bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electroconvulsive Therapy Practice in the Province of Quebec: Linked Health Administrative Data Study from 1996 to 2013
Authors: Lemasson Morgane , Haesebaert Julie , Rochette Louis , Pelletier Eric , Lesage Alain , Patry Simon 
Published: October 2017

Objective: As part of a quality improvement process, we propose a model of routinely monitoring electroconvulsive therapy (ECT) in Canadian provinces using linked health administrative databases to generate provincial periodic reports, influence policy, and standardise ECT practices. Methods: ECT practice in Quebec was studied from 1996 to 2013, using longitudinal data from the Quebec Integrated Chronic Disease Surveillance System of the Institut National de Santé Publique du Québec, which links 5 health administrative databases. The population included all persons, aged 18 y and over, eligible for the health insurance registry, who received an ECT treatment at least once during the year. Results: Among recorded cases, 75% were identified by physician claims and hospitalisation files, 19% exclusively by physician claims, and 6% by hospitalisation files. From 1996 to 2013, 8,149 persons in Quebec received ECT with an annual prevalence rate of 13 per 100,000. A decline was observed, which was more pronounced in women and in older persons. On average, each patient received 9.7 treatments of ECT annually. The proportion of acute ECT decreased whereas maintenance treatment proportions increased. A wide variation in the use of ECT was observed among regions and psychiatrists. Conclusion: This study demonstrates the profitable use of administrative data to monitor ECT use in Quebec, and provides a reliable method that could be replicated in other Canadian provinces. Although Quebec has one of the lowest utilisation rates reported in industrialized countries, regional disparities highlighted the need for a deeper examination of the quality and monitoring of ECT care and services.
The first female authors of the Journal of Urology
Authors: Marchetti Kathryn , Lee Ted , Bloom David A , Wan Julian 
Published: October 2017

Introduction In 1917, Alma Hiller became the first woman to publish in the Journal of Urology ( JU). Her contribution was followed by articles from Carol Beeler and Isabel Mary Wason. This study explores their careers and contributions. Methods We reviewed JU articles from 1917 to 1925 and identified Hiller, Beeler, and Wason as the first three women authors. Using public records, we obtained information of their educations and careers. Results Hiller demonstrated resilience in obtaining training and ultimately contributed to innovation in clinical chemistry. Beeler worked on research on metabolic physiology. Wason influenced both lab work and national policy. Conclusions For female scientists entering the workforce in the late 1800s/early 1900s, reception was contingent upon the acceptance of male colleagues. Despite these barriers, Hiller, Beeler, and Wason contributed to novel discoveries. Their most influential contributions remain their historic presence as early female researchers and the first female authors in JU.
What Getting Legal Land Title Really Means
Authors: Annez Patricia Clarke , Bhatt Bijal , Patel Bimal 
Published: October 2017

This article documents, for a neighbourhood in Ahmedabad, India, what would be involved for current occupants to regularise tenure and register legal title. We show that the process of clearing title can be expensive, fraught with risks and perhaps impossible to complete for either the current occupants or the owners of record. Staying on the land in their current ambiguous status seems viable for now, but investing in further development is very risky. We discuss these findings in the context of the debate about providing secure tenure to slum dwellers from two perspectives: (a) the practicality of providing legal tenure as part of neighbourhood upgrading programmes; (b) the impacts on the real estate market of a system that leaves many private plots, in slums or elsewhere, in legal limbo and difficult to develop—in essence an anti-commons. Both issues are of critical interest as India faces the challenge of urbanisation. JEL: R310, O170
An Evaluation of a Social Skills Application for Children Who Are Homeless
Authors: Baton Emily , Crosland Kimberly , Haynes Rocky 
Published: October 2017

Purpose: Homeless children are more likely to have social skills deficits relative to same aged peers and may benefit from a social skills intervention. Therefore, the purpose of this study was to assess the Let’s Be Social application with the addition of behavioral skills training (BST) to teach social skills to children who were homeless. Method: This study used a multiple baseline across behaviors design to evaluate the effects of the iPad application and BST for teaching three social skills to three participants. Results: Participants did not demonstrate increases in targeted social skills after the introduction of the application, but social skills did increase after BST was added. Conclusions: The findings suggest that the application needs to be paired with BST in order to see improvement and maintenance in social skills. Future downloadable applications might consider including features that are similar to BST to assist in teaching social skills.
“It can’t happen to me”
Authors: Belackova Vendula , Janikova Barbara , Vacek Jaroslav , Fidesova Hana , Miovsky Michal 
Published: October 2017

Background: In September 2012, a series of methanol poisonings occurred in the Czech Republic as a result of an influx of illicit alcohol into (predominantly) cheap alcoholic beverages on the retail market. The public authorities decided to prevent public health risks by prohibiting sales of liquors that contained more than 20% alcohol (> 20% liquor). The “partial” prohibition lasted for almost two weeks, but the poisonings still continued. This article assesses the impact of the methanol poisoning risks and the (partial) prohibition on alcohol drinking patterns, and describes the understanding of risks and their mitigation in vulnerable groups. Methods: The rapid assessment and response method (RAR) was used during the (partial) alcohol prohibition. Semi-structured interviews were conducted with respondents recruited for the study in alcohol-intake settings (e.g., bars and restaurants, street alcohol outlets) in six regions. In total, 107 alcohol users were interviewed, mostly with risky drinking patterns (69% scored ≥ 1 on the CAGE scale), and 53 alcohol retailers/staff members serving alcohol. Results: About one third of the alcohol users in the study (35%) drank > 20% liquors during the prohibition; a higher score on the CAGE scale was associated with a lower probability of drinking > 20% liquors during the period of the prohibition, probably because of the perception of being at high risk of poisoning. There was some increase in drinking liquors with an alcohol content less than 20%. Those who continued drinking > 20% liquors typically did so in the belief that some sources of these were safe. Conclusions: Public policies aimed at reducing the risk of methanol poisonings in emergency situations should adopt broader measures than those focusing on market control. These measures include increased access to brief interventions, addressing the strategies that alcohol consumers adopt to prevent risk, and, in general, helping consumers make informed choices to prevent further fatalities.
Factors Associated With Wandering Behaviors in Veterans With Mild Dementia: A Prospective Longitudinal Community-Based Study
Authors: Barrett Blake , Bulat Tatjana , Schultz Susan K. , Luther Stephen L. 
Published: October 2017

Objective: To investigate baseline factors associated with caregiver-reported wandering among community-dwelling veterans with mild dementia. Methods: Veterans with mild dementia (N = 143) and their caregivers participated in a 2-year prospective longitudinal study. Measures assessed wandering, daily function, behavior, cognition, and personality features. Wandering was dichotomized as present or absent across study periods, and associations with baseline characteristics were examined. Results: One-quarter of participants demonstrated caregiver-reported wandering at 1 or more study visits, with 14% to 15% wandering at any 1 visit. Wandering was associated with significantly lower baseline scores in performance of daily function, behavioral response to stress, gait, and balance, and conscientiousness. Conclusions: This novel study evaluated wandering in a community-dwelling sample of veterans with mild dementia. Wandering was associated with a specific personality trait, poorer behavioral response to stress as well as greater functional and gait/balance impairment. These findings may assist in developing community-based interventions for caregivers.
Functional near-infrared spectroscopy is in moderate accordance with functional MRI in determining lateralisation of frontal language areas
Authors: Arun KM , Smitha KA , Rajesh PG , Kesavadas Chandrasekharan 
Published: October 2017

Purpose Understanding language dominance is crucial in pre-surgical evaluation of patients with epilepsy and in patients having a tumour close to the language area. Functional magnetic resonance imaging (fMRI) studies are well established in evaluating language dominance. Functional near-infrared spectroscopy (fNIRS) is a non-invasive optical imaging modality that offers a convenient and affordable technique to image language-related cortical areas. This study investigates the agreement between results from task-based fMRI and fNIRS in determining language lateralisation. Methods Language laterality indices LIs were calculated from both fMRI and fNIRS measurements of the same individual volunteers by using an identical paradigm. Statistical measures of percentage agreement and kappa value have been calculated for testing agreement and reliability. Results A correlation analysis of the LI values shows a good correlation with r = 0.677 at p < 0.05. Statistical comparison of both fMRI and fNIRS methods for language lateralisation yielded a percentage agreement of 90% and a moderate kappa value of κ = 0.621. Conclusion Our study suggests that fNIRS is in moderate accordance with fMRI in determining lateralisation of the frontal language areas. It implies that the optical imaging technique can provide additional information on functional lateralisation of frontal language areas.
Multi-modality imaging of a left atrial myxoma
Authors: Jung Hae Won , Doh Joon Hyung , Chang Woo-Ik 
Published: October 2017

Objectives: Although echocardiography has traditionally been used to diagnose myxoma, invasive or non-invasive coronary angiography can be useful diagnostic tool before surgery. Methods: We present a case of an angiographically detected left atrial myxoma feeding from the left circumflex coronary artery. Results: The patient underwent open-heart surgery to remove the left atrial myxoma. After ligation of feeding artery, the mass was successfully excised Conclusion: Preoperative coronary angiography can offer additional valuable information moreover detecting coronary artery disease. Because, there is sudden death risk from embolization during invasive coronary angiography, preoperative cardiac computed tomography angiography should be considered to plan the surgery of myxoma.
National Trends for Primary and Revision Lumbar Disc Arthroplasty Throughout the United States
Authors: Saifi Comron , Cazzulino Alejandro , Park Caroline , Laratta Joseph , Louie Philip K. , Shillingford Jamal N. , Lehman Ronald , An Howard , Phillips Frank 
Published: October 2017

Study Design: Retrospective database study. Objectives: Analysis of economic and demographic data concerning lumbar disc arthroplasty (LDA) throughout the United States to improve value-based care and health care utilization. Methods: The National Inpatient Sample database was queried for patients who underwent primary or revision LDA between 2005 and 2013. Demographic and economic data included total surgeries, costs, length of stay, and frequency of routine discharge. The National Inpatient Sample database represents a 20% sample of discharges from US hospitals weighted to provide national estimates. Results: Primary LDA decreased 86% from 3059 to 420 from 2005 to 2013. The mean total cost of LDA increased 33% from $17 747 to $23 804. The mean length of stay decreased from 2.8 to 2.4 days. The mean routine discharge (home discharge without visiting nursing care) remained constant at 91%. Revision procedures (removal, supplemental fixation, or reoperation at the treated level) declined 30% from 194 to 135 cases over the study period. The mean revision burden, defined as the ratio of revision procedures to the sum of primary and revision procedures, was 12% (range 6% to 24%). The mean total cost of revisions ranged from $12 752 to $22 282. Conclusions: From 2005 to 2013, primary LDA significantly declined in the United States by 86% despite several studies pointing to improved efficacy and cost-efficiency. This disparity may be related to a lack of surgeon reimbursement from insurance companies. Congruently, the number of revision LDA cases has declined 30%, while revision burden has risen from 6% to 24%.
Allograft Versus Demineralized Bone Matrix in Instrumented and Noninstrumented Lumbar Fusion: A Systematic Review
Authors: Buser Zorica , Brodke Darrel S. , Youssef Jim A. , Rometsch Elke , Park Jong-Beom , Yoon S. Tim , Wang Jeffrey C. , Meisel Hans-Joerg 
Published: October 2017

Study Design: Systematic review. Objectives: The aim was to determine the fusion efficacy of allograft and demineralized bone matrix (DBM) in lumbar instrumented and noninstrumented fusion procedures for degenerative lumbar disorders. Methods: A literature search was conducted using the PubMed and Cochrane databases. To be considered, publications had to meet 4 criteria: patients were treated for a degenerative lumbar disorder, a minimum group size of 10 patients, use of allograft or DBM, and at least a 2-year follow-up. Data on the study population, follow-up time, surgery type, grafting material, fusion rates, and its definition were collected. Results: The search yielded 692 citations with 17 studies meeting the criteria including 4 retrospective and 13 prospective studies. Six studies used DBM and 11 employed allograft alone or in the combination with autograft. For the allograft, fusion rates ranged from 58% to 68% for noninstrumented and from 68% to 98% for instrumented procedures. For DBM, fusion rates were 83% for noninstrumented and between 60% and 100% for instrumented lumbar fusion procedures. Conclusions: Both allograft and DBM appeared to provide similar fusion rates in instrumented fusions. On the other hand, in noninstrumented procedures DBM was superior. However, a large variation in the type of surgery, outcomes collection, lack of control groups, and follow-up time prevented any significant conclusions. Thus, studies comparing the performance of allograft and DBM to adequate controls in large, well-defined patient populations and with a sufficient follow-up time are needed to establish the efficacy of these materials as adjuncts to fusion.
Decompression in Adult Lumbar Deformity Surgery Is Associated With Increased Perioperative Complications but Favorable Long-Term Outcomes
Authors: Karikari Isaac O. , Bridwell Keith H. , Elsamadicy Aladine A. , Lenke Lawrence G. , Sugrue Patrick , Bumpass David , Ahmad Azeem , Gum Jeffrey 
Published: October 2017

Study Design: Retrospective cohort study. Objectives: To analyze the impact of performing a formal decompression in patients with adult lumbar scoliosis with symptomatic spinal stenosis on perioperative complications and long-term outcomes. Methods: Adult patients undergoing at least 5 levels of fusion to the sacrum with iliac fixation from 2002 to 2008 who had a minimum 5-year follow-up at one institution were studied. Patients who had 3-column osteotomy were excluded from the study. Perioperative complications and clinical outcomes (Scoliosis Research Society [SRS], Oswestry Disability Index [ODI], and Numerical Rating Scale [NRS] back/leg pain) were analyzed. Patients who underwent formal laminectomy/decompressions were compared with those who did not. Differences between the 2 groups were analyzed using Student’s t test. Results: A total of 147 patients were included in the study (Decompression: n = 55 [37%], No decompression: n = 92 [63%]). Average fusion levels for the decompression and no decompression groups were 11 and 12 levels, respectively ( P = .26). Mean improvements in SRS domains for decompression versus no decompression patients, respectively, were pain (1.1 vs 0.9, P = .3), function (0.7 vs 0.5, P = .09), self-image (1.1 vs 1.1, P = .9), and mental health (0.5 vs 0.4, P = .5). Furthermore, additional mean improvements were ODI (21 vs 21, P = .14), NRS-Back pain (3.0 vs 1.3, P = .16), and NRS-Leg pain (3.9 vs 0.5, P = .002). Complication rates between the decompression group and no decompression group differed in incidental durotomies (18.2% vs 0%) and cardiac-related (9.1% vs 1.1%). Conclusions: Performing a formal decompression in adult lumbar scoliosis with symptomatic spinal stenosis is associated with increased perioperative complications but favorable long-term clinical outcomes.
Risk Factors for Unplanned Reoperation Within 30 Days Following Elective Posterior Lumbar Spinal Fusion
Authors: Durand Wesley M. , Eltorai Adam E. M. , Depasse J. Mason , Yang JaeWon , Daniels Alan H. 
Published: October 2017

Study Design: Retrospective cohort study. Objectives: Unplanned reoperation following lumbar spinal fusion is detrimental to patients, providers, and health systems. The aim of this study was to identify risk factors associated with unplanned reoperation following elective posterior lumbar spinal fusion and assess the reasons for reoperation. Methods: A retrospective analysis of 22 151 patients from the American College of Surgeons National Surgical Quality Improvement Program data set between 2012 and 2015 was completed. The primary outcome measure was unplanned reoperation within 30 days. Secondary outcome measures were specific diagnoses and procedures associated with unplanned reoperation, as well as time to reoperation from initial procedure. Multiple stepwise logistic regression was employed to determine preoperative variables predictive of unplanned 30-day reoperation. Results: Patients with disseminated cancer (OR = 3.44, P = .0049), weight loss >10% in 6 months prior to surgery (OR = 3.26, P = .0276), bleeding disorders (OR = 1.92, P = .0049), American Society of Anesthesiologists score of 3 (OR = 1.46, P < .0001), body mass index of 35.0 to 39.9 (OR = 1.50, P = .0037), body mass index of ≥40 (OR = 1.83, P < .0001), and multilevel fusion (OR = 1.24, P = .0069) exhibited increased odds of 30-day reoperation. The most common diagnosis associated with reoperation was postoperative infection (n = 121, 21.1% of reoperations). Conclusions: Predictors and causes of unplanned reoperation within 30 days following elective posterior lumbar spinal fusion are identifiable. In this study cohort, obesity, American Society of Anesthesiologists score, disseminated cancer, weight loss, bleeding disorders, and multilevel fusion were identified as significant risk factors for reoperation. Further research investigating risk factor modification on reoperation in elective posterior lumbar spinal fusion is warranted.
Can a Clinical Examination Demonstrate Intramuscular Tendon Involvement in Acute Hamstring Injuries?
Authors: Crema Michel D. , Guermazi Ali , Reurink Gustaaf , Roemer Frank W. , Maas Mario , Weir Adam , Moen Maarten H. , Goudswaard Gert J. , Tol Johannes L. 
Published: October 2017

Background: Involvement of the intramuscular (central) tendon in acute hamstring injuries, as detected on magnetic resonance imaging (MRI), may prolong recovery times. To date, it is unclear whether hamstring injuries exhibiting intramuscular tendon involvement can be identified though routine clinical examinations that assess flexibility and strength. Purpose: To test whether MRI-detected intramuscular tendon involvement could be identified by a clinical assessment of muscle strength and flexibility. Study Design: Case-control study; Level of evidence, 3. Methods: Participants were drawn from a multicenter randomized controlled trial on the effect of platelet-rich plasma in acute hamstring injuries. Clinical parameters assessed within 5 days of injury were active knee extension and passive straight-leg raise for hamstring flexibility and isometric knee flexion force with 15° and 90° of knee flexion. Also, 1.5-T MRI of the thigh was performed within 5 days of injury and was evaluated for the presence of different types of intramuscular tendon involvement. One-way analysis of variance was used to determine whether clinical parameters could discriminate injuries with intramuscular tendon involvement from those without such involvement. Results: A total of 74 acute hamstring injuries were included, with 52 (70.3%) injuries affecting the myotendinous junction. Injuries exhibiting intramuscular tendon discontinuity on MRI had an increased mean absolute flexibility deficit for active knee extension (20.4° ± 14.9° vs 10.7° ± 9.0°, respectively; P = .006) and decreased mean strength at 15° (62.2 ± 26.7 N vs 76.6 ± 22.5 N, respectively; P = .05) compared with injuries without intramuscular tendon discontinuity. Flexibility and strength showed major overlap and variance among injuries with and without intramuscular tendon involvement. Conclusion: Hamstring flexibility and strength cannot be used to discriminate the presence of intramuscular tendon involvement.
Evaluating SME Policies and Programmes—Micro-level Datasets, Analytical Toolkits and Institutional Factors
Authors: Gramigna Giuseppe 
Published: October 2017

Big Data changed the paradigm of how the private sector serves its clients. The adroit use of Program Administrative Data (PAD) collected as part of the normal delivery of government services, when linked to records in other datasets, can change the cost and empirical paradigm of how the government learns what works and what does not, and can serve as the foundation for evidence-based policymaking. The linking of individual records is best achieved when records are associated with a Unique Identifier. The use of these linked datasets require a robust data-sharing and data-use infrastructure of laws and technologies that include regulations and procedures on (1) Privacy that outline which data are collected, (2) Confidentiality that outline the allowable users and uses these data, and (3) Security, that outline the excluded users and uses of these data. PAD is used for Performance Measurements to asses who was served, when they were served, how intensively they were served, and at what costs. These measurements, however, do not inform on the change in recipient behavior, or how the recipient behavior impacted a community or a region. Tracing and evaluating a program’s impacts on recipients or communities requires linking PAD to micro data found across government and possibly private entities. There are several challenges with this learning process. The most common among them is learning from insignificant, null or negative findings. Similar challenges arise when evaluating new programs that may not have been in existence long enough to gestate impacts, or for evaluating the impacts of small programs that may not have generated sufficient service-provision observations.