bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of robot-(Morning Walk®) assisted gait training for patients after stroke: a randomized controlled trial
Authors: Kim JaYoung , Kim Dae Yul , Chun Min Ho , Kim Seong Woo , Jeon Ha Ra , Hwang Chang Ho , Choi Jong Kyoung , Bae Suhwan 
Published: October 2018

Objective: To investigate the effects of Morning Walk®–assisted gait training for patients with stroke. Design: Prospective randomized controlled trial. Setting: Three hospital rehabilitation departments (two tertiary and one secondary). Patients: We enrolled 58 patients with hemiparesis following a first-time stroke within the preceding year and with Functional Ambulation Category scores ⩾2. Intervention: The patients were randomly assigned to one of two treatment groups: 30 minutes of training with Morning Walk®, a lower limb rehabilitation robot, plus 1 hour of conventional physiotherapy (Morning Walk® group; n = 28); or 1.5 hour of conventional physiotherapy (control group; n = 30). All received treatment five times per week for three weeks. Main outcome measurements: The primary outcomes were walking ability, assessed using the Functional Ambulation Category scale, and lower limb function, assessed using the Motricity Index-Lower. Secondary outcomes included the 10 Meter Walk Test, Modified Barthel Index, Rivermead Mobility Index, and Berg Balance Scale scores. Results: A total of 10 patients were lost to follow-up, leaving a cohort of 48 for the final analyses. After training, all outcome measures significantly improved in both groups. In Motricity Index-Lower of the affected limb, the Morning Walk® group (∆mean ± SD; 19.68 ± 14.06) showed greater improvement ( p = .034) than the control group (∆mean ± SD; 11.70 ± 10.65). And Berg Balance Scale scores improved more ( p = .047) in the Morning Walk® group (∆mean ± SD; 14.36 ± 9.01) than the control group (∆mean ± SD; 9.65 ± 8.14). Conclusion: Compared with conventional physiotherapy alone, our results suggest that voluntary strength and balance of stroke patients with hemiparesis might be improved with Morning Walk®–assisted gait training combined with conventional physiotherapy.
Apparent diffusion coefficients measured using different regions of interest in differentiating borderline from malignant ovarian tumors
Authors: Lu Jing Jing , Pi Shan , Ma Feng Hua , Zhang Guo Fu , Wei Qiang Jin 
Published: October 2018

Background Apparent diffusion coefficients (ADCs) measured using different regions of interest (ROIs) are widely used in differentiating ovarian tumors. Purpose To evaluate the diagnostic performance of ADCs with different ROIs in differentiating borderline ovarian tumors (BOTs) from malignant ovarian tumors (MOTs). Material and Methods Thirty-five BOTs and 54 MOTs who underwent diffusion-weighted magnetic resonance imaging (MRI) were evaluated retrospectively. ADC values were independently measured using five ROI methods: round; rectangle; hot-spot; edge drawing; and five sample ROIs. The inter- and intraclass correlation coefficients (ICCs), one-way analysis of variance, receiver operating characteristic curve analysis, and unpaired t-tests were used to perform the statistical analyses. Results The measurement reproducibility of the minimum ADC and mean ADC values were good or excellent for BOTs and MOTs (ICC = 0.70–0.95). The minimum and mean ADC value by the edge drawing ROI were significantly higher than those of the other ROI methods (both P < 0.05). The area under the curve (AUC) of the minimum ADC value was less than that of the mean ADC value from the five ROI methods, whereas the AUCs of the mean ADC values from the round ROI and five sample ROIs were significantly larger than those of the other ROI methods ( P < 0.05). The minimum and mean ADC values from the five ROI methods showed significant differences between BOTs and MOTs (all P < 0.05). Conclusion The ROI shape influences the diagnostic performance of ADC value for differentiating BOTs from MOTs. The mean ADC values from the round ROI and five sample ROIs have better diagnostic efficiency.
Diagnostic accuracy of digital radiography for the diagnosis of osteonecrosis of the femoral head, revisited
Authors: Chee Choong Guen , Cho Jungheum , Kang Yusuhn , Kim Youngjune , Lee Eugene , Lee Joon Woo , Ahn Joong Mo , Kang Heung Sik 
Published: October 2018

Background The radiographic diagnosis of osteonecrosis of the femoral head (ONFH) is challenging for radiologists. Purpose To measure the sensitivity and specificity of digital radiography for diagnosing ONFH and to evaluate the diagnostic value of the frog-leg view. Material and Methods Patients diagnosed with ONFH by magnetic resonance imaging (MRI) (n = 132) and normal controls (n = 69) were included. Two radiologists independently graded the likelihood of ONFH and subchondral fracture on radiographs. First, the anteroposterior (AP) and frog-leg radiographs were assessed as a whole. Subsequently, randomly ordered unilaterally cropped AP radiographs were analyzed. Sensitivity and specificity were measured using MRI as reference standard. A subgroup analysis for pre-collapse ONFH was performed. The effect of within-subject correlation was analyzed using a generalized-estimating-equation approach. Inter-reader agreement was assessed with κ statistics. McNemar’s test was used to determine the additional diagnostic value of the frog-leg view. Results Among the 402 hips from 201 individuals, 191 were classified as normal, 73 as pre-collapse ONFH, and 138 as post-collapse ONFH. The sensitivity and specificity ranges for ONFH were 76–89% and 77–97%, respectively. For pre-collapse ONFH, the sensitivity and specificity were 52–71% and 78–97%, respectively. The κ ranges for the likelihood of ONFH and pre-collapse ONFH were 0.59–0.66 and 0.35–0.59, respectively. The frog-leg view did not provide additional value for diagnosing ONFH. Conclusion Diagnostic performance of digital radiography for ONFH revealed low sensitivity and poor-to-moderate inter-reader agreement for diagnosing pre-collapse ONFH. There was no additional value of the frog-leg view.
Struggling with everyday life after mild stroke with cognitive impairments – The experiences of working age women
Authors: Alenljung Maria , Ranada Åsa Larsson , Liedberg Gunilla M 
Published: October 2018

Introduction The aim of this study was to explore how women of working age who have had a mild stroke resulting in cognitive impairment experience and manage their everyday lives. Method Data were collected using semi-structured interviews. The participants consisted of 10 women of working age who had sustained cognitive impairment after a mild stroke. The interviews were analysed using qualitative content analysis. Results Three main categories appeared: The everyday is affected by the symptoms, Living strategies, and The social environment effects and changes. Participants feel insecure about their abilities and capabilities, experience anxiety and fear in relation to work, and find it hard to live up to demands and expectations. They are required to plan their daily activities in a new way and to prioritise chores that benefit the family, rather than follow their own interests and social activities. In order to cope with everyday life, they need to allocate chores to other family members. Conclusions The constant impact of fatigue and cognitive impairments affects everyday life. The women said that they had to learn to continuously manage their limitations through their experience of everyday life, something that can be facilitated with occupational therapy.
Cervical or trigonal transurethral resection in local advanced carcinoma of the prostate. Our experience
Authors: Fandella A. , Checchin P. , Maccatrozzo L. , Merlo F. , Faggiano L. , Tuccitto G. , Mangano M. , Anselmo G. 
Published: October 2018

Gli Autori riportano l'esperienza riguardo alla resezione endoscopica prostatica o trigonale (TUR) nei pazienti con neoplasia prostatica non suscettibile di soluzione radicale e non rispondente localmente alla terapia ormonale, con sintomatologia ostruttiva o con estensione trigonale ed infiltrazione degli osti ureterali (fino all'insufficenza renale). Tale metodica viene ritenuta una valida alternativa ad una derivazione urinaria mediante cateterismo o nefrostomia, sotto il profilo di una migliore qualità di vita. Vengono considerati 63 pazienti, su 72 trattati in 6 anni, con follow-up medio di 36 mesi; il successo immediato della procedura è stato dell'83% per quel che riguarda la disostruzione cervicale (53 pazienti su 63), e del 55% per le resezioni trigonali. In base all'analisi della esperienza pur numericamente limitata, la TUR sembrerebbe non compromettere la prognosi a distanza, non accelerando la diffusione sistemica della malattia. Patients with obstructive advanced prostatic carcinoma who don't respond to hormonal therapy, need a urinary drainage through an indwelling catheter or nephrostomy for a dilated kidney. The authors perform an endoscopic resection of the prostate with an associated trigonal resection if there is a dilated urinary system. Successful treatment, permits a better quality of life without a catheter or nephrostomies. We analysed 63 patients of 72 treated in 6 years with an average 36–month follow-up; the success of the procedure was 83% for cervical TUR and 55% for trigonal TUR. In our experience TUR in prostatic cancer appears to be a safe procedure; in fact in our series there is no postoperative mortality or morbility and the treatment doesn't increase cancer dissemination.
Young People, Alcohol and Norms: Italian Young People’s Opinions and Attitudes towards Alcohol Regulation
Authors: Beccaria Franca , Molinengo Giorgia , Prina Franco , Rolando Sara 
Published: October 2018

The study examines Italian young people’s opinions and attitudes towards alcohol policies in order to shed light on the potential challenges to the introduction of more restrictive policies. A mixed methods research design was employed. A CAWI survey and online forum targeted 15–25 year olds, resulting in 1,816 valid responses to the online questionnaires and 86 blog comments; focus groups were conducted with two different groups, aged 15–17 and 23–25, including 31 participants. The study indicated that young people are rather well informed about the law, and have generally positive opinions about alcohol-related regulation. Nevertheless, opinions and behaviours do not always match. Findings are consistent with more general reflections about the gap between attitudes and behaviours. A large majority of respondents express negative opinions about more restrictive alcohol availability norms. The study shows the lack of enforcement of current laws and the consequences of that on young people’s attitudes towards the law.
Use of intraosseous hypertonic saline in critically ill patients
Authors: Farrokh Salia , Cho Sung-Min , Lefebvre Austen T , Zink Elizabeth K , Schiavi Adam , Puttgen Hans A 
Published: October 2018

Background: Rapid administration of hypertonic saline 23.4% is crucial in treatment of herniation syndromes. Hypertonic 23.4% saline must be administered via a central line. In cases where central line access is difficult to obtain and leads to delay in therapy, placement of intraosseous access can be lifesaving. Main body: The purpose of this case series is to describe the use of intraosseous administration of 23.4% saline in critically ill patients and to assess feasibility. Conclusion: Intraosseous administration of 23.4% saline in 6 adult patients with neurological emergencies was feasible and should be considered in cases where obtaining intravenous access is time consuming.
Mechanical Noise Improves the Vibration Perception Threshold of the Foot in People With Diabetic Neuropathy
Authors: Zwaferink Jennefer B. J. , Hijmans Juha M. , Schrijver Claudia M. , Schrijver Laura K. , Postema Klaas , van Netten Jaap J. 
Published: October 2018

Background: Mechanical noise may improve somatosensation at the dorsal side of the foot, but the effect at the plantar side of the foot, the side most at risk for foot ulceration, is unknown. Moreover, techniques used in research so far have several problems that limit applicability in daily practice. Piezoelectric actuators may provide mechanical noise with better clinical applicability. We assessed the effects of piezoelectric actuators generating mechanical noise on the vibration perception threshold (VPT) at the plantar side of the foot in people with diabetic neuropathy. Methods: Double-blind within-subjects design in a controlled laboratory setting including participants with diabetic neuropathy (N = 40; 18 male; mean age 69.6 years; mean duration of diabetes 14.1 years; mean BMI 30.5). VPT was measured at three plantar foot locations with and without mechanical noise applied via piezoelectric actuators. Results: Mechanical noise improved VPT at metatarsophalangeal joint (MTP) 1 (left 39.3V vs 43.5V; right 39.0 vs 42.6 V), MTP5 (left 37.5V vs 41.7V; right 34.5V vs 40.8V) and the heel (left 40.0V vs 44.0V; right 39.3V vs 41.0V), all P < .001. Conclusions: Mechanical noise improves VPT at the plantar side of the foot in people with diabetic neuropathy. This is an important step for further development of insoles using mechanical noise that may have the potential to improve VPT and decrease the risk of foot ulceration.
Long-term mortality is increased in patients with undetected prediabetes and type-2 diabetes hospitalized for worsening heart failure and reduced ejection fraction
Authors: Pavlović Andrija , Polovina Marija , Ristić Arsen , Seferović Jelena P , Veljić Ivana , Simeunović Dejan , Milinković Ivan , Krljanac Gordana , Ašanin Milika , Oštrić-Pavlović Irena , Seferović Petar M 
Published: October 2018

Background We assessed the prevalence of newly diagnosed prediabetes and type-2 diabetes mellitus (T2DM), and their impact on long-term mortality in patients hospitalized for worsening heart failure with reduced ejection fraction (HFrEF). Methods We included patients hospitalized with HFrEF and New York Heart Association (NYHA) functional class II–III. Baseline two-hour oral glucose tolerance test was used to classify patients as normoglycaemic or having newly diagnosed prediabetes or T2DM. Outcomes included post-discharge all-cause and cardiovascular mortality during the median follow-up of 2.1 years. Results At baseline, out of 150 patients (mean-age 57 ± 12 years; 88% male), prediabetes was diagnosed in 65 (43%) patients, and T2DM in 29 (19%) patients. These patients were older and more often with NYHA class III symptoms, but distribution of comorbidities was similar to normoglycaemic patients. Taking normoglycaemic patients as a reference, adjusted risk of all-cause mortality was significantly increased both in patients with prediabetes (hazard ratio, 2.6; 95% confidence interval (CI), 1.1–6.3; p = 0.040) and in patients with T2DM (hazard ratio, 5.3; 95% CI, 1.7–15.3; p = 0.023). Likewise, both prediabetes (hazard ratio, 2.9; 95% CI, 1.1–7.9; p = 0.041) and T2DM (hazard ratio, 9.7; 95% CI 2.9–36.7; p = 0.018) independently increased the risk of cardiovascular mortality compared with normoglycaemic individuals. There was no interaction between either prediabetes or T2DM and heart failure aetiology or gender on study outcomes (all interaction p-values > 0.05). Conclusions Newly diagnosed prediabetes and T2DM are highly prevalent in patients hospitalized for worsening HFrEF and NYHA functional class II–III. Importantly, they impose independently increased long-term risk of higher all-cause and cardiovascular mortality.
Role competency scale on shared decision-making nurses: Development and psychometric properties
Authors: Tariman Joseph D , Katz Pamela , Bishop-Royse Jessica , Hartle Lisa , Szubski Katharine L , Enecio Toreend , Garcia Ima , Spawn Nadia , Masterton Katherine Jones 
Published: October 2018

Objectives: This study aimed to develop a scale that can measure the role competency of oncology nurses during shared decision-making process. Methods: A total of 226 oncology nurses who actively provide direct care to patients from inpatient and outpatient oncology units in the Midwest and Pacific Northwest completed the online or mail survey. Exploratory factor analysis and parallel analysis showed the multidimensionality of the role competency scale on shared decision-making nurses. Results: The role competency scale on shared decision-making nurses revealed four dimensions: knowledge, attitudes, communication, and adaptability. The 22 items have excellent internal consistency with a Cronbach’s alpha of 0.91. The four subscales also have adequate reliability with Cronbach’s alpha >0.70 as well as greater than 0.70 Spearman–Brown’s correlation coefficients in split-half reliability testing for each subscale. Conclusion: The new scale has the potential to be used as a clinical tool to assess the need for shared decision-making education and training in oncology nurses.
Infectious Endophthalmitis: Trends in Microbiology, Management, and Surgical Techniques
Authors: Keffer Stephen T. , Chin Eric K. , Almeida David R.P. 
Published: October 2018

Purpose: The purpose of this review is to provide an update on etiologies, preventive practices, management options, and surgical techniques for infectious endophthalmitis. Methods: A literature search was conducted for studies published over the past 5 years. Results: Endophthalmitis continues to be an uncommon but dangerous complication following cataract surgery. Recently, intravitreal injections have become heavily utilized as a treatment for various ocular diseases, leading to a greater incidence of postinjection infections. Likewise, long-term risk of endophthalmitis should always be a consideration following glaucoma surgery and implanted drainage devices. Although significant overlap exists for causative organisms among the different etiologies, more targeted studies are needed to better optimize treatment. There has been a lack of updates to treatment guidelines since the Endophthalmitis Vitrectomy Study was published in 1995. Despite promising outcomes seen with newer surgical techniques, the lack of randomized clinical trials represents a major barrier to widespread implementation of these approaches. Conclusions: Povidone-iodine prophylaxis remains the primary evidence-based technique for decreasing the rates of endophthalmitis following intraocular procedures. Intracameral antibiotics have gained momentum in recent years and represent a step forward in mitigating the risk of infection with cataract surgery, although some debate still exists. Newer surgical techniques for vitrectomy that improve visualization, minimize surgical trauma, and decrease operative time would benefit from large-scale randomized trials.
Genetic heterogeneity of cytogenetically normal AML with mutations of CEBPA
Authors: Konstandin Nikola P. , Pastore Friederike , Herold Tobias , Dufour Annika , Rothenberg-Thurley Maja , Hinrichsen Tanja , Ksienzyk Bianka , Tschuri Sebastian , Schneider Stephanie , Hoster Eva , Berdel Wolfgang E. , Woermann Bernhard J. , Sauerland Maria C. , Braess Jan , Bohlander Stefan K. , Klein Hanns-Georg , Hiddemann Wolfgang , Metzeler Klaus H. , Spiekermann Karsten 
Published: October 2018

AbstractBiallelic mutations of the CCAAT/enhancer binding protein α (CEBPA) gene define a distinct genetic entity of acute myeloid leukemia (AML) with favorable prognosis. The presence of GATA2 and CSF3R mutations that are specifically associated with this subgroup but not mutated in all samples suggests a genetic heterogeneity of biCEBPA-mutated AML. We characterized the mutational landscape of CEBPA-mutated cytogenetically normal AML by targeted amplicon resequencing. We analyzed 48 biallelically mutated CEBPA (biCEBPA), 32 monoallelically mutated CEBPA (moCEBPA), and 287 wild-type CEBPA (wtCEBPA) patient samples from German AML Cooperative Group studies or registry. Targeted sequencing of 42 genes revealed that moCEBPA patients had significantly more additional mutations and additional mutated genes than biCEBPA patients. Within the group of biCEBPA patients, we identified 2 genetic subgroups defined by the presence or absence of mutations in chromatin/DNA modifiers (C), cohesin complex (C), and splicing (S) genes: biCEBPACCSpos (25/48 [52%]) and biCEBPACCSneg (23/48 [48%]). Equivalent subgroups were identified in 51 biCEBPA patients from the Cancer Genome Project. Patients in the biCEBPACCSpos group were significantly older and had poorer overall survival and lower complete remission rates following intensive chemotherapy regimens compared with patients in the biCEBPACCSneg group. Patients with available remission samples from the biCEBPACCSpos group cleared the biCEBPA mutations, but most had persisting CCS mutations in complete remission, suggesting the presence of a preleukemic clone. In conclusion, CCS mutations define a distinct biological subgroup of biCEBPA AML that might refine prognostic classification of AML. This trial was registered at www.clinicaltrials.gov as #NCT00266136 and NCT01382147.
Natural History of Obesity Subphenotypes: Dynamic Changes Over Two Decades and Prognosis in the Framingham Heart Study
Authors: Echouffo-Tcheugui Justin B , Short Meghan I , Xanthakis Vanessa , Field Patrick , Sponholtz Todd R , Larson Martin G , Vasan Ramachandran S 
Published: October 2018

AbstractContextThe natural histories of obesity subphenotypes are incompletely delineated.ObjectivesTo investigate dynamic changes in obesity subphenotypes and associations with outcomes.Design, Setting, Participants, and MeasurementsFramingham Offspring Cohort participants (n = 4291) who attended the examination cycles 2 (1979 to 1983) to 7 (1998 to 2001), which included 26,508 participant observations. Obesity subphenotypes [metabolically healthy nonobese (MHNO), metabolically healthy obese (MHO), metabolically unhealthy nonobese (MUNO), and metabolically unhealthy obese (MUO)] were ascertained based on metabolic health (&lt;2 Adult Treatment Panel III criteria). The outcomes were subclinical cardiovascular disease (CVD), incident diseases [diabetes, hypertension, chronic kidney disease (CKD), CVD], and all-cause mortality.ResultsAt baseline, 4% and 31% of participants exhibited the MHO and MUNO subphenotypes, respectively. Four-year probability of MHO participants becoming MUO was 43% in women and 46% in men. Compared with MHNO, MHO participants had 1.28-fold (95% CI, 0.85 to 1.93) and 1.92-fold (95% CI, 1.38 to 2.68) higher odds of subclinical CVD and coronary artery calcification, respectively; corresponding values for MUNO were 1.95 (1.54 to 2.47) and 1.92 (1.38 to 2.68). During follow-up (median of 14 years), 231 participants developed diabetes, 784 hypertension, 423 CKD, 639 CVD, and 1296 died. Compared with MHNO, MHO conferred higher risks of diabetes [hazard ratio (HR), 4.69; 95% CI, 2.21 to 9.96] and hypertension (HR, 2.21; 95% CI, 1.66 to 2.94). Compared with MUO, MHO conferred lower risks of diabetes (0.21; 0.12 to 0.39), CVD (0.64; 0.43 to 0.95), and CKD (0.44; 0.27 to 0.73), but similar hypertension, cardiovascular mortality, and overall mortality risks.ConclusionOver time, most MHO participants developed metabolic abnormalities and clinical disease. The MHO subphenotype is a harbinger of future risk.