bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of diacutaneous fibrolysis for the treatment of chronic lateral epicondylalgia: a randomized clinical trial
Authors: López-de-Celis Carlos , Barra-López Martin-Eusebio , González-Rueda Vanessa , Bueno-Gracia Elena , Rodríguez-Rubio Pere-Ramón , Tricás-Moreno José-Miguel 
Published: October 2017

Objective: To assess the end of treatment and three months after treatment effects of diacutaneous fibrolysis as adjuvant of physical therapy for chronic lateral epicondylalgia. Design: Double-blind (patient and evaluator) randomized controlled trial. Setting: Primary Care Center of the Spanish NHS. Subjects: A total of 54 people with 60 elbows affected with chronic lateral epicondylalgia, 33 women, mean (SD) age was 48.43 (8.69) years. Interventions: All three groups (Intervention, Placebo and Control) received three weeks of physical therapy treatment and in addition Intervention Group received six sessions of real diacutaneous fibrolysis and Placebo Group received six sessions of sham diacutaneous fibrolysis. Main measures: Pain intensity, pressure pain threshold, pain free grip strength, function and subjective assessment were assessed at baseline, at the end of treatment and three months after treatment. Results: Between-group results at three months after treatment showed a statistically significant improvement of the Intervention Group in pain free grip strength (mean, 7.91 km/cm2; SD, 9.23) compared to the Placebo Group (mean, 1.47 km/cm2; SD, 7.86) and to the Control Group (mean, 2.09 km/cm2; SD, 4.45) ( P values <0.01 and <0.03, respectively) and also in function (mean, 20.87; SD, 14.25) compared to the Control Group (mean, 4.17; SD, 18.02) ( P < 0.01). Subjective assessment was statistically better in the Intervention Group both at the end of treatment ( P < 0.01) and three months after treatment ( P < 0.03). Conclusion: Diacutaneous fibrolysis added to physical therapy provides better results in the treatment of chronic lateral epicondylalgia, with greater clinical satisfaction among patients.
Accuracy and Applications of Lung Ultrasound to Diagnose Ventilator-Associated Pneumonia: A Systematic Review
Authors: Staub Leonardo Jönck , Biscaro Roberta Rodolfo Mazzali , Maurici Rosemeri 
Published: October 2017

Background: Lung ultrasound (LUS) is an accurate tool to diagnose community-acquired pneumonia. However, it is not yet an established tool to diagnose ventilator-associated pneumonia (VAP). Purpose: To assess the evidence about LUS in the diagnosis of VAP, we conducted a systematic review of the literature. Methods: We searched PubMed, Embase, Scopus, Web of Science, and LILACS. Two researchers independently selected the studies that met the inclusion criteria. Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the studies. In a qualitative synthesis, 3 questions guided the review: Q1. What are the sonographic signs of VAP? Q2. How can LUS be combined with others tests or signs of VAP? Q3. What is the role of LUS in VAP screening? Main Results: Three studies (n = 377 patients) with different designs were included. In terms of Q1, the 3 studies assessed the accuracy of sonographic consolidations. In patients suspected for VAP, lobar or hemilobar consolidation alone was not sufficient to diagnose VAP but seems useful to exclude it. The most useful signs were small subpleural consolidations (sensitivity: 81%; specificity: 41%) and dynamic air bronchograms (sensitivity: 44%; specificity: 81%). Two studies were assessed for Q2, when the 2 signs above were included in a clinical score (Ventilator-associated Pneumonia Lung Ultrasound Score associated with quantitative culture of endotracheal aspirate—VPLUS-EAquant), the accuracy was amplified (sensitivity: 48% and specificity: 97% for score ≥4; sensitivity: 78% and specificity: 77% for score ≥3 points). Finally, regarding Q3, no studies have assessed the use of LUS in screening of VAP. Conclusion: Small subpleural consolidations and dynamic air bronchograms were the most useful sonographic signs to diagnose VAP in suspected patients. Clinical scores including LUS had better diagnosis accuracy than LUS alone. There are no data on LUS for VAP screening.
Determination of Imminent Brain Death Using the Full Outline of Unresponsiveness Score and the Glasgow Coma Scale: A Prospective, Multicenter, Pilot Feasibility Study
Authors: Zappa Sergio , Fagoni Nazzareno , Bertoni Michele , Selleri Claudio , Venturini Monica Aida , Finazzi Paolo , Metelli Marta , Rasulo Frank , Piva Simone , Latronico Nicola ,   Imminent Brain Death (IBD) Network Investigators
Published: October 2017

Purpose: To evaluate the accuracy of the imminent brain death (IBD) diagnosis in predicting brain death (BD) by daily assessment of the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale (GCS) with the assessment of brain stem reflexes. Materials and Methods: Prospective multicenter pilot study carried out in 5 adult Italian intensive care units (ICUs). Imminent brain death was established when the FOUR score was 0 (IBD-FOUR) or the GCS score was 3 and at least 3 among pupillary light, corneal, pharyngeal, carinal, oculovestibular, and trigeminal reflexes were absent (IBD-GCS). Results: A total of 219 neurologic evaluations were performed in 40 patients with deep coma at ICU admission (median GCS 3). Twenty-six had a diagnosis of IBD-FOUR, 27 of IBD-GCS, 14 were declared BD, and 9 were organ donors. The mean interval between IBD diagnosis and BD was 1.7 days (standard deviation [SD] 2.0 days) using IBD-FOUR and 2.0 days (SD 1.96 days) using IBD-GCS. Both FOUR and GCS had 100% sensitivity and low specificity (FOUR: 53.8%; GCS: 50.0%) in predicting BD. Conclusions: Daily IBD evaluation in the ICU is feasible using FOUR and GCS with the assessment of brain stem reflexes. Both scales had 100% sensitivity in predicting IBD, but FOUR may be preferable since it incorporates the pupillary, corneal, and cough reflexes and spontaneous breathing that are easily assessed in the ICU.
Profile of BAFF and its receptors’ expression in lupus nephritis is associated with pathological classes
Authors: Suso J P , Posso-Osorio I , Jiménez C A , Naranjo-Escobar J , Ospina F E , Sánchez A , Cañas C A , Tobón G J 
Published: October 2017

Background/Objective B-cell activating factor (BAFF) plays an important role in the pathogenesis of systemic lupus erythematosus. However, the role of BAFF in lupus nephritis (LN) is not understood. Our aim was to evaluate the expression of BAFF and its three receptors in renal biopsy samples from patients with LN and investigate a relationship with pathological class. Methods We conducted a prospective descriptive study (2011–2014) on 52 kidney biopsy samples from patients with LN. Immunohistochemistry for BAFF, its receptors (transmembrane activator and calcium modulator and cyclophilin ligand interaction (TACI), protein maturation of B cells (BCMA), and BAFF-receptor (BAFF-R)), and CD20 expression was performed. Samples were scored according to the percentage of cells with positive expression. Results In class II LN, BAFF-R and TACI were not expressed, whereas BCMA and BAFF were lowly expressed in the interstitial inflammatory infiltrates. Proliferative class III/IV had elevated BAFF expression in the glomeruli, and TACI was expressed in interstitial inflammatory infiltrates and the glomeruli. Interestingly, the class IV cases with vasculopathy ( n = 4) had endothelial BAFF expression, which was not visible in thrombotic microangiopathy ( n = 4). Class V was characterized by low BAFF expression in interstitial inflammatory infiltrates and by BAFF, TACI, and BCMA expression in the glomeruli. BAFF expression was associated with inflammatory scores and CD20 positive infiltrates, mainly in class IV. Conclusions Expression patterns of BAFF and its receptors differ according to LN class. Our study provides evidence that BAFF could be used as a routine marker in LN biopsies and to determine which patients will benefit from anti-BAFF therapy.
Recommencing lithium in Older Adults with Bipolar I Disorder
Authors: Gallur Lara , Powell Alice , Flynn Patrick 
Published: October 2017

Objectives: This paper addresses considerations in recommencing lithium in elderly patients with Bipolar I Disorder and medical comorbidity. We focus on nephrotoxicity and cognitive impairment. Methods: Case reports and review of relevant literature. Results: Three elderly psychogeriatric inpatients admitted with severe manic relapse following lithium cessation are described. In all cases, lithium was recommenced safely with good response. Conclusions: Even with medical comorbidity it may be possible to recommence modified lithium therapy.
Comparison of Group Decision Making in Japan, Thailand, Vietnam, and Russia Using a Business Game
Authors: Morita Mitsuru , Iwai Chiaki , Rompho Nopadol , Phadoongsitthi Monvika 
Published: October 2017

Background. Numerous preceding research studies have analyzed the relationship between strategy and culture through questionnaires and case studies. However, very few regard the input results of a business game’s decision making variables as strategy. Moreover, few conduct an analysis using the same scenario, under a controlled environment from the perspective of experimental business management studies, while using adult subjects with similar characteristics. Aim. This study compared the group decision making of Japan, Thailand, Vietnam, and Russia, particularly analyzing each culture’s influence on strategy. We verified the relationship between the cultural dimensions used in the GLOBE project and strategies within the business game. Method. This was a mixed methods study on the relation between cultural dimensions and business game entry strategies, based upon data collected by observation using a quasi-experimental approach that includes questionnaires and business games, and utterance analysis by counting the frequency of words. Findings. Countries differ in their tendencies to engage in sharing, with an emphasis on strategies such as, product differentiation differentiation, being marketing emphasized, or cost saving. Further, we could confirm relationships between several cultural dimensions and strategy.
The Effectiveness of Developing Motor Skills Through Motion-Based Video Gaming: A Review
Authors: Jenny Seth E. , Schary David P. , Noble Kristy M. , Hamill Shelley D. 
Published: October 2017

Background. Technology growth affords innovative teaching techniques as video gaming within education has increased in popularity. Motion-based video gaming (MBVG) is a type of gaming that requires the individual playing the game to be physically interactive. Thus, whatever movements the individual playing the game does is picked up by motion sensors and is mimicked via the on-screen character. MBVG provides constant feedback to learners and has been found to help motivate students, replace sedentary with active gaming, and can facilitate social interactions with peers. Aim. This literature review reveals the current knowledge regarding the potential educational benefits of MBVG, particularly in physical education and sport pedagogy settings. Developments of video gaming in education as well as recent research regarding MBVG and its potential impact on physical skill development within educational environments are discussed. Conclusion. MBVG may be beneficial with novices in teaching basic sport concepts or with individuals with special needs who might otherwise not be able to participate in the full authentic version of the sport. However, empirical evidence is lacking which supports the effective use of MBVG in accurately teaching authentic sport-specific motor skills.
Understanding experiences of undergoing transcatheter aortic valve implantation: one-year follow-up
Authors: Baumbusch Jennifer , Lauck Sandra B , Achtem Leslie , O’Shea Tamar , Wu Sarah , Banner Davina 
Published: October 2017

Background: Transcatheter aortic valve implantation (TAVI) is the treatment of choice for frail, older adults with severe symptomatic aortic stenosis. Although research about long-term clinical outcomes is emerging, there is limited evidence from the perspectives of patients and family caregivers on their perceived benefits and challenges after TAVI. Aims: The aim of this study was to describe older adults and family caregivers’ perspectives on undergoing TAVI at one year post-procedure. Methods: Qualitative description was the method of inquiry. A purposive sample of 31 patients and 15 family caregivers was recruited from a TAVI programme in western Canada. Semi-structured interviews were conducted with participants one year after TAVI. Data were analysed thematically. Results: All participants were satisfied with the decision to undergo TAVI. There were three central themes. First, recovery was experienced in the context of aging and comorbidities, which was shaped by patients’ limited options for care and post-procedure symptom burden. Second, reconciling expectations with reality meant that, for some patients, symptom burden remained prevalent and was also influenced by others’ expectations. Third, recommendations for recovery related to having information needs met, keeping informed of evolving care processes, and addressing individualised needs for support. Conclusions: The perspectives of participants provide a valuable contribution to the literature about undergoing TAVI. Clinicians need to be attentive to patients’ expectations of benefit and temper these with consideration of the individual’s broader health situation to provide treatment decision support. Patients and family caregivers also need adequate teaching and support to facilitate safe transition home given the shift towards early discharge after TAVI.
A qualitative study of practice, culture and education of doctors in Sri Lanka regarding ‘do not attempt cardiopulmonary resuscitation’ decisions and disclosure
Authors: Dodd Alexander , De Silva Vijitha , Fritz Zoë 
Published: October 2017

Background Doctors and the Sri Lanka Medical Association recognise the importance of do not attempt cardiopulmonary resuscitation decisions and disclosure; however, few previous studies exist examining these practices in Sri Lanka. Resuscitation decisions have seen significant changes in the UK in recent years, with a legal imperative for clear communication and a move to understand patients’ preferred outcomes before recommending clinical guidance. Methods Participants from two Sri Lankan hospitals were selected purposively to represent a range of specialties and seniorities for semi-structured interview. Results Fifteen participants of varying seniorities were recruited. Practice of do not resuscitate and informing patients is highly variable; there is no definitive guidance published on best practice of these issues in Sri Lanka. Participants felt that inpatients were generally not aware of their medical conditions or treatments. With the poor social and palliative care service provision in Sri Lanka comes a pressure to involve families in the patient care, particularly at the end of life. This feeds into a culture where patient autonomy plays a subordinate role to family involvement. Participants understand the ethical need for do not resuscitate, however, it is viewed to be a consideration for when the patient is close to death. Conclusion Do not resuscitate does not appear to be a prominent feature of end-of-life care in Sri Lanka and thus consideration of the appropriateness of resuscitation is commonly left late in a patient’s deterioration. Education, inclination and respect for doctors are suggested barriers to effective inclusion of patients in their healthcare and end-of-life decisions.
Dose Accuracy, Injection Force, and Usability Assessment of a New Half-Unit, Prefilled Insulin Pen
Authors: Kappes Christopher M. , Kershner James R. , Morwick Tina M. , Corrigan Sheila M. 
Published: October 2017

Background: This study examines the utility of the first prefilled, rapid-acting insulin pen that can be dialed in half-unit increments. Dose accuracy and injection force were examined through a series of design-verification tests, and usability was established by human factors validation testing. Methods: Devices were tested for dose accuracy at 3 different doses and temperatures and under free fall, vibration, and cold storage conditioning. Injection force was measured at the maximum dose (30 units). Both experiments used the same semiautomated testing system. Usability was validated in a human factors simulated-use study that included 60 participants (patients with type 1 or type 2 diabetes [aged 10-79 years], adult caregivers, and health care providers). Results: The pen met the International Organization for Standardization (ISO) 11608-1:2014 requirements for dose accuracy at all settings and conditions tested. Furthermore, all individual results were within the ISO specification limits. Mean injection force across temperature settings ranged from 9.25 to 10.85 N at the highest dose. The usability validation study confirmed that use-related risks were reduced to the extent possible and that additional modifications were not likely to afford further reductions. Conclusions: The results from these studies demonstrated accurate dosing over the dose range (0.5-30 units) at different temperatures and conditions with an injection force that should accommodate the intended users. Use safety and usability in patients with diabetes, caregivers, and health care professionals were validated. The added convenience of this new half-unit, prefilled pen may ease the burden of diabetes management for patients who require smaller incremental dosing.
Use of touchscreen tablet technology by people with dementia in homes: A scoping review
Authors: Hitch Danielle , Swan Jodie , Pattison Ruth , Stefaniak Rachel 
Published: October 2017

Background The aim of this scoping review was to identify the range, extent and nature of research around the use of touchscreen tablets by people with dementia in their home environment, particularly in regards to its use as a means of supporting participation in meaningful and socially connected activity. Methods A review of both peer-reviewed and grey literature was undertaken across 61 databases, along with reference list checking for articles published between 2010 and 2016. Results Twelve articles were included in this review, predominantly from Western European cultures and community-based home environments. The studies were exploratory in nature, with the majority focusing on the development of applications for people with dementia. Conclusions The study identified a range of exploratory research related to the use of touchscreen tablets by people with dementia. However, there were significant gaps within this evidence base, which provide opportunities for further research using more robust methodologies. Given the ubiquitous nature of touchscreen tablets in modern communities, further research could facilitate their use as a minimally stigmatizing and culturally appropriate form of support for people with dementia.
Ambulatory cleft lip surgery: A value analysis
Authors: Arneja Jugpal S , Mitton Craig 
Published: October 2017

Background Socialized health systems face fiscal constraints due to a limited supply of resources and few reliable ways to control patient demand. Some form of prioritization must occur as to what services to offer and which programs to fund. A data-driven approach to decision making that incorporates outcomes, including safety and quality, in the setting of fiscal prudence is required. A value model championed by Michael Porter encompasses these parameters, in which value is defined as outcomes divided by cost. Objectives To assess ambulatory cleft lip surgery from a quality and safety perspective, and to assess the costs associated with ambulatory cleft lip surgery in North America. Conclusions will be drawn as to how the overall value of cleft lip surgery may be enhanced. Methods A value analysis of published articles related to ambulatory cleft lip repair over the past 30 years was performed to determine what percentage of patients would be candidates for ambulatory cleft lip repair from a quality and safety perspective. An economic model was constructed based on costs associated with the inpatient stay related to cleft lip repair. Results On analysis of the published reports in the literature, a minority (28%) of patients are currently discharged in an ambulatory fashion following cleft lip repair. Further analysis suggests that 88.9% of patients would be safe candidates for same-day discharge. From an economic perspective, the mean cost per patient for the overnight admission component of ambulatory cleft surgery to the health care system in the United States was USD$2,390 and $1,800 in Canada. Conclusions The present analysis reviewed germane publications over a 30-year period, ultimately suggesting that ambulatory cleft lip surgery results in preservation of quality and safety metrics for most patients. The financial model illustrates a potential cost saving through the adoption of such a practice change. For appropriately selected patients, ambulatory cleft surgery enhances overall health care value.
BRAFV600E accelerates disease progression and enhances immune suppression in a mouse model of B-cell leukemia
Authors: Tsai Yo-Ting , Lakshmanan Aparna , Lehman Amy , Harrington Bonnie K. , Lucas Fabienne McClanahan , Tran Minh , Sass Ellen J. , Long Meixiao , Flechtner Alan D. , Jaynes Florinda , La Perle Krista , Coppola Vincenzo , Lozanski Gerard , Muthusamy Natarajan , Byrd John C. , Grever Michael R. , Lucas David M. 
Published: October 2017

Key PointsMutated BRAF accelerates disease and enhances immune abnormalities in murine B-cell leukemia. This new model will be valuable for understanding and targeting disease-induced immune modulation in MAPK-mutated B-cell malignancies.
Dose-Dependent Effects of Intranasal Insulin on Resting-State Brain Activity
Authors: Kullmann Stephanie , Veit Ralf , Peter Andreas , Pohmann Rolf , Scheffler Klaus , Häring Hans-Ulrich , Fritsche Andreas , Preissl Hubert , Heni Martin 
Published: October 2017

Abstract

Context
Insulin action in the human brain influences eating behavior, cognition, and whole-body metabolism. Studies investigating brain insulin rely on intranasal application.

Objective
To investigate effects of three doses of insulin and placebo as nasal sprays on the central and autonomous nervous system and analyze absorption of insulin into the bloodstream.

Design, Participants, and Methods
Nine healthy men received placebo or 40 U, 80 U, and 160 U insulin spray in randomized order. Before and after spray, brain activity was assessed by functional magnetic resonance imaging, and heart rate variability (HRV) was assessed from electrocardiogram. Plasma insulin, C-peptide, and glucose were measured regularly.

Setting
General community.

Results
Nasal insulin administration dose-dependently modulated regional brain activity and the normalized high-frequency component of the HRV. Post hoc analyses revealed that only 160 U insulin showed a considerable difference from placebo. Dose-dependent spillover of nasal insulin into the bloodstream was detected. The brain response was not correlated with this temporary rise in circulating insulin.

Conclusions
Nasal insulin dose-dependently modulated regional brain activity with the strongest effects after 160 U. However, this dose was accompanied by a transient increase in circulating insulin concentrations due to a spillover into circulation. Our current results may serve as a basis for future studies with nasal insulin to untangle brain insulin effects in health and disease.