bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concussion Symptoms Predictive of Adolescent Sport-Related Concussion Injury
Authors: Harriss Alexandra B. , Abbott Kolten C. , Humphreys David , Daley Mark , Moir Marci Erin , Woehrle Emilie , Balestrini Christopher S. , Fischer Lisa K. , Fraser Douglas D. , Shoemaker Joel Kevin 
Published: April 2019

Objective:To assess the predictive capability of the postconcussion symptom scale (PCSS) of the sport concussion assessment tool (SCAT) III to differentiate concussed and nonconcussed adolescents.Design:Retrospective.Setting:Tertiary.Participants:Sixty-nine concussed (15.2 ± 1.6 years old) and 55 control (14.4 ± 1.7 years old) adolescents.Independent Variables:Postconcussion symptom scale.Main Outcome Measure:Two-proportion z-test determined differences in symptom endorsement between groups. To assess the predictive power of the PCSS, we trained an ensemble classifier composed of a forest of 1000 decision trees to classify subjects as concussed, or not concussed, based on PCSS responses. The initial classifier was trained on all 22-concussion symptoms addressed in the PCSS, whereas the second classifier removed concussion symptoms that were not statistically significant between groups.Results:Concussion symptoms common between groups were trouble falling asleep, more emotional, irritability, sadness, and anxious. After removal, analysis of the second classifier indicated that the 5 leading feature rankings of symptoms were headache, head pressure, light sensitivity, noise sensitivity, and “don't feel right,” which accounted for 52% of the variance between groups.Conclusions:Collectively, self-reported symptoms through the PCSS can differentiate concussed and nonconcussed adolescents. However, predictability for adolescent patients may be improved by removing emotional and sleep domain symptoms.
Delayed-Union of Acetabular Stress Fracture in Female Gymnast: Use of Teriparatide to Augment Healing
Authors: Gende Alecia , Thomsen Timothy W. , Marcussen Britt , Hettrich Carolyn 
Published: April 2019

Abstract:
Pelvic stress fractures are rare and present unique challenges for medical personnel. Delayed healing can lead to increased physical, psychological, and social stress for athletes. Recent literature suggests effective use of a synthetic derivative of parathyroid hormone, teriparatide, to augment healing of delayed-union stress fractures. We present a case of a female National Collegiate Athletic Association Division I gymnast successfully returned to play after a 12-week course of teriparatide injections for an ischioacetabular stress fracture.
Multimodal Assessment of Sport-Related Concussion
Authors: Sherry Natalie Sandel , Fazio-Sumrok Vanessa , Sufrinko Alicia , Collins Michael W. , Kontos Anthony P. 
Published: April 2019

Objective:
The purpose of this study was to determine which assessments best identify athletes with sport-related concussion (SRC) from healthy controls in the acute/early subacute phase (within 10 days of SRC) of injury.

Design:
Prospective, cohort study.

Setting:
Specialty concussion clinic.

Participants:
Sixty-four athletes with SRC (52% male) and 59 matched (age and sex), healthy controls (56% male) aged 12 to 20 years (Mean [M] = 15.07, Standard Deviation [SD] = 2.23).

Assessment:
Participants completed symptom, cognitive, vestibular/oculomotor, near point of convergence (NPC), and balance assessments.

Main Outcome Measures:
Univariate analyses were conducted to compare athletes with SRC to healthy controls across all assessments. Assessments that significantly differed between the SRC group and healthy controls were used as predictors in an enter method logistic regression (LR) model and subsequent forward stepwise LR.

Results:
Results of LR analyses indicated that symptom inventory and symptom provocation on vestibular/oculomotor assessments significantly predicted athletes with SRC versus controls. The forward stepwise LR accurately classified 84.6% of the overall sample (78.3% of athletes with SRC and 91.2% of controls were accurately predicted) and accounted for 60.5% of the variance in predicting athletes with SRC versus controls. Total symptom inventory score (P = 0.003) and vestibular/oculomotor symptom provocation (P < 0.01) were the most sensitive and specific measures in a comprehensive, multimodal assessment for distinguishing athletes with SRC from healthy controls within 10 days of injury.

Conclusions:
Elements within a multimodal evaluation that are the most robust at discriminating athletes with SRC from healthy controls in the acute/early subacute phase of injury include symptom report and provocation of symptoms on vestibular/oculomotor assessment. These assessments should be considered in conjunction with other objective assessments (ie, NPC measurement and cognitive testing) as part of a comprehensive evaluation of SRC.
Organ Weight Reference Ranges for Ages 0 to 12 Years
Authors: Molina D. Kimberley , Pinneri Kathy , Stash John A. , Li Ling , Vance Kathryn , Cross Caroline 
Published: April 2019

Abstract
Abnormal organ weights often serve as an indicator of underlying disease or other pathological process making assessment of organ weight a critical part of the autopsy examination and interpretation. Unfortunately, normal organ weights for children are often based on studies done in the 1930s and 1960s. Thus, the present study was designed to accurately assess organ weights in children to establish reference ranges for use in autopsy examinations. A total of 1759 traumatic deaths in children aged 0 to 12 years were reviewed. Analysis revealed that body length was the best predictor for organ weight. Reference ranges were established and stratified by both age and body length.
Health Literacy, Self-management Activities, and Glycemic Control Among Adults With Type 2 Diabetes: A Path Analysis
Authors: Luo Huabin , Patil Shivajirao P. , Cummings Doyle M. , Bell Ronny A. , Wu Qiang , Adams Alyssa D. 
Published: April 2019

Purpose:
This study evaluated a novel composite measure of health literacy and numeracy by assessing its predictive validity for diabetes self-care activities and glycemic control.

Methods:
Patients (N = 102) with type 2 diabetes were recruited from a family medicine clinic at an academic medical center. Combined health literacy was assessed by combining the results of the Health Literacy Scale and the Subjective Numeracy Scale. Self-management activities were assessed by the Summary of Diabetes Self-Care Activities scale. Hemoglobin A1c (A1c) values were extracted from patients' medical records to assess glycemic control. Path models were used to test the predicted pathways linking health literacy and numeracy, independently and together, to self-management activities and glycemic control.

Results:
The mean combined literacy score was 72.0 (range, 33-104); the mean health literacy score alone was 43.9 (range, 14-56); and the mean numeracy score alone was 28.1 (range, 8-48). The direct effects results showed that the combined health literacy score (B = 0.107, P < .05) and the health literacy score alone (B = 0.234, P < .05) were significantly associated with self-care activities. The health literacy score alone also had a significant direct effect on A1c (B = −0.081, P < .05). The indirect effects of the combined health literacy on glycemic control through self-care activities were not statistically significant.

Conclusions:
Findings from this study suggest that the combined health literacy has predictive validity for self-care activities whereas the health literacy alone has predictive validity for glycemic control. More research is needed to validate these findings. Higher patient health literacy skills were not consistently associated with higher perceived numeracy skills. Additional attention and efforts should be made to make sure patients understand medical instructions involving numerical calculations.
Building Collective Efficacy to Support Public Health Workforce Development
Authors: Tower Craig , Van Nostrand Elizabeth , Misra Ranjita , Barnett Daniel J. 
Published: April 2019

Context:
Leaders in public health have made great advances in workforce development over the past 30 years, while shifting from an emphasis based in training on individual, technical skills to a more holistic development approach, which boosts crosscutting skills. Efforts to increase public health workforce capabilities remain focused on workers as individuals, rather than the workforce as a collective unit.

Program:
Research has shown that a strategic adult learning approach can improve both individual capabilities and the collective performance of the workforce, which can be explained using social cognitive theory and the concept of collective efficacy, or the collective belief of workers in the ability of the group to succeed. We explain how a prior training program pushed us to explore this approach.

Implementation:
The proposed approach covers proposed implementation strategies to build collective efficacy as part of existing workforce development initiatives, with a focus on 5 key steps.

Evaluation:
Experience in fields as diverse as sports psychology and organizational development has shown that it is possible to evaluate changes in collective efficacy using measures that can be adopted in public health.

Discussion:
Adjusting existing public health workforce development initiatives to build collective efficacy can help link workforce self-confidence to performance. More actionable data are needed to determine the best methods for achieving those goals in the field of public health.
Spatiotemporal Analysis of Oklahoma Tobacco Helpline Registrations Using Geoimputation and Joinpoint Analysis
Authors: Dilekli Naci , Janitz Amanda , Martinez Sydney , Gopalani Sameer , Dougherty Tyler , Williams Aaron , Sabzi Hamed Zamani , Campbell Janis 
Published: April 2019

Objective:
Tobacco quitlines provide free smoking cessation telephone services to smokers interested in quitting tobacco. We aimed to explore spatial and temporal analyses of registrations to the Oklahoma Tobacco Helpline including those of any racial group and American Indians (AI) from January 1, 2006, to June 30, 2017. This will allow tribal and community organizations, such as the Oklahoma Tribal Epidemiology Center, to better implement and evaluate public health prevention efforts at a smaller geographic area using the larger geographic units that are publicly available.

Design:
Retrospective, descriptive study.

Setting:
Oklahoma.

Participants:
Registrants to the Oklahoma Tobacco Helpline.

Main Outcome Measures:
To evaluate the spatial distribution of Helpline participants using geoimputation methods and evaluate the presence of time trends measured through annual percent change (APC).

Results:
We observed increased density of participants in the major population centers, Oklahoma City and Tulsa. Density of AI registrations was higher in the rural areas of Oklahoma where there is a larger tribal presence compared with participants of any racial group. For all racial groups combined, we identified 3 significant trends increasing from July 2008 to March 2009 (APC: 10.9, 95% confidence interval [CI], 0.8-21.9), decreasing from March 2009 to May 2014 (APC: −0.8, 95% CI: −1.1 to −0.4), and increasing from May 2014 to June 2017 (APC: 0.8, 95% CI: 0.0-1.6). The number of AI registrations to the Helpline increased significantly from July 2008 to March 2009 (APC: 12.0, 95% CI: 2.0-22.9) and decreased from March 2009 to June 2014 (APC: −0.7, 95% CI: −1.0 to −0.3).

Conclusions:
Results of this project will allow the Helpline to efficiently identify geographic areas to increase registrations and reduce commercial tobacco use among the AI population in Oklahoma through existing programs at the Oklahoma Tribal Epidemiology Center.
An Observational Study of a Simulation-Based Cross-Discipline Learning Activity Between Theater Arts and Physical Therapy Students
Authors: Dennis Diane M. , Parry Sharon , Miolin Philip , Mercer Leah , Furness Anne 
Published: April 2019

Introduction
Professional actors are often used to portray simulated patients during healthcare professional training. This study aimed to create an activity where physical therapy (PT) and theater arts (TA) students could address discrete learning outcomes in a common setting with mutual benefit.

Methods
Mixed methods observational study of 246 university students (201 PT, 45 TA) undertaking a scenario involving the provision of a clinical history. All students completed a 5-question qualitative survey relating to the activity, and each group scored themselves and each other using an observer rubric rating performance from 1 (do not agree) to 10 (agree).

Results
For PT students, the range of means (SDs) across the five questions were significantly different (P < 0.001) with 6.2 (1.6) to 6.8 (1.4) for self-assessment and 8.2 (1.4) to 8.7 (1.1) for TA assessment of PT. For TA students, across all repetitions and all questions, the mean (SD) was 7.6 (1.5) for self-assessment and 7.9 (1.2) for PT assessment of TA, representing a significant difference (P < 0.001). After initial enactment, there was a significant improvement in TA self-assessment of performance (P = 0.002), but thereafter, there was no significant difference over time (P = 0.114).
Qualitative data analysis revealed the following three themes common to both groups: worthiness, authenticity/realism, and anxiety/confidence. The PT students also identified history-taking skills and the importance of patient/PT relationships. The TA students identified learning around character portrayal, improvisation, and concentration.

Conclusions
This study describes a simulation-based learning activity undertaken within existing infrastructure with complementary learning objectives for both TA and PT students that was realistic and engaging.
Association of the Number of a Simulation Faculty With the Implementation of Simulation-Based Education
Authors: Takahashi Jin , Shiga Takashi , Funakoshi Hiraku , Homma Yosuke , Mizobe Michiko , Ishigami Yuichiro , Honda Hideki 
Published: April 2019

Introduction
Although the implementation of simulation-based education (SBE) is essential for emergency medicine residency programs (EMRPs), little is known about the factors associated with its degree of SBE implementation in EMRPs. Therefore, this study aimed to investigate factors associated with SBE implementation in EMRPs. We hypothesized that the number of the simulation faculty was associated with the degree of SBE implementation.

Methods
We conducted a multicenter, cross-sectional survey on SBE implementation in emergency medicine resident education, in accredited EMRPs in the Greater Tokyo area, Japan. Survey question themes included institutional characteristics and the status of simulation education in them. For analyzing factors associated with SBE implementation, we defined EMRPs with a robust SBE implementation as those having an annual simulation time exceeding 10 hours.

Results
The survey response rate was 73% (115/158). Of the EMRPs that responded, 32% reported that their annual simulation time was more than 10 hours. In the unadjusted analysis, possession of a simulator in the emergency department was significantly associated with nonrobust SBE implementation, but the number of the simulation faculty was significantly associated. On adjusting for possession of a simulator in the emergency department, presence of simulation curriculum, and presence of simulation-based formative or comprehensive assessment, we observed an association of robust SBE implementation with a number of the simulation faculty (unit odds ratio = 1.33; 95% confidence interval = 1.10–1.60).

Conclusions
To our knowledge, this is the first Japanese study to demonstrate that the number of the simulation faculty at a program is independently associated with a robust SBE implementation.
Breast Cancer Detection
Authors: Veitch Daisy E. , Bochner Melissa , Molenbroek Johan F. M. , Goossens Richard H. M. , Owen Harry 
Published: April 2019

Introduction
There is still a need for competent breast lump detection palpation skills, especially in developing countries. Our goal is to design, develop, and establish a test to determine whether students can, by touch alone, identify and discriminate between a range of different simulated lesions at different adiposity levels.

Methods
Common lesions, breast cancers, and cysts were physically simulated and hidden in a test object referred to as the “tactile landscape” (TL). Ribs, intercostal muscle, and nodularity—normal anatomical features—increased their realistic complexity. Varying depths of features simulated varying degrees of adiposity. A testing protocol was created to determine the testee's ability to identify and discriminate different commonly occurring breast masses using palpation. Five experts (four breast surgeons and one general practitioner) and 20 inexperienced medical students were recruited and tested. Results were compared.

Results
The TL has been based on previously verified breast models and has softness similar to 53% of women's breasts and nodularity similar to 60% as assessed in a breast clinic by breast surgeons. The five experts indicated that the simulated lesions felt like those they might encounter in clinical practice and all of them identified the lesions and nonlesions hidden in the TL 100% correctly, thus indicating the value of the model. In contrast, only one student was able to identify all the lesions. One student identified none of them. The remaining students mean score was 65%.

Conclusions
All students but one performed poorly in comparison to the experts. This indicates that the test could be useful to test students' ability to identify and discriminate breast masses. If successful, it will add previously missing capability to the mix of assessment instruments already used, thus potentially improving clinical breast examination training and assessment.
Widespread FUS mislocalization is a molecular hallmark of ALS
Authors: Tyzack Giulia E. , Luisier Raphaelle , Taha Doaa M. , Neeves Jacob , Modic Miha , Mitchell Jamie S. , Meyer Ione , Greensmith Linda , Newcombe Jia , Ule Jernej , Luscombe Nicholas M. , Patani Rickie 
Published: April 2019

AbstractAmyotrophic lateral sclerosis (ALS)-causing mutations clearly implicate ubiquitously expressed and predominantly nuclear RNA binding proteins (RBPs), which form pathological cytoplasmic inclusions in this context. However, the possibility that wild-type RBPs mislocalize without necessarily becoming constituents of ALS cytoplasmic inclusions themselves remains unexplored. We hypothesized that nuclear-to-cytoplasmic mislocalization of the RBP Fused in Sarcoma (FUS), in an unaggregated state, may occur more widely in ALS that previously recognized. To address this hypothesis, we analysed motor neurons (MNs) from an human ALS induced-pluripotent stem cells (iPSC) model caused by the VCP mutation. Additionally, we examined mouse transgenic models and post-mortem tissue from human sporadic ALS cases. We report nuclear-to-cytoplasmic mislocalization of FUS in both VCP-mutation related ALS and, crucially, in sporadic ALS spinal cord tissue from multiple cases. Furthermore, we provide evidence that FUS protein binds to an aberrantly retained intron within the SFPQ transcript, which is exported from the nucleus into the cytoplasm. Collectively, these data support a model for ALS pathogenesis whereby aberrant intron-retention in SFPQ transcripts contributes to FUS mislocalization through their direct interaction and nuclear export. In summary, we report widespread mislocalization of the FUS protein in ALS and propose a putative underlying mechanism for this process.
Impaired speed encoding is associated with reduced grid cell periodicity in a mouse model of tauopathy
Authors: Ridler Thomas , Witton Jonathan , Phillips Keith G. , Randall Andrew D. , Brown Jonathan T. 
Published: April 2019

AbstractDementia is associated with severe spatial memory deficits which arise from dysfunction in hippocampal and parahippocampal circuits. For spatially-sensitive neurons, such as grid cells, to faithfully represent the environment these circuits require precise encoding of direction and velocity information. Here we have probed the firing rate coding properties of neurons in medial entorhinal cortex (MEC) in a mouse model of tauopathy. We find that grid cell firing patterns are largely absent in rTg4510 mice, while head direction tuning remains largely intact. Conversely, neural representation of running speed information was significantly disturbed, with smaller proportions of MEC cells having firing rates correlated with locomotion in rTg4510 mice. Additionally, the power of local field potential oscillations in the theta and gamma frequency bands, which in wildtype mice are tightly linked to running speed, was invariant in rTg4510 mice. These deficits in locomotor speed encoding likely severely impact path integration systems in dementia.
Correlation of Microglial Activation with White Matter Changes in Dementia with Lewy Bodies
Authors: Nicastro Nicolas , Mak Elijah , Williams Guy B. , Surendranathan Ajenthan , Bevan-Jones William Richard , Passamonti Luca , Rodriguez Patricia Vazquez , Su Li , Arnold Robert , Aigbirhio Franklin I. , Rowe James B. , O’brien John T. 
Published: April 2019

ABSTRACTDementia with Lewy bodies (DLB) is the second-leading degenerative dementia after Alzheimer’s disase. Neuropathologically, it is characterized by alpha-synuclein protein deposition with variable degree of concurrent Alzheimer pathology. Neuroinflammation is increasingly recognized as a significant contributor of degeneration.Objectiveto examine the relationship between microglial activation as measured with [11C]-PK11195 brain PET and MR diffusion tensor imaging (DTI) in DLB.Methodsnineteen clinically probable DLB and 20 similarly aged controls underwent structural MRI with T1-weighted and 3T DTI sequences. Eighteen DLB subjects also underwent [11C]-PK11195 PET imaging. Tract-Based Spatial Statistics (TBSS) were performed to compare DTI parameters in DLB relative to controls and identify associations of [11C]-PK11195 binding with white matter integrity.ResultsTBSS showed widespread changes in all DTI parameters in the DLB group compared to controls (Threshold Free Cluster Enhancement (TFCE) p < 0.05). [11C]-PK11195 binding in parietal cortices also correlated with widespread lower mean and radial diffusivity (TFCE p < 0.05).ConclusionOur study demonstrates that higher PK11195 binding is associated with a relative preservation of white matter, positioning neuroinflammation as a potential early marker in the DLB pathogenic cascade.
Using balances to engineer features for the classification of health biomarkers: a new approach to balance selection
Authors: Quinn Thomas P. , Erb Ionas 
Published: April 2019

AbstractSince the turn of the century, technological advances have made it possible to obtain a molecular profile of any tissue in a cost-effective manner. Among these advances include sophisticated high-throughput assays that measure the relative abundance of microorganisms, RNA molecules, and metabolites. While these data are most often collected to gain new insights into biological systems, they can also be used as biomarkers to create clinically useful diagnostic classifiers. How best to classify high-dimensional “-omics” data remains an area of active research. However, few explicitly model the relative nature of these data, and instead rely on cumbersome normalizations which often invoke untestable assumptions. This report (a) emphasizes the relative nature of health biomarkers, (b) discusses the literature surrounding the classification of relative data, and (c) benchmarks how different transformations perform across multiple biomarker types. In doing so, this report explores how one could use balances to engineer features prior to classification, and proposes a simple procedure, called discriminative balance analysis, to select discriminative 2- and 3-part balances.