bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of zonisamide on interictal electroencephalography in familial spontaneous epileptic cats
Authors: Ukai Masayasu , Hamamoto Yuji , Yu Yoshihiko , Fujiwara-Igarashi Aki , Fujita Michio , Hasegawa Daisuke 
Published: December 2017

Objectives The effectiveness of zonisamide (ZNS) against spontaneous epilepsy in cats has not yet been described. The purpose of this study was to investigate the effect of ZNS on interictal paroxysmal discharges (PDs) using scalp electroencephalography (EEG) in familial spontaneous epileptic cats (FSECs). Methods Eight FSECs were evaluated (six males and two females). Scalp EEG measurements were performed once a week for 3 weeks before ZNS administration (Pre-ZNS). Thereafter, administration of ZNS was started and an adjustment period was instituted until the drug in plasma achieved the steady state. When ZNS in plasma was confirmed to be within 10–40 μg/ml, scalp EEG measurements were performed once a week for 3 weeks (Post-ZNS). The number of PDs (counts/min) were compared between Pre-ZNS and Post-ZNS treatment. Results The median number of PDs for Pre-ZNS and Post-ZNS were 0.43/min (0.13–0.82/min) and 0.28/min (0.07–0.87/min), respectively. The number of PDs Post-ZNS was significantly reduced compared with Pre-ZNS ( P = 0.02). Conclusions and relevance This study showed that ZNS, within the recommended therapeutic range suggested for use in humans and dogs (10–40 µg/ml), reduced the number of PDs recorded on EEG in FSECs that are considered a model for cats with idiopathic epilepsy. Although phenobarbital is the antiepileptic drug of choice for epileptic cats, the results of this research provide evidence to support the use of ZNS in cats with phenobarbital-resistant epilepsy or for cats that cannot use phenobarbital due to adverse side effects.
Metastatic Melanoma in Sentinel Node–Negative Patients: The Ottawa Experience
Authors: Ward Chloe E. , MacIsaac Jennifer L. , Heughan Caroline E. , Weatherhead Louis 
Published: December 2017

Background: Lymph node involvement is a major independent prognostic factor for survival in patients with malignant melanoma. Sentinel lymph node biopsy (SLNB) detection of microscopic nodal melanoma has been shown to improve both 5-year survival and 5-year disease-free survival. Objective: To determine the rate of metastatic melanoma in SLNB-negative patients at long-term follow-up. Methods: Study subjects include all 152 patients who had a negative SLNB and were followed at the Ottawa Regional Cancer Centre (ORCC) between 1999 and 2004. Patients with a follow-up period less than 6 months, more than 1 primary melanoma, and metastatic melanoma at diagnosis were excluded. Age at diagnosis, sex, Breslow thickness, ulceration, mitoses, regression, Clark level, anatomical location, development of metastatic melanoma, time to detection of metastatic disease, and time to death from melanoma were studied. Results: In this retrospective study at the ORCC, 40 of 140 (28.6%) patients with a single primary melanoma developed metastatic melanoma following negative SLNB at a mean follow-up of 63 months. Conclusion: The rate of metastatic melanoma following negative SLNB at long-term follow-up at the ORCC is higher than the upper limit of rates reported in the literature (6%-24%). The reason for this is multifactorial, and the long follow-up period of 5 years allowed for detection of metastatic disease at a mean of 3.9 years. Long-term prognosis may be guarded in node-negative patients with a primary cutaneous melanoma, and surveillance by a multidisciplinary team is crucial.
The effectiveness of exercise-based telemedicine on pain, physical activity and quality of life in the treatment of chronic pain: A systematic review
Authors: Adamse Corine , Dekker-Van Weering Marit GH , van Etten-Jamaludin Faridi S , Stuiver Martijn M 
Published: December 2017

Introduction The aim of this study was to systematically review the evidence on the effectiveness of exercise-based telemedicine in chronic pain. Methods We searched the Cochrane, PubMed, MEDLINE, EMBASE, CINAHL and PEDRO databases from 2000 to 2015 for randomised controlled trials, comparing exercise-based telemedicine intervention to no intervention or usual care in adults with chronic pain. Primary outcome data were pooled using random effect meta-analysis. Primary outcomes were pain, physical activity (PA), limitations in activities of daily living (ADL) and quality of life (QoL). Secondary outcomes were barriers, facilitators and usability of telemedicine. Results Sixteen studies were included. Meta-analyses were performed in three subgroups of studies with comparable control conditions. Telemedicine versus no intervention showed significantly lower pain scores (MD −0.57, 95% CI −0.81; −0.34), but not for telemedicine versus usual care (MD −0.08, 95% CI −0.41; 0.26) or in addition to usual care (MD −0.25, 95% CI −1.50; 1.00). Telemedicine compared to no intervention showed non-significant effects for PA (MD 19.93 min/week, 95% CI −5.20; 45.06) and significantly diminished ADL limitations (SMD −0.20, 95% CI −0.29; −0.12). No differences were found for telemedicine in addition to usual care for PA or for ADL (SMD 0.16, 95% CI −0.66; 0.34). Telemedicine versus usual care showed no differences for ADL (SMD 0.08, 95% CI −0.37; 0.53). No differences were found for telemedicine compared to the three control groups for QoL. Limited information was found on the secondary outcomes. Conclusions Exercise-based telemedicine interventions do not seem to have added value to usual care. As substitution of usual care, telemedicine might be applicable but due to limited quality of the evidence, further exploration is needed for the rapidly developing field of telemedicine.
Efficacy of cognitive behavioural therapy delivered over the Internet for depressive symptoms: A systematic review and meta-analysis
Authors: Sztein Dina M , Koransky Charles E , Fegan Leah , Himelhoch Seth 
Published: December 2017

Introduction Cognitive behavioural therapy has been shown to improve depressive symptoms in adults with mild to moderate depression. To overcome many of the barriers associated with delivering this treatment, attempts have been made to deliver cognitive behavioural therapy via the Internet. The objective of this meta-analysis is to assess whether Internet-based cognitive behavioural therapy delivered to adults with depressive symptoms leads to a reduction in these symptoms as compared to those who receive no therapy. Methods In September 2015, the Cochrane, PubMed and PsycInfo databases were searched; studies were also found through bibliography searches. Studies were included if they were randomized controlled trials published in English between 2005–2015 conducted with adults >18 years of age experiencing mild to moderate depression where study subjects received Internet-based cognitive behavioural therapy, and the control group was placed on a wait-list. The search yielded 257 articles; 14 of these were included in the meta-analysis. Results Internet delivered cognitive behavioural therapy had a medium effect on reducing depressive symptoms at the end of the study period (standardized mean difference: 0.74, confidence interval: 0.62–0.86, p < 0.001). Internet-delivered cognitive behavioural therapy also has a large sustained effect in maintaining reduction of depressive symptoms in follow-up measures done 3–6 months after the conclusion of the therapy (standardized mean difference: 0.83, confidence interval: 0.69–0.99, p < 0.001). There was no publication bias and low heterogeneity. Discussion Cognitive behavioural therapy delivered over the Internet leads to immediate and sustained reduction in depressive symptoms; thus, it may be a good treatment modality for individuals unable or unwilling to access traditional face-to-face therapy.
Outcomes following telestroke-assisted thrombolysis for stroke in Ontario, Canada
Authors: Porter Joan , Hall Ruth E , Kapral Moira K , Fang Jiming , Khan Ferhana , Silver Frank L 
Published: December 2017

Introduction Since 2002, the Ontario Telestroke Program has provided hospitals in under-served regions of the province the opportunity to offer intravenous thrombolysis with tissue plasminogen activator (IV tPA) to eligible patients. The purpose of this study was to determine whether telestroke-assisted IV tPA patients had similar risks of 7- and 90-day mortality, symptomatic intracerebral haemorrhage (sICH), and poor functional outcome compared to patients who received IV tPA with on-site expertise. Methods Data from two audits of patients with acute ischaemic stroke hospitalized in Ontario, Canada in 2010 and 2012 were analysed. We modelled the risk of all-cause death within 7 and 90 days of receiving IV tPA using proportional hazards adjusting for hospital type, patient characteristics, and whether IV tPA was administered as part of a telestroke consultation. Outcomes of sICH and modified Rankin Scale ≥ 3 at discharge were modelled using generalized estimating equations adjusting for the same variables used in the mortality model. Results There was no difference in 7- or 90-day mortality among those who received IV tPA with telestroke ( n = 214) compared to those without ( n = 1885) (7-day adjusted hazard ratio (aHR) 1.29 (95% confidence interval (CI) 0.68, 2.44); 90-day aHR 1.01 (95% CI 0.67, 1.50)). Complications were similar between groups, with an adjusted odds ratio (aOR) for sICH of 0.71 (95% CI 0.29, 1.71) and an aOR of 0.75 (95% CI 0.46, 1.23) for poor functional ability at discharge. Discussion Patients receiving IV tPA supported by telestroke had similar outcomes to those managed with on-site expertise.
Incorporating cardiopulmonary resuscitation training into a cardiac rehabilitation programme: A feasibility study
Authors: Cartledge Susie , Finn Judith , Bray Janet E , Case Rosalind , Barker Lauren , Missen Diane , Shaw James , Stub Dion 
Published: December 2017

Background: Patients with a cardiac history are at future risk of cardiac events, including out-of-hospital cardiac arrest. Targeting cardiopulmonary resuscitation (CPR) training to family members of cardiac patients has long been advocated, but is an area in need of contemporary research evidence. An environment yet to be investigated for targeted training is cardiac rehabilitation. Aim: To evaluate the feasibility of providing CPR training in a cardiac rehabilitation programme among patients, their family members and staff. Methods: A prospective before and after study design was used. CPR training was delivered using video self-instruction CPR training kits, facilitated by a cardiac nurse. Data was collected pre-training, post-training and at one month. Results: Cardiac patient participation rates in CPR classes were high ( n = 56, 72.7% of eligible patients) with a further 27 family members attending training. Patients were predominantly male (60.2%), family members were predominantly female (81.5%), both with a mean age of 65 years. Confidence to perform CPR and willingness to use skills significantly increased post-training (both p<0.001). Post training participants demonstrated a mean compression rate of 112 beats/min and a mean depth of 48 mm. Training reach was doubled as participants shared the video self-instruction kit with a further 87 people. Patients, family members and cardiac rehabilitation staff had positive feedback about the training. Conclusions: We demonstrated that cardiac rehabilitation is an effective and feasible environment to provide CPR training. Using video self-instruction CPR training kits enabled further training reach to the target population.
The Role of Ethics and Targets in Environmental Governance and the Enduring Importance of New Public Management
Authors: Shand Rory 
Published: December 2017

This article examines the importance of new public management in environmental governance. In order to explain what makes new public management such a robust framework for environmental governance, the article draws on the key themes of individual and collective responsibility in responding to climate change, examining the role of new public management in response to ecological and environmental change, resource scarcity, focus on global energy sources and politics. The article discusses the role of three aspects of environmental governance in turn: the theoretical understandings relating to individuals and society in response to climate change, the politics of these responses and governance arrangements, and how these are formed by the hastening paucity of certain energy resources. The article then moves on to examine these themes in the context of new public management, arguing that the responses we see to climate change in environmental governance are driven by measurement and targets, as these can be universally set and communicated. This shows the enduring nature of new public management in political and policy responses to the challenges of climate change. Bradshaw B (2014) Global Energy Dilemmas. Cambridge: Polity Press. Christensen C and Lægreid P (eds) (2011) The Ashgate Research Companion to New Public Management. Surrey: Ashgate. Cripps E (2013) Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. Death C (ed.) (2014) Critical Environmental Politics. Abingdon: Routledge.
Management of hemothorax after thoracic endovascular aortic repair for ruptured aneurysms
Authors: Ju Mila H , Nooromid Michael J , Rodriguez Heron E , Eskandari Mark K 
Published: December 2017

Background Thoracic aortic aneurysm rupture is often a fatal condition. Emergent thoracic endovascular aortic repair (TEVAR) has emerged as a suitable treatment option. Unfortunately, respiratory complications from hemothorax continue to be an important cause of morbidity and mortality even after successful management of the aortic rupture. We hypothesize that early hemothorax decompression after TEVAR for ruptured aneurysms decreases the rate of postoperative respiratory complications. Methods Single-center, retrospective eight-year review of ruptured thoracic aneurysms treated with TEVAR. Results Seventeen patients presented with ruptured degenerative thoracic aortic aneurysms, all of which were successfully treated emergently with TEVAR. The mean age was 74 years among the 12 (70.6%) men and 5 (29.4%) women treated. Inpatient and 30-day mortality rates for the entire cohort were both 17.6% (three patients). The 90-day mortality rate was 47.1% (eight patients). Thirty-day morbidities of the entire cohort included stroke ( n = 1, 5.9%), spinal cord ischemia ( n = 3, 17.6%; only one was temporary), cardiac arrest ( n = 4, 23.5%; 3 were fatal), respiratory failure ( n = 5, 29.4%), and renal failure ( n = 5, 29.4%). A large hemothorax was identified in the majority of patients ( n = 14, 82.4%). While six (42.9% of 14) patients had immediate chest tube decompression on the day of index procedure, three (21.4% of 14) patients had decompression on postoperative day 1, 4, and 7, respectively. Although not statistically significant, there were trends toward higher rates of respiratory failure (50.0% vs. 16.7%, P = 0.198) and 90-day mortality (62.5% vs. 33.3%, P = 0.280) for patients with delayed or no hemothorax decompression when compared to patients with immediate hemothorax decompression. Conclusions The morbidity and mortality of ruptured degenerative thoracic aortic aneurysms remains high despite the introduction of TEVAR. In this single-center experience, there was a trend toward decreased respiratory complications and increased survival with early chest decompression of hemothorax after TEVAR.
Arthroscopic repair of bony Bankart lesions in collision athletes
Authors: Shah Nasir , Nadiri Muhammed Nasir , Torrance Emma , Funk Lennard 
Published: December 2017

Background The present study aimed to report the outcomes of acute and subacute arthroscopic bony Bankart repairs in collision athletes. Methods We reviewed 22 consecutive rugby players with traumatic anterior glenohumeral instability who underwent arthroscopic bony Bankart repair within 4 months of injury over a 2-year period. All lesions were less than 25% of the glenoid bony area. Results A significant improvement was noted at three months and was maintained at 28 months postoperatively. The mean Constant score improved from 61.5 to 84.1, the mean Oxford shoulder score decreased from 26.3 to 13.6 and the mean Oxford instability score decreased from 42.9 to 13.5. The mean satisfaction score was 8.3 out of 10 at final follow-up. All patients returned to their pre-injury sporting level. Twenty patients (91%) remained stable and asymptomatic, although two (9%) had recurrent instability after further traumatic sports injuries. One required a modified Latarjet procedure, whereas the other patient sustained a soft tissue Bankart lesion and had a revision arthroscopic repair. Conclusions Acute and sub-acute bony Bankart lesions in collision athletes can be addressed through arthroscopic repair with a satisfactory outcome and return to pre-injury level of sport
The influence of full-thickness supraspinatus tears on abduction moments: the importance of the central tendon
Authors: Thompson Simon M. , Prinold Joe A. I. , Hill Adam M. , Reilly Peter , Emery Roger J. H. , Bull Anthony M. J. 
Published: December 2017

Background Detachment of the central tendon of the supraspinatus from its insertion is considered to be crucial to functional deficit. The aim of the present study was to assess the function of the supraspinatus in terms of abduction moments by introducing different tear configurations to assess the functional effect of the central tendon insertion. Methods Ten fresh frozen shoulders from five cadavers were prepared for testing. A testing protocol was established to measure the abduction moment of the supraspinatus under physiological loading tailored to the anthropometrics of each specimen. Four conditions were tested: intact supraspinatus; complete detachment of portion of the supraspinatus tendon anterior to the main central tendon; detachment of the main central tendon; and detachment of the region of the supraspinatus posterior to the main central tendon. Results There was a significant and large reduction in abduction moment when the central tendon was sectioned ( p < 0.05). A smaller reduction in abduction moment was found when the regions anterior and posterior to the main central tendon were sectioned ( p < 0.05). Conclusions The central tendon is vital in the role of functional arm abduction through force transmission through the intact rotator cuff. Reinsertion of the central tendon in the correct anatomical location is desirable to optimize functional outcome of surgery.
Interobserver reliability of radiographic assessment after radial head arthroplasty
Authors: Bexkens Rens , Claessen Femke M. A. P. , Kodde Izaäk F. , Oh Luke S. , Eygendaal Denise , van den Bekerom Michel P. J. 
Published: December 2017

Background Radiographs are part of routine clinical care after radial head arthroplasty (RHA). Therefore, the aim of this diagnostic study was to assess the interobserver reliability of radiographic assessment following RHA. Methods Anteroposterior (AP) and lateral radiographs of 24 consecutive patients who underwent press-fit bipolar RHA were evaluated with respect to 14 parameters by 14 orthopaedic surgeons specializing in the elbow: shaft loosening (AP, lateral), subcollar bone resorption, nonbridging heterotopic ossification, capitellar erosion, capitellar osteopenia, implant size, ulnohumeral joint gapping, ulnohumeral joint degeneration, proximal radio-ulnar joint congruency, stem size, stem positioning (AP, lateral) and component dissociation or polyethylene wear of the head with increased angulation. Observer agreement was evaluated using the multirater kappa (κ) measure. Results Nine of 14 parameters had poor interobserver agreement [κ = 0.0 to 0.20, confidence interval (CI) = 0.0 to 0.31). Four parameters had fair agreement: subcollar bone resorption (κ = 0.27, CI = 0.12 to 0.40), capitellar erosion (κ = 0.30, CI = 0.20 to 0.40), ulnohumeral joint degeneration (κ = 0.35, CI = 0.22 to 0.51) and stem positioning in AP view (κ = 0.24, CI = 0.14 to 0.36). One parameter had moderate agreement: nonbridging heterotopic ossification (κ = 0.47, CI = 0.31 to 0.64). Conclusions The overall interobserver reliability of radiographic assessment following press-fit bipolar RHA was poor among experienced elbow surgeons. Therefore, radiographic evaluation after RHA should be interpreted with caution when making treatment decisions.
Content Relevance of the Foot and Ankle Ability Measure in Patients With Achilles Tendon Diseases
Authors: Reb Christopher W. , Saini Sundeep S. , Stenson James F. , Albana Mohamed F. , Pedowitz David I. , Raikin Steven M. , Daniel Joseph N. 
Published: December 2017

Background. The Foot and Ankle Ability Measure (FAAM) is among the most widely utilized and best psychometrically supported lower extremity–specific patient-reported outcome measures. However, its content relevance has never been directly subjected to patient assessment. Methods. This was an institutional review board–approved, prospective, cross-sectional study of 75 patients with Achilles tendon diseases who ranked the relevance of the FAAM’s items and subscales as 1 = Not relevant, 2 = Somewhat relevant, or 3 = Very relevant. Substantial content relevance was indicated by a minimum mean item or subscale score of 2.0. Nonsurgical and surgical subgroups were compared. Results. At the whole group level, the mean score was above 2.0 for each individual item and subscale. Subgroup analysis revealed that the mean relevance was above 2.0 for each of the items and subscales with the exception of the “Personal Care” item, which nonsurgical patients ranked significantly lower than did surgical patients (mean = 1.74 vs 2.23, P = .02). Additionally, this was part of a general trend across items with more 95% confidence intervals crossing below 2.0 in the nonsurgical data set (15 items, 52%) than the surgical data set (1 item, 3%). Conclusion. These data confirm that the FAAM has substantial content relevance to patients with Achilles tendon diseases. However, it is unclear why the surgical subgroup consistently ranked items higher than did the nonsurgical subgroup. Future work should address how a patient’s content relevance perception is influenced by the relative effects of their Achilles disease type and their perceived level of disease-related functional impairment. Levels of Evidence: Diagnostic, Level III