bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of meningococcal group B vaccination in hospitalised premature infants
Authors: Kent Alison , Beebeejaun Kazim , Braccio Serena , Kadambari Seilesh , Clarke Paul , Heath Paul T , Ladhani Shamez 
Published: April 2018

ObjectivesTo assess the risk of significant adverse events in premature infants receiving the novel 4-component group B meningococcal vaccine (4CMenB) with their routine immunisations at 2 months of age.Participants, design and settingIn December 2015, Public Health England requested neonatal units across England to voluntarily participate in a national audit; 19 units agreed to participate. Anonymised questionnaires were completed for infants receiving 4CMenB alongside their routine immunisations. For comparison, a historical cohort of premature infants receiving their primary immunisations without 4CMenB or paracetamol prophylaxis was used.Main outcome measuresParacetamol use; temperature, cardiovascular, respiratory and neurological status before and after vaccination; and management and investigations postvaccination, including serum C reactive protein levels, infection screens and antibiotic use.ResultsComplete questionnaires were returned for 133 premature infants (<35 weeks’ gestation) who received their first dose of 4CMenB at 8 weeks of age, including 108 who received prophylactic paracetamol according to national recommendations. Overall, 7% (8/108) of infants receiving 4CMenB with paracetamol had fever (>38°C) after vaccination compared with 20% (5/25) of those receiving 4CMenB without paracetamol (P=0.06) and none of those in the historical cohort. There were no significant differences between cohorts in the proportion of infants with apnoea, bradycardia, desaturation and receiving respiratory support after vaccination.Conclusions4CMenB does not increase the risk of serious adverse events in hospitalised premature infants. This audit supports the current national recommendations to offer 4CMenB with other routine vaccinations and prophylactic paracetamol to premature infants at their chronological age.
Reliability of the Shoulder Symptom Modification Procedure and association of within-session and between-session changes with functional outcomes
Authors: Meakins Adam , May Stephen , Littlewood Chris 
Published: April 2018

BackgroundDespite being a common problem, there is considerable diagnostic uncertainty with regard to shoulder pain. This uncertainty relates to the reliability and validity of current examination tests. The Shoulder Symptom Modification Procedure (SSMP) has been proposed as an alternative to existing approaches.ObjectiveTo evaluate interclinician reliability of the SSMP and the association of within-session and between-session changes on clinical outcome at 1 week, and at 1 and 3 months.DesignA single-centre reliability study, with prospective follow-up.MethodsTwenty-six patients with shoulder pain were recruited. Following an initial SSMP-based examination, a second examination was performed by a second physiotherapist, blinded to the results of the first examination. Clinical outcome data were completed after 1 week, 1 month and 3 months via theNumeric Pain Rating Scale and the Shoulder PainandDisability Index. Reliability was evaluated using kappa and associations were evaluated using Spearman’s r.ResultsInter-rater reliability of the SSMP was moderate (κ=0.47). Association of within-session changes ranged from fair to poor in the short term (r=0.24–0.01) to poor in the mid-term (r=−0.03). The association of between-session changes ranged from substantial to moderate in the short term (r=0.74–0.47) but slight in the mid-term (r=0.22).ConclusionsBased on this study, we cannot recommend the SSMP as a reliable tool for physical examination of patients with shoulder pain. The importance of within-session and between-session changes remains uncertain.
Long-term effects of daily physical education throughout compulsory school on duration of physical activity in young adulthood: an 11-year prospective controlled study
Authors: Lahti Amanda , Rosengren Björn E , Nilsson Jan-Åke , Karlsson Caroline , Karlsson Magnus K 
Published: April 2018

ObjectivesWe examined whether daily physical activity (PA) during compulsory school encourages children to be more physically active during the intervention and 4 years after termination of the programme.MethodsThis prospective controlled intervention study followed the same 124 children (81 children in an intervention group and 43 controls) aged 7.7±0.6 (mean±SD) during a 7-year PA intervention and 4 years after the intervention when the children were 18.7±0.3 years old. The intervention included daily school physical education (PE) (200 min/week), whereas the controls continued with the Swedish standard of 60 min/week. Using a questionnaire, we gathered data about total PA, leisure time PA and sedentary activities (SA). Group comparisons are adjusted for age and gender, and data are provided as means with 95% CIs.ResultsAt baseline, we found similar duration of PA and SA between groups. After a mean of 7 years with intervention, the intervention group was more physically active than the controls (+4.5 (2.9 to 6.0) hours/week), whereas SA was similar (+0.6 (−2.5 to 3.9) hours/week). Four years beyond the intervention, the intervention group was still more physically active than the controls (2.7 (0.8 to 4.7) hours/week), and SA was still similar (−3.9 (−9.7 to 1.7) hours/week).ConclusionsIntervention with daily school PE throughout compulsory school is associated with higher duration of PA not only during the intervention but also 4 years after termination of the programme.
Seatbelt use is associated with lower risk of high-grade hepatic injury in motor vehicle crashes in a national sample
Authors: Renson Audrey , Musser Brynne , Schubert Finn D , Bjurlin Marc A 
Published: April 2018

BackgroundSeatbelt use, alone and in conjunction with an airbag, is associated with lower risk of mortality, blunt abdominal trauma and kidney injury in motor vehicle crashes (MVCs). However, the effect of these protective devices on risk of severe liver injury is not well characterised.MethodsThis retrospective cohort study included patient admissions with liver injuries from MVCs from the National Trauma Data Bank (NTDB), collected from 2010 to 2015 in the USA. We examined associations between injury severity and seatbelt use and airbag presence individually and in the presence of additive interaction. Secondary outcomes were mortality, complications and discharge disposition.ResultsWe analysed 55 543 records from the National Trauma Data Bank. In adjusted analysis, seatbelt use alone was protective against severe (AAST VI or above) hepatic injury (risk ratio (RR) 0.79, 95% CI 0.75 to 0.84), while airbag presence alone was not (RR 1.05, 95% CI 0.8 to 1.12). The joint association of seatbelt use and airbag presence with injury severity was greater than seatbelts alone (RR 0.74, 95% CI 0.70 to 0.79), with 13% of the joint lower risk attributable to interaction (95% CI 3% to 24%). The adjusted mortality risk of those without protective devices (10.3%, n=2297) was nearly double that of patients who used a seatbelt in conjunction with a present airbag (5.3%, n=699, p<0.001).ConclusionsSeatbelts are associated with lower liver injury severity and are more protective with airbags present, while airbags without seatbelt use were not protective against severe injury among patients with liver injury.
Clinical and epidemiological variability in severe sepsis: an ecological study
Authors: Vakkalanka J Priyanka , Harland Karisa K , Swanson Morgan B , Mohr Nicholas M 
Published: April 2018

BackgroundTo assess clinical and epidemiological trends of severe sepsis.MethodsEcological study of patients presenting to the emergency department with severe sepsis or septic shock between 2005 and 2013. Patients were identified using the state-wide hospital administrative database. Key outcomes included incidence rates (IRs) and mortality rates (per 1000 population) by age and medically underserved areas (MUAs), sepsis case fatality rate (deaths per 100 sepsis cases), and proportions of transfer and comorbidities.ResultsThere were 154 019 sepsis cases identified. In 2005, 85+ yo in non-MUAs had a 44% increase in IR compared with those in MUAs, and this difference rose to 74% by 2013. Mortality rates were 1.6 (95% CI 1.3 to 1.8) times greater among 85+ yo in non-MUAs. Mortality rates increased by 1.8% annually, while the sepsis case fatality rate decreased by 7.7%. The proportion of transfer among sepsis cases decreased by 2.1% per year (3.8% in non-MUAs, 0.7% in MUAs).ConclusionsSepsis incidence varies geographically, and access to healthcare is one proposed mechanism that may explain heterogeneity. Over time, we may be capturing higher acuity sepsis cases with better recognition and management, as well as observing differential diagnostic coding documentation by location.
Calcium-Induced Differentiation of Human Colon Adenomas in Colonoid Culture: Calcium Alone versus Calcium with Additional Trace Elements
Authors: McClintock Shannon D. , Colacino Justin A. , Attili Durga , Dame Michael K. , Richter Aliah , Reddy Anusha R. , Basrur Venkatesha , Rizvi Areeba H. , Turgeon D. Kim , Varani James , Aslam Muhammad N. 
Published: April 2018

AbstractPrevious murine studies have demonstrated that dietary Aquamin, a calcium-rich, multi-mineral natural product, suppressed colon polyp formation and transition to invasive tumors more effectively than calcium alone when provided over the lifespan of the animals. In the current study, we compared calcium alone to Aquamin for modulation of growth and differentiation in human colon adenomas in colonoid culture. Colonoids established from normal colonic tissue were examined in parallel. Both calcium alone at 1.5 mmol/L and Aquamin (provided at 1.5 mmol/L calcium) fostered differentiation in the adenoma colonoid cultures as compared with control (calcium at 0.15 mmol/L). When Aquamin was provided at an amount delivering 0.15 mmol/L calcium, adenoma differentiation also occurred, but was not as complete. Characteristic of colonoids undergoing differentiation was a reduction in the number of small, highly proliferative buds and their replacement by fewer but larger buds with smoother surface. Proliferation marker (Ki67) expression was reduced and markers of differentiation (CK20 and occludin) were increased along with E-cadherin translocalization to the cell surface. Additional proteins associated with differentiation/growth control [including histone-1 family members, certain keratins, NF2 (merlin), olfactomedin-4 and metallothioneins] were altered as assessed by proteomics. Immunohistologic expression of NF2 was higher with Aquamin as compared with calcium at either concentration. These findings support the conclusions that (i) calcium (1.5 mmol/L) has the capacity to modulate growth and differentiation in large human colon adenomas and (ii) Aquamin delivering 0.15 mmol/L calcium has effects on proliferation and differentiation not observed when calcium is used alone at this concentration. Cancer Prev Res; 11(7); 413–28. ©2018 AACR.
Larval host plants of the butterflies of the Western Ghats, India
Authors: Nitin Ravikanthachari , Balakrishnan V. C. , Churi Paresh V. , Kalesh S. , Prakash Satya , Kunte Krushnamegh 
Published: April 2018

We present a systematic, updated checklist of larval host plants of the butterflies of the Western Ghats, a globally recognized biodiversity hotspot. This includes recent new records, with a total of approximately 834 plant species/groups belonging to 88 families that are used by 320 butterfly species of the Western Ghats (the host plant records for 16 species are unknown). A reverse list is also provided as a reference to plant species-wise plant-butterfly associations. This work highlights the diversity of plant species on which the endemic and other butterfly species of the Western Ghats depend.
Frequency of Patent Foramen Ovale and Migraine in Patients With Cryptogenic Stroke
Authors: West Brian H. , Noureddin Nabil , Mamzhi Yakov , Low Christopher G. , Coluzzi Alexandra C. , Shih Evan J. , Gevorgyan Fleming Rubine , Saver Jeffrey L. , Liebeskind David S. , Charles Andrew , Tobis Jonathan M. 
Published: April 2018

Background and Purpose—
Individuals with migraine are at higher risk for stroke, but the mechanism has not been established. On the basis of the association between migraine and intracardiac right-to-left shunt, it has been proposed that stroke in migraineurs could be caused by a paradoxical embolus passing through a patent foramen ovale (PFO) or pulmonary arteriovenous malformation. The aim of this study was to determine the prevalence of PFO with right-to-left shunt in patients who presented with cryptogenic stroke and had a history of migraine.

Methods—
Patients between 18 and 60 years old who presented with an ischemic stroke were characterized based on ASCOD phenotyping (atherosclerosis; small-vessel disease; cardiac pathology; other causes; dissection). A migraine diagnosis was identified by reviewing physician notes, and frequent aura was defined if present in at least 50% of attacks. A PFO with right-to-left shunt diagnosis was identified by the presence of a positive bubble contrast study with either transcranial Doppler, transthoracic, or transesophageal echocardiography.

Results—
Of the 712 patients who presented with ischemic stroke, 127 (18%) were diagnosed as cryptogenic; 68 patients had adequate testing for PFO and a documented migraine history. The prevalence of PFO in patients with cryptogenic stroke without migraine was elevated (59%) compared with the general population (18%). Patients with both cryptogenic stroke and migraine had a higher prevalence of PFO (79%). In patients with cryptogenic stroke who had migraine with frequent aura, the prevalence of PFO was 93%. Only 5 patients (4%) had a history compatible with migrainous infarction.

Conclusions—
In patients with cryptogenic stroke who have migraine, there is a high prevalence (79%) of PFO with right-to-left shunt. The timing of the stroke in migraineurs is usually not related to a migraine attack. These observations are consistent with the hypothesis that the mechanism of stroke in migraineurs is most likely because of a paradoxical embolus. Future cryptogenic stroke classification schemes should consider including PFO as a separate etiologic category.
The Record-Breaking Heat Wave in 2016 over South Korea and Its Physical Mechanism
Authors: Yeh Sang-Wook , Won You-Jin , Hong Jin-Sil , Lee Kang-Jin , Kwon MinHo , Seo Kyong-Hwan , Ham Yoo-Geun 
Published: April 2018

Abstract
It is important to understand the dynamical processes that cause heat waves at regional scales. This study examined the physical mechanism that was responsible for a heat wave in South Korea in August 2016. Unlike previous August heat waves over the Korean Peninsula, the intensity of the geopotential height over the Kamchatka Peninsula in August 2016 was the strongest since 1979, which acted as an atmospheric blocking in the downstream region of the Korean Peninsula. Therefore, the anomalous high geopotential height in Mongolia, where the surface temperature was quite high, was observed persistently in August 2016. This anomalous high in Mongolia induced northerly winds with warm temperatures onto the Korean Peninsula, which contributed to a heat wave in August 2016. We further showed that the anomalous high geopotential height over the Kamchatka Peninsula in August 2016 was triggered by strong convection in the western-to-central subtropical Pacific through atmospheric teleconnections, which was quite different from a typical heat wave over the Korean Peninsula, in which convective forcing around the South China Sea is strong. This implies that convective forcing in the subtropical Pacific should also be monitored to predict heat wave events in East Asia, including South Korea. On the other hand, the zonal wave train associated with the circumglobal teleconnection pattern is also associated with the anomalous high geopotential height around Mongolia and the Kamchatka Peninsula, which may have contributed to the heat wave in August 2016.
Second pelvic recurrence of rectal cancer successfully treated with a re-reirradiation (3rd radiation course)
Authors: Dell’Acqua Veronica , Ferrari Annamaria , Ciardo Delia , Piperno Gaia , Vigorito Sabrina , Leonardi Mariacristina , Dicuonzo Samantha , Orecchia Roberto , Jereczek-Fossa Barbara Alicja 
Published: April 2018

Introduction: In case of pelvic recurrence of colorectal cancer, reirradiation of previously irradiated patients may increase the rate of salvage radical resection. Due to the high cumulative dose, one of the main concerns is radiation-induced lumbosacral plexopathy. This report describes multiple irradiations of a lesion adjacent to the lumbosacral plexus, using a highly selective technique, which allows optimal sparing of such a critical structure. Case description A 53-year-old woman treated in 2008 for a locally advanced rectal adenocarcinoma with preoperative pelvic irradiation and concomitant chemotherapy followed by surgery had disease recurrence in 2011 and underwent a second course of pelvic radiotherapy. In December 2015, magnetic resonance imaging showed a single local recurrence infiltrating the muscle next to the right lumbosacral plexus and close to the cauda equina. Repeat reirradiation was planned. The total dose deriving from the previous treatment plans was assessed by nonrigid image registration using the dedicated tool implemented in MIM 6.1.7 (MIMvista Corp., Cleveland, OH). The treatment was performed with Cyberknife (Accuray, Sunnyvale, CA) with a schedule of 20 Gy in 5 fractions (4 Gy per fraction). The dose was prescribed to 70% isodose and target coverage was 97%. Two months after the treatment, magnetic resonance imaging showed a decreased signal and stable disease with no change in tumor size. Conclusions This case report suggests that pelvic re-reirradiation might be a possibility in very carefully selected cases of rectal cancer, using high-precision radiation modalities.
Examination of psychometric properties of PROMIS®: Pediatric upper limb measures in youth with cerebral palsy
Authors: Mulcahey Mary Jane , Slavin Mary D , Pengsheng Ni , Kratz Anna , Kisala Pamela A , Tulsky David S , Jette Alan M 
Published: April 2018

Introduction This study examines the validity and distribution characteristics of the PROMIS® pediatric upper limb measures in a sample of young people with cerebral palsy. Method Data are a cross-sectional subset of a larger prospective study of the responsiveness to change of PROMIS® pediatric measures following surgery to improve functioning in young people with cerebral palsy. Ninety-three participants between the ages of eight and 21 years completed the PROMIS® pediatric mobility and upper limb computer adaptive tests and short forms in conjunction with a set of static “legacy” measures of physical functioning, including a parent-report of upper limb function. Results The PROMIS® Pediatric upper limb short form demonstrated acceptable internal consistency (Cronbach’s alpha = 0.85). PROMIS® pediatric upper limb computer adaptive tests and short form mean values (42.1(11) and 43(10.4), respectively) were nearly 1 SD below normal, which is appropriate when a generic measure is used in a sample of young persons with cerebral palsy. The PROMIS® pediatric upper limb computer adaptive tests had a higher frequency of ceiling effects (29.50%) compared to the short form (18.30%). Conclusion Results of this study suggest that the PROMIS® pediatric upper limb computer adaptive tests and the short form are valid indicators of upper limb function in young people with cerebral palsy. The item bank can be replenished to address ceiling effects.
Iloprost infusion through elastomeric pump in the treatment of Raynaud’s phenomenon and digital ulcers
Authors: Fartura Braga Temido Maria Helena , Gomes Manuel , Parente Francisco , Santos Lèlita 
Published: April 2018

Introduction: Systemic sclerosis is a systemic autoimmune disease characterized by microangiopathy and fibroblast dysfunction resulting in fibrosis of the skin and internal organs. Raynaud’s phenomenon and digital ulcers are the main clinical features of vascular involvement. Treatment with iloprost is recommended to reduce the frequency and severity of Raynaud’s phenomenon attacks and to heal active digital ulcer. Classical forms of treatment require admission to a ward or day-hospital unit to ensure safety during infusion, causing disruption of the patient’s normal daily life and resulting in significant costs with hospitalization. Nowadays, new portable devices, of which the elastomeric pump is an example, are becoming available in order to avoid hospitalization. Case reports: We describe five cases of patients with systemic sclerosis or mixed connective tissue disease and severe Raynaud’s phenomenon/critical ischaemia or active digital ulcers that were successfully treated with iloprost infusion through elastomeric pump without experiencing any side effects. We present our unit’s protocol for ambulatory infusion. Discussion/conclusion: Our case reports and a brief review of literature prove that iloprost infusion through elastomeric pump is safe, easy and well tolerated and might even improve patient compliance with treatment. Meanwhile, it may also decrease the economic burden of hospitalization with these patients.
The Role of Task Difficulty in Learning a Visuomotor Skill
Authors: BOOTSMA JOSJE M. , HORTOBÁGYI TIBOR , ROTHWELL JOHN C. , CALJOUW SIMONE R. 
Published: April 2018

ABSTRACT

Introduction
Task difficulty affects the amount of interpretable information from a task, which is thought to interfere with motor learning. However, it is unclear whether task difficulty in itself is a stimulus for motor learning because the experimental evidence is mixed in support of the optimal challenge point framework that predicts one specific level of task difficulty to produce the greatest magnitude of motor learning.

Purpose
We determined the effects of functional task difficulty on motor skill acquisition, retention, and transfer.

Methods
Healthy young participants (N = 36) learned a mirror star-tracing task at a low, medium, or hard difficulty level defined by the bandwidth of the star. We measured skill acquisition, retention, and transfer to untrained difficulty levels, as well as the perceived mental workload during the task.

Results
Task difficulty affected motor performance, but did not affect motor learning and transfer. For the groups that practiced the task at the medium and hard but not at the low difficulty level, initial skill level correlated with the magnitude of learning.

Conclusions
The optimal challenge point framework does not capture the complex relationship between task difficulty and motor learning. Previously reported effects of task difficulty on the magnitude of motor learning are probably mediated by perceived mental workload. Task difficulty did not affect the magnitude of visuomotor skill learning but it affected how learning occurred. The data have implications on how athletes learn new motor skills and patients relearn injury-impaired motor skills during rehabilitation.