bluuebunny/crossref_metadata_2025_split huggingface dataset:
Concussion Nondisclosure During Professional Career Among a Cohort of Former National Football League Athletes
Authors: Kerr Zachary Y. , Register-Mihalik Johna K. , Kay Melissa C. , DeFreese J.D. , Marshall Stephen W. , Guskiewicz Kevin M. 
Published: September 2017

Background: Despite a focus on the incidence and effects of concussion, nondisclosure of sports-related concussions among retired players from the National Football League (NFL) has yet to be examined. Purpose: Examine the prevalence of and factors associated with nondisclosure of sports-related concussions in former NFL athletes. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A sample of 829 former NFL players completed a general health survey. This historical cohort included players who had played before World War II to 2001. Respondents retrospectively recalled sports-related concussions that they sustained during their professional careers and whether at least one of these sports-related concussions was not reported to medical staff. We computed the prevalence of nondisclosure among those recalling sport-related concussions during their professional careers. Multivariable binomial regression estimated adjusted prevalence ratios (PR) with 95% confidence intervals (CIs) controlling for race/ethnicity, number of years played, primary position played, professional career concussion history, and playing era. Playing era was categorized by whether the majority of a player’s career was before or after a 1976 rule change to limit contact (“spearing”). Results: Overall, 417 (50.3%) respondents reported they had sustained a concussion and did not inform medical staff at least once during their professional playing career. Nonwhite respondents had a higher prevalence of nondisclosure than white/non-Hispanic respondents (adjusted PR = 1.19; 95% CI, 1.02-1.38). An interaction between professional career concussion history and playing era was also found ( P = .08). Compared with those in the pre–spearing rule change group with 1 or 2 concussions, all other groups had larger prevalences of nondisclosure (increases ranging from 41% to 153% in multivariable models). Across concussion strata, nondisclosure prevalence was generally higher in the post–spearing rule change group than the pre–spearing rule change group, with the largest differences found among those with 1 or 2 concussions or those with 3 or 4 concussions. Conclusion: A large proportion of former NFL players in this historical cohort reported at least one instance of not disclosing sports-related concussions to medical staff. Future research on concussion nondisclosure needs to identify mechanisms to improve football players’ intentions to disclose concussion-related symptoms to health care providers and to equip health care providers with more effective strategies for timely identification of concussion.
Arthroscopic Single-Row Versus Double-Row Suture Bridge Technique for Rotator Cuff Tears in Patients Younger Than 55 Years: A Prospective Comparative Study
Authors: Hantes Michael E. , Ono Yohei , Raoulis Vasilios A. , Doxariotis Nikolaos , Venouziou Aaron , Zibis Aristidis , Vlychou Marianna 
Published: September 2017

Background: When arthroscopic rotator cuff repair is performed on a young patient, long-lasting structural and functional tendon integrity is desired. A fixation technique that potentially provides superior tendon healing should be considered for the younger population to achieve long-term clinical success. Hypothesis/Purpose: The purpose was to compare the radiological and clinical midterm results between single-row and double-row (ie, suture bridge) fixation techniques for arthroscopic rotator cuff repair in patients younger than 55 years. We hypothesized that a double-row technique would lead to improved tendon healing, resulting in superior mid- to long-term clinical outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: A consecutive series of 66 patients younger than 55 years with a medium to large full-thickness tear of supraspinatus and infraspinatus tendons who underwent arthroscopic single-row or double-row (ie, suture bridge) repair were enrolled and prospectively observed. Thirty-four and 32 patients were assigned to single-row and double-row groups, respectively. Postoperatively, tendon integrity was assessed by MRI following Sugaya’s classification at a minimum of 12 months, and clinical outcomes were assessed with the Constant score and the University of California, Los Angeles (UCLA) score at a minimum of 2 years. Results: Mean follow-up time was 46 months (range, 28-50 months). A higher tendon healing rate was obtained in the double-row group compared with the single-row group (84% and 61%, respectively [ P < .05]). Although no difference in outcome scores was observed between the 2 techniques, patients with healed tendon demonstrated superior clinical outcomes compared with patients who had retorn tendon (UCLA score, 34.2 and 27.6, respectively [ P < .05]; Constant score, 94 and 76, respectively [ P < .05]). Conclusion: The double-row repair technique potentially provides superior tendon healing compared with the single-row technique. Double-row repair should be considered for patients younger than 55 years with medium to large rotator cuff tears.
Analytical and numerical investigations on the penetration of rigid projectiles into the foam core sandwich panels with aluminum face-sheets
Authors: Alavi Nia A , Kazemi M 
Published: September 2017

The aim of this study was to evaluate the penetration of ballistic projectiles into the sandwich panels both analytically and numerically. Due to the complexity of the mathematical equations governing this phenomenon, very few analytical studies have been conducted in this area. Given the widespread use of sandwich panels consisting of metal face-sheets and metal foam core in aerospace industries, revisions are carried out on analytical method provided by Hoo Fatt et al. on polymer foam core and composite face-sheets sandwich panels. Then using the improved relations, the high speed impact of a cylindrical projectile on the sandwich panels with aluminum face-sheets and aluminum foam core with different density ratios has been discussed. Also, the penetration process is simulated and finally to evaluate the accuracy of the improved analytical method and simulations, the results are compared to the experimental data obtained from tests have been done on the panels with aluminum foam core and aluminum face-sheets. Results of the research show that the improved procedure and numerical simulations are in good agreement with the experiments.
Risk of developing antiphospholipid antibodies following viral infection: a systematic review and meta-analysis
Authors: Abdel-Wahab N , Talathi S , Lopez-Olivo M A , Suarez-Almazor M E 
Published: September 2017

Objective The objective of this paper is to conduct a systematic review and meta-analysis on the risk of developing elevated antiphospholipid (aPL) antibodies and related thromboembolic and/or pregnancy events following a viral infection. Method We searched Medline, EMBASE, Web of Science, PubMed ePubs, and Cochrane Central Register of Controlled Trials through June 2016. Independent observational studies of elevated aPL antibodies in patients with a viral infection compared with controls or patients with lupus were included. Results We analyzed 73 publications for 60 studies. Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) were most commonly reported. Compared with healthy controls, patients with HIV were more likely to develop elevated anticardiolipin (aCL) antibodies (risk ratio (RR) 10.5, 95% confidence interval (CI) 5.6–19.4), as were those with HCV (RR 6.3, 95% CI 3.9–10.1), hepatitis B virus (HBV) (RR 4.2, 95% CI 1.8–9.5), and Epstein-Barr virus (EBV) (RR 10.9 95% CI 5.4–22.2). The only statistically significant increased risk for anti-β2-glycoprotein I (anti-β2-GPI) antibodies was observed in patients with HCV (RR 4.8 95% CI 1.0–22.3). Compared with patients with lupus, patients with HIV were more likely to develop elevated aCL antibodies (RR 1.8, 95% CI 1.3–2.6), and those with EBV, elevated anti-β2-GPI antibodies (RR 2.2, 95% CI 1.3–3.9). Thromboembolic events were most prevalent in patients with elevated aPL antibodies who had HCV (9.1%, 95% CI 3.0–18.1), and HBV (5.9%, 95% CI 2.0–11.9) infections, and pregnancy events were most prevalent in those with parvovirus B19 (16.3%, 95% CI 0.78–45.7). However, compared to virus-infected patients with negative aPL antibodies, the only statistically significant increased risk was observed in those with HCV and positive aPL. Conclusions Viral infection can increase the risk of developing elevated aPL antibodies and associated thromboembolic events. Results are contingent on the reported information.
Gamified Modules for an Introductory Statistics Course and Their Impact on Attitudes and Learning
Authors: Smith Tamarah 
Published: September 2017

Background. The theory of gamified learning (Landers, 2014) posits that gamified approaches positively impact students’ attitudes, and in turn this change in attitudes impacts learning; however, research is needed to examine the role of attitude change in gamified approaches (Seaborn & Fels, 2014). A strong negative relationship between students’ attitudes towards statistics and their performance in statistics has been well documented. The need to help students have positive attitudes towards statistics, and therefore be more likely to achieve in the course, makes using gamified learning, which targets attitudes, an ideal domain to test the effects of gamification on attitudes. Methods. The aim in this quasi-experimental study was to examine the ability of gamified modules in a statistics course to have positive impacts on learning and attitudes towards statistics. Students in the experimental group were compared to previous cohorts completing the same course, but without the gamified exercises as well as published results from a large cohort of comparable students. Results. The attitudes of cognitive competence, affect, value and perceived difficulty were all positively impacted after completing the gamified exercises. The experimental group also had large effects of test performance one semester after completing the course. Conclusion. In line with the theory of gamified learning, these findings suggested that the gamified modules were successful in shifting students’ attitudes in a positive direction and subsequently increasing performance. Future studies should introduce randomization between students and examine the specific pathways between attitudes and performance.
Can ethanol intoxication secondary to docetaxel be predicted based on dose administered using a point-of-care saliva ethanol test?
Authors: Cheng Serena , Awad Nadia I , Toomey Kathleen C , Gibson Zinasia , Chari Venai , Brunetti Luigi 
Published: September 2017

Background The Food and Drug Administration issued a drug safety alert highlighting the potential association of docetaxel infusion with signs and symptoms of alcohol intoxication. This concern is significant because patients treated with docetaxel often have comorbidities and are prescribed concomitant centrally active medications. As a result, these patients may be at risk for iatrogenic events. Objective The objective of this study was to identify a correlation with docetaxel infusion and saliva ethanol concentration using a point-of-care ethanol test. Methods In this pilot study, ethanol concentrations were measured using a validated saliva ethanol test in patients receiving intravenous docetaxel as part of their chemotherapy regimen. Both ethanol dose and infusion rate were calculated based on the amount of the specific docetaxel product administered. Saliva ethanol concentrations were measured at baseline, immediately after infusion completion, and at 30 and 60 min postinfusion. Results A total of 17 patients were included in the analysis. The mean ethanol dose administered was 2.6 ± 0.5 g of ethanol per infusion of docetaxel with a mean infusion rate of 3.2 ± 0.7 ml of ethanol per hour. At baseline, immediately after infusion, and 30 and 60 min postinfusion, all patients had a saliva ethanol test result of 0 mg/dl. Conclusion Based on this small pilot study, the prediction of patients who will experience ethanol intoxication using a point-of-care saliva ethanol test based on the docetaxel dose administered is challenging. This observation requires confirmation in larger and more heterogeneous populations.
Effect of body position on intraocular pressure in clinically normal cats
Authors: Selk Ghaffari Masoud , Arman Gherekhloo Ahoora 
Published: September 2017

Objectives The objective of this study was to investigate the effect of body position on intraocular pressure in clinically normal cats. Methods Sixteen clinically normal cats without any ocular abnormalities were used in this study. Cats were sequentially placed in three different recumbency positions (sternal recumbency, right lateral recumbency and dorsal position). For each of the three body positions, intraocular pressure (IOP) was recorded in the left eye using a Tono-Pen Vet tonometer (Reichert). Results Mean IOP readings in cats in the sternal recumbency, right lateral recumbency and dorsal positions were 15.6 ± 4.1, 16.6 ± 6.4 and 18.6 ± 6.8 mmHg, respectively. A significant increase was observed in IOP in cats in the dorsal position compared with the IOP observed in cats in sternal recumbency ( P = 0.01) and right lateral recumbency ( P = 0.04). There was no significant difference between the IOP recorded in the lateral recumbency and sternal recumbency ( P = 0.17) positions. Conclusions and relevance Body position has a significant effect on the IOP of cats. IOP increases when cats are placed in dorsal recumbency.
Effect of psychotherapy for depression via home telehealth on glycemic control in adults with type 2 diabetes: Subgroup analysis of a randomized clinical trial
Authors: Egede Leonard E , Walker Rebekah J , Payne Elizabeth H , Knapp Rebecca G , Acierno Ronald , Frueh B Christopher 
Published: September 2017

Objective We evaluated the impact of telemedicine-delivered behaviour activation treatment (BAT) on glycemic control in a subgroup of older adults with diabetes who participated in a randomized controlled trial for depression. Research design and methods We randomized older adults with major depression to same-room or telemedicine BAT. Each group received eight weekly sessions. For the subgroup analysis, we identified individuals with type 2 diabetes and obtained hemoglobin A1c at baseline and 12 months’ follow-up. We used mixed-effects models (MEM) for repeated measures analysis to compare the longitudinal mean A1c. We estimated model-derived mean A1c values and considered an adjusted model to account for baseline health status. Results We included 90 individuals with type 2 diabetes of the original 241 in the subgroup analysis (43 in telemedicine and 47 in same room). Treatment groups were not significantly different at baseline for demographics, depression, anxiety or A1c levels (telemedicine 6.9 vs. same room 7.3, p = 0.19). Baseline mean A1c for the telemedicine group remained at 6.9 (55 mmol/mol) at 12 months, whereas baseline mean A1c for the same-room group increased to 7.7 (61 mmol/mol). Longitudinal trajectories of model-derived mean A1c indicated a significant main effect of treatment group on mean A1c value at study end (difference = −0.82, 95% CI −1.41, −0.24). Adjusted analyses gave comparable results. Conclusions Telemedicine-delivered BAT was superior to same room in achieving lower mean A1c values in participants with type 2 diabetes, suggesting BAT-delivered via telemedicine is a viable treatment option for adults with diabetes.
Virtual care policy recommendations for patient-centred primary care: findings of a consensus policy dialogue using a nominal group technique
Authors: Shaw James , Jamieson Trevor , Agarwal Payal , Griffin Bailey , Wong Ivy , Bhatia R. Sacha 
Published: September 2017

Background The development of new virtual care technologies (including telehealth and telemedicine) is growing rapidly, leading to a number of challenges related to health policy and planning for health systems around the world. Methods We brought together a diverse group of health system stakeholders, including patient representatives, to engage in policy dialogue to set health system priorities for the application of virtual care in the primary care sector in the Province of Ontario, Canada. We applied a nominal group technique (NGT) process to determine key priorities, and synthesized these priorities with group discussion to develop recommendations for virtual care policy. Methods included a structured priority ranking process, open-ended note-taking, and thematic analysis to identify priorities. Results Recommendations were summarized under the following themes: (a) identify clear health system leadership to embed virtual care strategies into all aspects of primary and community care; (b) make patients the focal point of health system decision-making; (c) leverage incentives to achieve meaningful health system improvements; and (d) building virtual care into streamlined workflows. Two key implications of our policy dialogue are especially relevant for an international audience. First, shifting the dialogue away from technology toward more meaningful patient engagement will enable policy planning for applications of technology that better meet patients’ needs. Second, a strong conceptual framework on guiding the meaningful use of technology in health care settings is essential for intelligent planning of virtual care policy. Conclusions Policy planning for virtual care needs to shift toward a stronger focus on patient engagement to understand patients’ needs.
Laparoscopic Roux-En-Y Gastric Bypass in Elderly Patients (60 Years or Older): A Meta-Analysis of Comparative Studies
Authors: Giordano S. , Victorzon M. 
Published: September 2017

Background and Aims: Elderly patient might experience an increased risk of complications after laparoscopic Roux-en-Y gastric bypass. We aimed to perform a meta-analysis of comparative studies on this issue in patients aged 60 years or older. Material and Methods: A systematic literature search was performed. Medline, Cochrane Library, Embase, Scopus, and Google Scholar were searched until July 2016 for studies on outcomes of laparoscopic Roux-en-Y gastric bypass in elderly versus younger patients. Primary outcomes were mortality and overall complications. Secondary outcomes were length of hospital stay, excess weight loss percentage, effect on diabetes, hypertension, hyperlipidemia and obstructive sleep apnea. Heterogeneity across the studies was evaluated by the I2 test, and a random effects model was used. Results were expressed as mean difference and risk ratio (RR). Results: Seven studies involving 3128 patients were retrieved and included in this study. A significantly increased risk of mortality and overall complications was observed among patients older than 60 years compared with younger ones (RR, 6.12; 95% confidence interval 1.08–34.83; p = 0.04; RR, 1.51; 95% confidence interval 1.07–2.11; p = 0.02). Particularly, elderly patients experienced 1% increased risk of mortality and 3% increased risk of overall complications. Length of stay, diabetes, and obstructive sleep apnea remission rates were similar among the groups. Excess weight loss percentage was significantly greater among younger patients (mean difference, −3.44; 95% confidence interval −5.20, −1.68; p < 0.001), as were hypertension (RR, 0.57; 95% confidence interval 0.42–0.76; p < 0.001) and hyperlipidemia (RR, 0.61; 95% confidence interval 0.45–0.83; p = 0.002) remission rates. Conclusion: Laparoscopic Roux-en-Y gastric bypass in patients older than 60 years may be a risky bariatric surgery operation due to higher complications and mortality and may not be as effective as in patients younger than 60 years. Thus, older patients should be carefully counseled before this procedure for individual risk–benefit assessment.
Clinical Outcome after Plaster Cast Fixation for 10 Days Versus 1 Month in Reduced Distal Radius Fractures: A Prospective Randomized Study
Authors: Christersson A. , Larsson S. , Sandén B. 
Published: September 2017

Introduction: This study aimed to evaluate clinical results after plaster cast fixation for 10 days versus 1 month of moderately displaced and reduced distal radius fractures. Material and Methods: In a prospective randomized study, 109 patients with moderately displaced and conservatively treated distal radius fractures (age ≥50 years) were randomized 10 days after reduction to either removal of the plaster cast and immediate mobilization (active group) or to continued plaster cast fixation for another 3 weeks (control group). Grip strength, pincer strength, range of motion, and pain were assessed at 1, 4, and 12 months after reduction. Clinical outcome was evaluated using three functional assessment scores at 12 months. Results: Treatment failed in 3/54 (6%) patients in the active group. One of these patients had the plaster cast reinstituted because of feelings of instability. The fractures in the other two patients displaced severely after mobilization and were therefore treated surgically. For the remaining 51 patients in the active group, the range of wrist motion was slightly better at 1 month compared with the controls, but there were no differences in grip or pincer strength or pain at the 1-month follow-up. There were no differences between the active and control group in any outcome at 4 or 12 months, including functional assessment scores at 12 months. Conclusion: Treatment with mobilization 10 days after reduction of moderately displaced distal radius fractures resulted in a few treatment failures compared with none among controls. The only functional benefit for the remaining patients was a small and transient increase in range of motion at the 1-month follow-up. Plaster cast removal 10 days after reduction in moderately displaced distal radius fractures is therefore not recommended.