients who were given a “low risk” for readmission were readmitted within 30 days. Conclusions: This small set of data in a specific patient population found that the current risk prediction score was inaccurate in predicting readmission in the neuroscience intensive care unit population. Further evaluation is needed of a larger patient population to generalize these results for all neuroscience intensive care unit patients. To design an accurate readmission risk tool, centers should create unique readmission scores based on less heterogeneous patient populations.
Feasibility and Variability of Automated Pupillometry Among Stroke Patients and Healthy Participants: Potential Implications for Clinical Practice
Authors: Marshall Matthew , Deo Ritesh , Childs Charmaine , Ali Ali 
Published: November 2018

ABSTRACT

Background: Early neurological deterioration (END) is common after stroke and represents a poor prognostic marker. Manual pupillary assessment to detect END is subjective and has poor interrater reliability. Novel methods of automated pupillometry may be more reliable and accurate. This study aims to evaluate the acceptability and feasibility of automated pupillometry in patients with acute stroke and healthy volunteers and compare its interrater reliability with that of the traditional manual method. Methods: Automated and manual pupillary assessments were recorded between 2 independent observers alongside routine neurological observations from 12 acute stroke patients at a high risk of END. The proportion of completed measurements, adverse events, and qualitative feedback from patients and staff nurses was used to assess acceptability and feasibility of automated pupillometry. Paired automated and manual assessments were supplemented with measures from healthy volunteers to analyze measures of variability and agreement. Results: Automated pupillometry was acceptable and safe among 12 acute stroke patients, but feasibility criteria were not attained. Interrater agreement for automated pupillometry was superior to manual assessment for measurements of pupil size, anisocoria, and pupillary light reactivity, for both patients and healthy volunteers. Substantial disparity existed in agreement between automated and manual assessments of these parameters. Conclusions: Automated pupillometry represents an alternative to manual pupillary assessment that may have greater interrater agreement and reliability. As an optimized method of neurological assessment, it has the potential to improve detection and treatment of conditions leading to END after stroke.
Validity and Reliability of the Finnish Version of the Locomotor Capabilities Index-5 in Patients Fitted with a Prosthesis after Major Lower Extremity Amputation
Authors: Becker Paju , Repo Jussi P. , Piitulainen Kirsi , Tukiainen Erkki J. , Roine Risto P. , Järvenpää Salme , Ylinen Jari , Häkkinen Arja H. 
Published: November 2018

ABSTRACT

Introduction
There has been a lack of psychometrically sound instruments in Finnish for assessment of mobility after major lower-limb amputation. This study aimed to translate the Locomotor Capabilities Index-5 (LCI-5) into Finnish and assess its psychometric properties.

Materials and Methods
The LCI-5 was translated and cross-culturally adapted into Finnish. Lower-limb prosthesis users (N = 112, mean time since amputation 9 years) completed the questionnaire compilation twice in a 2-week interval.

Results
No semantic discord emerged during the translation process. The mean (SD) total LCI-5 score was 42 (15), and intraclass correlation coefficient was 0.95 (95% confidence interval [CI], 0.93–0.96). Cronbach's alpha was 0.96 (95% CI, 0.95–0.97). Item-to-total correlations varied between 0.70 and 0.88. The LCI-5 correlated strongly with the 15D Mobility dimension (r = 0.76; P < 0.01), Houghton scale (r = 0.78; P < 0,001), and the Mobility section of the Prosthesis Evaluation Questionnaire (0.70; P < 0.001). The LCI-5 discriminated between transtibial and transfemoral amputation groups and had a moderate correlation with patients' age. Maximum scores were reached by 24% of the respondents.

Conclusions
Based on the findings of the present study, the Finnish LCI-5 has good reliability and validity for assessing mobility in patients who have undergone major lower-limb amputation and successful prosthesis fitting.
CDC Guideline on Mild Traumatic Brain Injury in Children: Important Practice Takeaways for Sports Medicine Providers
Authors: Sarmiento Kelly , Waltzman Dana , Lumba-Brown Angela , Yeates Keith O. , Putukian Margot , Herring Stanley 
Published: November 2018

Objectives:The Centers for Disease Control and Prevention (CDC) published an evidence-based guideline on the diagnosis and management of pediatric mild traumatic brain injury (mTBI) in 2018. This commentary provides key practice takeaways for sports medicine providers outlined in the Guideline recommendations.Data Sources:The CDC Pediatric mTBI Guideline was developed through a rigorous scientific process using a modified Grading of Recommendations, Assessment, Development and Evaluations (GRADE) methodology. A systematic review of the scientific literature published over a 25-year period for all causes of pediatric mTBI formed the basis of the Guideline.Main Results:The key practice takeaways for sports medicine providers focus on preseason evaluations, neuroimaging, symptom-based assessment, managing recovery, monitoring for persistent symptoms, and return to activity, including sport and school.Conclusions:Sports medicine providers play an integral part in the implementation of evidence-based practices that promote appropriate diagnosis and management of mTBI in children. This commentary highlights key practice takeaways that sports medicine providers can implement.
Alternative strategies to improve success rate of mitral isthmus block
Authors: Lee Ji Hyun , Nam Gi-Byoung , Go Tae-Hwa , Hwang Jongmin , Kim Minsu , Hwang You Mi , Kim Jun , Choi Kee-Joon , Kim You-Ho 
Published: November 2018

Abstract
Achieving bidirectional conduction block (BDB) across the mitral isthmus (MI) is technically challenging. We describe our experience using different ablation strategies for achieving successful MI block.
We reviewed the records of patients who had undergone MI ablation for peri-mitral (PM) flutter at our institution from January 2010 to May 2015. We investigated ablation strategies for achieving MI block and their long-term outcomes in terms of recurrence of atrial tachyarrhythmia.
Single endocardial MI ablation with or without distal coronary sinus (CS) ablation achieved MI block in 129 out of 236 (54.7%) patients. After failure of MI block, a new MI line ablation, ablation targeting the vein of Marshall (VOM), or anterior line ablation was performed in selected patients. The MI block was achieved in 13 (52.0%) out of 25 patients with new MI line ablation and in 13 (68.4%) out of 19 patients with VOM ablation. Anterior line ablation was tried in 23 patients and the line of block was achieved in 12 (52.2%) patients. Finally, overall PM BDB (PMB, MI block or anterior line block) was achieved in 167 (70.8%) of 236 patients. The incidence atrial tachyarrhythmia was similar between the patients with successful PMB and those with failed PMB (32.9% vs 42.0%, P = .18). In multivariable Cox regression analysis, the PMB was not associated with recurrence of atrial tachyarrhythmia (hazard ratio [HR]: 0.70, 95% confidence interval [CI]: 0.43–1.12).
In conclusion, single endocardial MI line with or without distal CS ablation showed limited success for achieving MI block. Additional substrate modifications such as a new MI line ablation, anterior line ablation, or ablation targeting the VOM may improve the success rate of PMB block. However, the benefits of PMB were not clear in this study.
A multi-facet comparative analysis of neuromyelitis optica spectrum disorders in patients with seropositive and seronegative AQP4-IgG
Authors: Wang Xiaojuan , Chen Xiaoyang , Zhu Chaoxia , Ma Haichang , Wang Fang , Qin Lingzhi , Li Wei 
Published: November 2018

Abstract

Introduction:
Neuromyelitis optica spectrum disorders (NMOSD), a rare, serious, demyelinating disease of the central nervous system (CNS), is associated with immunoglobulin G (IgG) antibodies targeting aquaporin-4 (AQP4-IgG). This study retrospectively analyzed the clinical features of 67 patients. 49 and 18 of 67 cases (male/female: 11/56) were AQP4-IgG (+) and AQP4-IgG (−), respectively. The initial symptoms were optic neuritis [n = 34, AQP4-IgG (+)/(−): 31/3], myelitis [n = 18, AQP4-IgG(+)/(−): 13/5], co-occurrence of ON and myelitis [n = 15, AQP4-IgG (+)/(−): 5/10].

Conclusions:
There was no statistically significant difference between the 2 groups in terms of ages, and magnetic resonance imaging findings, but the patients had a significant difference (P <.05) in sex, the course of disease and Expanded Disability Status Scale (EDSS) scores after drug treatment. Patients with AQP4-IgG (−) are likely to have a better prognosis and a favorable monophasic course.
Computed tomography portography of patients with cirrhosis with normal body mass index
Authors: Liu Sulan , Sheng Huaqiang , Shi Hao , Li Wei , Fan Jingli , He Jingzhen , Sun Hongjun 
Published: November 2018

Abstract
This study is to investigate the computed tomography (CT) image quality of the low- tube-voltage protocol with low contrast agent dose.
CT portography was performed in 118 cirrhosis patients with body mass index (BMI) less than 25 kg/m2 under 2 protocols: Protocol A, tube voltage of 90 kVp/395 mAs and contrast agent dosage of 1.2 mL/kg, and, Protocol B, tube voltage of 120 kVp/200 mAs and contrast agent dosage of 1.5 mL/kg.
The number of patients in each protocol was 59. The CT value noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) in portal veins was comparatively analyzed between the 2 protocols. The subjective image quality was further assessed on 5-point scales. Radiation dose was also recorded and statistical analysis was performed.
The CT value, CNR, and SNR of the images were higher at 90 kVp than those at 120 kVp (P < .05). There was no significant difference in image noise between the 2 protocols (P > .05). The CT dose index volume, dose-length product, and effective dose at 90 kVp were 18.2%, 16.0%, and 16.0% less than that at 120 kVp, respectively. There was no difference in image quality score between the 2 protocols (P > .05). The average amount of contrast agent was decreased by 17.8% when the 90 kVp protocol was used.
CT portography at 90 kVp combined with low-dosage contrast agent leads to a significant reduction in radiation dose and improved SNR and CNR, without deterioration of image quality.
Improvement of bone microarchitecture parameters after 12 months of treatment with asfotase alfa in adult patient with hypophosphatasia
Authors: Freitas Thiago Quadrante , Franco André Silva , Pereira Rosa Maria Rodrigues 
Published: November 2018

Abstract

Rationale:
Hypophosphatasia is an inborn error of metabolism that can appear any time in life, mainly with bone manifestations due to low alkaline phosphatase activity. Asfotase alfa is a specific enzyme reposition treatment that has shown promising results in children; however, there are few reports about the outcomes in adult patients.

Patient concerns:
A 36-year-old male presented with an early history of craniosynostosis, short stature, and multiple fractures since the age of 13 years—which needed numerous surgical corrections. He was admitted with a previous diagnosis of osteogenesis imperfecta, taking alendronate, calcium carbonate, cholecalciferol, and calcitriol. Bone mineral density was low (lumbar spine Z-score = −3.0 SD), with impairment of all parameters of high-resolution peripheral quantitative computed tomography (HR-pQCT). Kidney impairment was also observed with reduced creatinine clearance, nephrolithiasis, and nephrocalcinosis.

Diagnosis:
Alkaline phosphatase was unexpectedly low (6 U/L, reference value: 30–120 U/L), with high serum vitamin B6 (260 mcg/L, reference value: 5.2–34.1). Genetic testing showed a homozygous missense mutation in ALPL gene c.443 C>T: p.Thr148Ile.

Intervention:
Asfotase alfa was requested due to important bone deterioration, ambulatory disability, and kidney impairment. It was given subcutaneously 2 mg/kg per dose, 3 times a week, for 12 months before reassessment.

Outcomes:
Bone mineral densities of the lumbar spine and whole body, besides almost all HR-pQCT microstructural parameters of the distal tibia, showed improvements and the patient was able to walk without assistant device. Kidney function did not further deteriorate.

Lessons:
Hypophosphatasia should be considered as a differential diagnosis in young patients with multiple fractures and kidney impairment, since the use of antiresorptive drugs, calcium and vitamin D, commonly used to treat fractures, worsen its symptoms and prognosis. A 12-month asfotase alfa treatment improved bone density and structural parameters even in an adult patient with late diagnosis.
Cardiac inflammatory myofibroblastic tumor in interventricular septum
Authors: Deng Ming-dan , Han Jun-yang , Lin Ke , Tang Hong 
Published: November 2018

Abstract

Rationale:
Cardiac inflammatory myofibroblastic tumor (IMT) is a rare primary cardiac tumor which is currently considered as a low-grade neoplasm. The tumor has a predilection in infants and adolescents and primarily occurs as an endocardial-based cavitary mass. However, cardiac IMT that only involves the interventricular septum in middle-aged adults is extremely rarely reported. Considering its infrequency, we report a rare clinical case, with the aim of sharing our experience during the diagnostic procedures.

Patient concerns:
A 45-year-old, previously healthy female, with no medical history was admitted to the outpatient clinic due to the identification of an abnormal radiographic finding during a routine health examination.

Diagnosis:
Transthoracic echocardiography (TTE) revealed a 3.5 cm × 4.0 cm × 4.5 cm heterogeneous mass in the interventricular septum. Color Doppler echocardiography detected sparse blood flow signals inside the mass. Magnetic resonance imaging (MRI) confirmed a hyperintense T2-weighted, isointense T1-weighted mass. Three-dimensional (3D) TTE demonstrated a spherical mass in the middle part of the interventricular septum. Postoperative histopathological examinations revealed a mesenchymal tumor composed of scattered spindle myofibroblasts with a myxoid atypia, associated with infiltration of lymphocytes and plasma cells.

Interventions:
Complete tumor resection was successfully performed via median sternotomy under general anesthesia.

Outcomes:
After surgery, the patient recovered successfully. The patient was in good general health without any clinical symptoms. The echocardiographic examination at the 12-month follow-up period revealed normal function of the heart, and there was no evidence of tumor recurrence.

Lessons:
To our knowledge, cardiac IMT only the involving interventricular septum in a middle-aged adult has never been previously reported before. Echocardiography plays a critical role in establishing the primary diagnosis of cardiac IMT and evaluating regular follow-up examinations. Complete surgical resection of the mass is considered the first-line treatment despite the absence of symptoms.
Long-term results of vascularized os pisiform transfer for advanced Kienböck disease after follow-up for at least 15 years
Authors: Tan Zhenwei , Xiang Zhou , Huang Fuguo , Yang Zhiming , Xiao Cong , Duan Xin 
Published: November 2018

Abstract
No surgical procedure perfectly treats advanced Kienböck disease. Although vascularized os pisiform transferring (VOPT) is one of the main therapeutic approaches, reports on long-term follow-up and case series for this technique are scarce.
We collected postoperative results in 11 patients with advanced Kienböck disease who underwent VOPT between 1986 and 2001 in our Hospital. Follow-up durations ranged from 15 to 26 years.
At the last follow-up, excellent and good results were found in 81.8% according to the Modified Green and O’Brien score. Postoperative imaging revealed significantly reduced pisiform bone; carpal height ratio and Nattrass index were decreased, while the radioscaphoid angle was increscent, compared with preoperative and mid-term follow-up results.
The favorable long-term results demonstrated that VOPT is a dependable and durable procedure for the treatment of advanced Kienböck disease, with pain relief and functional improvement despite some radiographic findings such as wrist osteoarthritis occurrence.
Role of ethnicity and environment on lifestyle and cardiometabolic profile in the Native American Mapuche population
Authors: Fernández-Cao José C. , Doepking Carlos 
Published: November 2018

Abstract

Introduction:
Cardiometabolic risk factors contribute to increase the incidence of some of the most widespread noncommunicable diseases today. The propensity to present an elevated cardiometabolic risk appears to especially affect non-Caucasians ethnic groups, such as the Native American Mapuche population. In addition, urbanization process has also a great impact on lifestyle and cardiometabolic profile. Therefore, a systematic review and meta-analysis will be conducted to summarize the relevant evidence regarding lifestyle and cardiometabolic profile in Mapuche population, and to assess the role of the ethnicity and the urbanization process on the lifestyle and cardiometabolic profile in Mapuche people with respect to European descendants.

Methods:
A comprehensive search until 2019 will be performed using PubMed/MEDLINE, SciELO, Web of Science and Scopus. Observational studies, carried out in general population of Mapuche ethnicity living in rural and urban areas, with data of lifestyle and/or cardiometabolic profile, will be selected. A qualitative summary, as well as meta-analyzes when possible, will be done to present the information. Random effects meta-analyzes will be performed using the generic inverse variance method. Pooled effect size will be expressed as mean difference with 95% confidence intervals. Heterogeneity will be assessed using the Cochran Q-statistic and the I
2 statistic. Stratified analyzes, meta-regressions, and sensitivity analyzes will be performed to evaluate potential sources of heterogeneity. In addition, random effects meta-regressions and stratified analyzes will also be used to examine the impact of covariates on the effect size estimated. Publication bias will be investigated using Egger and Begg test, and risk of bias will be assessed using the Research Triangle Institute Item Bank (RTI-IB). Finally, the quality of evidence will be evaluated through the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines.

Results:
The results of meta-analyzes will provide important information about differences in lifestyle and cardiometabolic profile between Mapuche people and European descendants, as well as between Mapuche people living in urban and rural areas.

Conclusion:
This systematic review and meta-analysis will be helpful to obtain a more reliable understanding of lifestyle and cardiometabolic profile in Mapuche population compared to European descendants, and the impact of the transition from rural to urban areas in this ethnic group.