bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Much Do Mental Health and Substance Use/Addiction Affect Use of General Medical Services? Extent of Use, Reason for Use, and Associated Costs
Authors: Graham Kathryn , Cheng Joyce , Bernards Sharon , Wells Samantha , Rehm Jürgen , Kurdyak Paul 
Published: August 2016

Objective: To measure service use and costs associated with health care for patients with mental health (MH) and substance use/addiction (SA) problems. Methods: A 5-year cross-sectional study (2007-2012) of administrative health care data was conducted (average annual sample size = 123,235 adults aged >18 years who had a valid Ontario health care number and used at least 1 service during the year; 55% female). We assessed average annual use of primary care, emergency departments and hospitals, and overall health care costs for patients identified as having MH only, SA only, co-occurring MH and SA problems (MH+SA), and no MH and/or SA (MH/SA) problems. Total visits/admissions and total non-MH/SA visits (i.e., excluding MH/SA visits) were regressed separately on MH, SA, and MH+SA cases compared to non-MH/SA cases using the 2011-2012 sample ( N = 123,331), controlling for age and sex. Results: Compared to non-MH/SA patients, MH/SA patients were significantly ( P < 0.001) more likely to visit primary care physicians (1.82 times as many visits for MH-only patients, 4.24 for SA, and 5.59 for MH+SA), use emergency departments (odds, 1.53 [MH], 3.79 [SA], 5.94 [MH+SA]), and be hospitalized (odds, 1.59 [MH], 4.10 [SA], 7.82 [MH+SA]). MH/SA patients were also significantly more likely than non-MH/SA patients to have non-MH/SA-related visits and accounted for 20% of the sample but over 30% of health care costs. Conclusions: MH and SA are core issues for all health care settings. MH/SA patients use more services overall and for non-MH/SA issues, with especially high use and costs for MH+SA patients.
Factors Associated with Recurrent Infant Feeding Practices in Subsequent Births
Authors: Bentley Jason P. , Bond Diana , de Vroome Michelle , Yip Elizabeth , Nassar Natasha 
Published: August 2016

Background: Previous breastfeeding experience has been associated with subsequent infant feeding practices. However, few longitudinal studies have investigated formula-only feeding patterns or the full range of potentially associated characteristics. Objective: This study aimed to determine the recurrence of infant feeding practices and maternal, birthing, and infant characteristics associated with recurrent formula-only feeding and changes between exclusive breastfeeding and formula-only feeding across subsequent births. Methods: We conducted a population-based record-linkage study of 317 027 mothers, with a term singleton live-birth in 2007-2011, New South Wales, Australia. Infant feeding patterns were described using sequential birth pairs. For mothers with a first and second birth, robust Poisson regression was used to investigate the association between maternal, birthing, and infant characteristics and infant feeding patterns. Combined relative risks (RRs) were calculated for selected maternal characteristics. Results: Across 69 994 sequential birth pairs, the recurrence rate of formula-only feeding was 71%, and 92% for exclusive breastfeeding. Maternal characteristics < 25 years old, being Australian born or single, smoking during pregnancy, and living in lower socioeconomic areas were most strongly associated with repeat formula-only feeding (RR, 22.1; 95% confidence interval [CI], 18.6-26.3), changing from exclusive breastfeeding to formula-only feeding (RR, 9.0; 95% CI, 7.4-10.7), and being less likely to change from formula-only feeding to exclusive breastfeeding (RR, 0.47; 95% CI, 0.38-0.59). Conclusion: Infant feeding practices were strongly recurrent, highlighting the importance of successful breastfeeding for first-time mothers. Additional support for young mothers from disadvantaged backgrounds accounting for infant feeding history, experiences, and common barriers could improve recurrent exclusive breastfeeding and positively affect infant and maternal health.
The Acquisition and Usage of the SODAS Problem-Solving Method Among Adults at Risk for Homelessness
Authors: Streetman Collin , Crosland Kimberly , “Rusty” Clark Hewitt B. 
Published: August 2016

Purpose: Individuals experiencing extended homelessness face multifaceted risks related to health, substance use, and continuing unemployment and may benefit from learning a problem-solving and decision-making method to assist them in dealing with everyday situations. Methods: This study used a multiple-baseline design to teach three men with extensive histories of homelessness the situation, options, disadvantages, advantages, and solution (SODAS) problem-solving and decision-making method and assessed their ability to learn it and guide another adult in the use of the method in simulated role-play problem situations. Results: All three participants demonstrated substantial increases (from approximately 10% of steps correct in baseline to 100% steps correct after intervention) in their ability to successfully guide another adult through the SODAS process when role-playing problem situations. Conclusions: The findings suggest that the SODAS problem-solving and decision-making method could be efficiently taught to adults who have histories of homelessness, and the participants found the process helpful for problems they encountered.
Psychometric Properties of an Arabic Version of the Depression Anxiety Stress Scales (DASS)
Authors: Moussa Miriam Taouk , Lovibond Peter , Laube Roy , Megahead Hamido A. 
Published: August 2016

Objective: To translate and evaluate the psychometric properties of an Arabic-language version of the Depression Anxiety Stress Scales (DASS). Method: The items were translated, back translated, refined, and tested in an Australian immigrant sample ( N = 220). Results: Confirmatory factor analysis showed that the Arabic DASS discriminates between depression, anxiety, and stress but to a lesser degree than the English DASS. The factor loadings for all 42 items were comparable to those of the English DASS, indicating that the items had been appropriately translated and adapted. Analysis of exploratory items suggested by Arabic-speaking mental health professionals failed to reveal any new items that were both psychometrically adequate and theoretically coherent. Analysis of a bilingual sample ( N = 24) indicated that the English norms was appropriate for the Arabic DASS. Conclusion: The results support the universality of depression, anxiety, and stress across cultures and provide initial support for the psychometric properties of the Arabic DASS.
Effect of single agent high-dose methotrexate-related acute kidney injury on length of hospitalization and relative dose intensity in adult patients with central nervous system lymphoma
Authors: Steward Jennifer S , Bullard Heather M , O’Rourke Timothy J , Campbell Alan D , Brinker Brett T , Yost Kathleen J , Vanderwoude Amy C , Scott William L , Kintzel Polly E 
Published: August 2016

Purpose Grade ≥3 adverse effects prolong hospitalization and reduce chemotherapy dose intensity. The purpose of this study was to evaluate the rate and severity of high-dose methotrexate-related acute kidney injury and analyze its effect on hospital length of stay and relative chemotherapy dose intensity. Methods This was a retrospective cohort analysis. Patients receiving ≥1 dose of high-dose methotrexate were analyzed for acute kidney injury and length of stay. Patients receiving ≥6 cycles of induction therapy were included in the analysis of relative chemotherapy dose intensity. Chi squared analysis was used to determine the differences between dichotomous data; Student’s t-test for parametric data and Mann-Whitney U test for non-parametric data for continuous variables. Statistical analyses were performed with IBM SPSS Statistics (version 21). Results Twenty-six patients and 194 treatment encounters were identified. Thirteen patients were evaluated for relative chemotherapy dose intensity. Grade ≥3 acute kidney injury occurred in four patients (15% of patients; 2% of encounters). There were no grade 5 adverse events. Mean length of stay for encounters with grade ≥3 acute kidney injury was almost three times longer than for those with ≤ grade 2 acute kidney injury (p = 0.041). Mean relative chemotherapy dose intensity was reduced approximately in half for patients experiencing grade ≥3 acute kidney injury (p < 0.01). The most common adverse events were hypokalemia and nausea. Proton pump inhibitors were the most frequently co-administered medications with the potential to affect high-dose methotrexate pharmacokinetics. Conclusion At our cancer program, the rate of grade ≥3 acute kidney injury with high-dose methotrexate is similar to that reported by others. Grade ≥3 acute kidney injury following high-dose methotrexate administration significantly prolonged length of stay and reduced relative chemotherapy dose intensity.
Determination of reference intervals and comparison of venous blood gas parameters using standard and non-standard collection methods in 24 cats
Authors: Bachmann Karin , Kutter Annette PN , Schefer Rahel Jud , Marly-Voquer Charlotte , Sigrist Nadja 
Published: August 2016

Objectives The aim of this study was to determine in-house reference intervals (RIs) for venous blood analysis with the RAPIDPoint 500 blood gas analyser using blood gas syringes (BGSs) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGSs. Methods Venous blood was collected from 24 healthy cats and directly transferred into a BGS and an LH tube. The BGS was immediately analysed on the RAPIDPoint 500 followed by the LH tube. The BGSs and LH tubes were compared using paired t-test or Wilcoxon matched-pairs signed-rank test, Bland–Altman and Passing–Bablok analysis. To assess clinical relevance, bias or percentage bias between BGSs and LH tubes was compared with the allowable total error (TEa) recommended for the respective parameter. Results Based on the values obtained from the BGSs, RIs were calculated for the evaluated parameters, including blood gases, electrolytes, glucose and lactate. Values derived from LH tubes showed no significant difference for standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate, while pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionised calcium and anion gap were significantly different to the samples collected in BGSs ( P <0.05). Furthermore, pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, ionised calcium and anion gap exceeded the recommended TEa. Conclusions and relevance Assessment of actual and standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate can be made based on blood collected in LH tubes and analysed within 5 mins. For pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, anion gap and ionised calcium the clinically relevant alterations have to be considered if analysed in LH tubes.
Fatigue and fluid hydration status in multiple sclerosis: A hypothesis
Authors: Cincotta Molly C , Engelhard Matthew M , Stankey Makela , Goldman Myla D 
Published: August 2016

Background: Fatigue is a prevalent and functionally disabling symptom for individuals living with multiple sclerosis (MS) which is poorly understood and multifactorial in etiology. Bladder dysfunction is another common MS symptom which limits social engagement and quality of life. To manage bladder issues, individuals with MS tend to limit their fluid intake, which may contribute to a low-hydration (LoH) state and fatigue. Objective: To evaluate the relationship between patient-reported MS fatigue, bladder dysfunction, and hydration status. Methods: We performed a prospective cross-sectional study in 50 women with MS. Participants submitted a random urine sample and completed several fatigue-related surveys. Using a urine specific gravity (USG) threshold of 1.015, we classified MS subjects into two groups: high-hydration (HiH) and LoH states. Results: LoH status was more common in MS subjects with bladder dysfunction. Statistically significant differences in self-reported Fatigue Performance Scale were observed between HiH and LoH subjects ( p = 0.022). USG was significantly correlated with fatigue as measured by the MS Fatigue Severity Scale (FSS) score ( r = 0.328, p = 0.020). Conclusion: Hydration status correlates with self-reported fatigue, with lower fatigue scores found in those with HiH status (USG < 1.015).
Initial Poor Function and Primary Nonfunction in Deceased-Donor Orthotopic Liver Transplantation Maintaining Short Cold Ischemic Time
Authors: Das Somak , Swain Sudeepta Kumar , Addala Pavan Kumar , Balasubramaniam Ramakrishnan , Gopakumar C. V. , Zirpe Dinesh , Renganathan Kirubakaran , Kollu Harsha , Patel Darshan , Vibhute Bipin B. , Rao Prashantha S. , Krishnan Elankumaran , Gopasetty Mahesh , Khakhar Anand K. , Vaidya Anil , Ramamurthy Anand 
Published: August 2016

Background: Nations with emerging deceased-donor liver transplantation programs, such as India, face problems associated with poor donor maintenance. Cold ischemic time (CIT) is typically maintained short by matching donor organ recovery and recipient hepatectomy to achieve maximum favorable outcome. We analyzed different extended criteria donor factors including donor acidosis, which may act as a surrogate marker of poor donor maintenance, to quantify the risk of primary nonfunction (PNF) or initial poor function (IPF). Methods: A single-center retrospective outcome analysis of prospectively collected data of patients undergoing deceased-donor liver transplantation over 2 years to determine the impact of different extended criteria donor factors on IPF and PNF. Results: From March 2013 to February 2015, a total of 84 patients underwent deceased-donor liver transplantation. None developed PNF. Thirteen (15.5%) patients developed IPF. Graft macrosteatosis and donor acidosis were only related to IPF ( P = .002 and P = .032, respectively). Cold ischemic time was maintained short (81 cases ≤8 hours, maximum 11 hours) in all cases. Conclusion: Poor donor maintenance as evidenced by donor acidosis and graft macrosteatosis had significant impact in developing IPF when CIT is kept short. Similar study with larger sample size is required to establish extended criteria cutoff values.
Enlarged perivascular spaces and cognitive impairment after stroke and transient ischemic attack
Authors: Arba Francesco , Quinn Terence J , Hankey Graeme J , Lees Kennedy R , Wardlaw Joanna M , Ali Myzoon , Inzitari Domenico ,   on behalf of the VISTA Collaboration
Published: August 2016

Background Previous studies suggested that enlarged perivascular spaces are neuroimaging markers of cerebral small vessel disease. However, it is not clear whether enlarged perivascular spaces are associated with cognitive impairment. We aimed to determine the cross-sectional relationship between enlarged perivascular spaces and small vessel disease, and to investigate the relationship between enlarged perivascular spaces and subsequent cognitive impairment in patients with recent cerebral ischemic event. Methods Anonymized data were accessed from the virtual international stroke trial archive. We rated number of lacunes, white matter hyperintensities, brain atrophy, and enlarged perivascular spaces with validated scales on magnetic resonance brain images after the index stroke. We defined cognitive impairment as a mini mental state examination score of ≤26, recorded at one year post stroke. We examined the associations between enlarged perivascular spaces and clinical and imaging markers of small vessel disease at presentation and clinical evidence of cognitive impairment at one year using linear and logistic regression models. Results We analyzed data on 430 patients with mean (±SD) age 64.7 (±12.7) years, 276 (64%) males. In linear regression analysis, age (β = 0.24; p < 0.001), hypertension (β = 0.09; p = 0.025), and deep white matter hyperintensities (β = 0.31; p < 0.001) were associated with enlarged perivascular spaces. In logistic regression analysis, basal ganglia enlarged perivascular spaces were independently associated with cognitive impairment at one year after adjusting for clinical confounders (OR = 1.72, 95% CI = 1.22–2.42) and for clinical and imaging confounders (OR = 1.54; 95% CI = 1.03–2.31). Conclusions Our data show that in patients with ischemic cerebral events, enlarged perivascular spaces are cross-sectionally associated with age, hypertension, and white matter hyperintensities and suggest that enlarged perivascular spaces in the basal ganglia are associated with cognitive impairment after one year.
Combination leflunomide and methotrexate in refractory rheumatoid arthritis: a biologic sparing approach
Authors: Hodkinson Bridget , Magomero Kingsley Ross , Tikly Mohammed 
Published: August 2016

Background: In resource-constrained settings where biologic agents are not widely available, there are limited therapeutic options for patients with rheumatoid arthritis (RA) refractory to other synthetic disease modifying antirheumatic (DMARD) therapies. The aim of this study is to evaluate the effectiveness and safety of leflunomide (LEF) with methotrexate (MTX) in refractory RA. Methods: A retrospective record review of adult RA patients treated with LEF/MTX. Demographic details, adverse reactions, and the 3-variable 28 joint disease activity score (DAS28-3) were recorded at initiation of LEF/MTX therapy, and after 4 and 12 months of treatment. Results: Of 194 patients, most were middle-aged seropositive Black African females, with established disease [mean (standard deviation, SD) disease duration 9.4 (8.2) years] and time on previous DMARDs of 7.0 (5.5) years. Before adding LEF, the mean (SD) dose of MTX was 21.7 (3.5) mg/week, and 87.6% of patients used low dose oral corticosteroids. A good or moderate EULAR response was achieved by 44% and 42% of patients, and the retention rate was 71%. Major infections were seen in 6 patients: comprising 2 deaths, 3 cases of leucopaenia and septicaemia and 1 case of tuberculosis. Hepatotoxicity ( n = 3), intolerable gastrointestinal symptoms ( n = 3), and hypertension ( n = 17) were the most common problems. Predictors of remission or low disease activity at 12 months was a baseline DAS28-3 ⩽ 5.5 [odds ratio (OR) = 2.7; 95% confidence interval (CI) 1.1–5.6; p = 0.01]. Conclusions: LEF/MTX was effective in the majority of patients in this cohort of mainly Black African women who failed other combination synthetic DMARDs, particularly in those with moderate disease activity at the time of addition of LEF. Infections and hypertension were important complications. In a setting where biologic DMARDs are not readily accessible, the combination of LEF/MTX is a cost-effective approach.
Arterial spin labeling: Pathologically proven superiority over conventional MRI for detection of high-grade glioma progression after treatment
Authors: Nyberg Eric , Honce Justin , Kleinschmidt-DeMasters Bette K , Shukri Brian , Kreidler Sarah , Nagae Lidia 
Published: August 2016

Background Standard of care for high-grade gliomas (HGGs) includes surgical debulking and adjuvant chemotherapy and radiation. Patients under treatment require frequent clinical and imaging monitoring for therapy modulation. Differentiating tumor progression from treatment-related changes can be challenging on conventional MRI, resulting in delayed recognition of tumor progression. Arterial spin labeling (ASL) may be more sensitive for tumor progression. Materials and methods ASL and associated conventional MR images obtained in patients previously treated for HGGs and before biopsy or re-resection were reviewed by three neuroradiologists who were blinded to the histopathologic results. Regions of interest (ROIs) of greatest perfusion were chosen by consensus, and mirror-image contralateral ROIs were also placed. Sensitivity of ASL for tumor progression was compared with those of contrast-enhanced T1-weighted (T1W-CE) and fluid-attenuated inversion recovery (FLAIR) images using McNemar’s test. We tested for an association between cerebral blood flow (CBF) and apparent diffusion correlation (ADC) using a Hotelling–Lawley trace. Finally, we used a Pearson’s analysis to test for a correlation between CBF and percentage of tumor within each resection. Results Twenty-two patients were studied. ASL demonstrated hyperperfusion in all cases with mean CBF ratio 3.37 (±1.71). T1W-CE and FLAIR images were positive in 15 ( p = 0.0233) and 16 ( p = 0.0412) cases, respectively. There was no association between ADC and CBF ( p = 0.687). There was a correlation between CBF and percentage of tumor ( p = 0.048). Conclusion ASL may be more sensitive than conventional MR sequences for the detection of tumor progression in patients treated for HGGs.
Factors Predicting Meniscal Allograft Transplantation Failure
Authors: Parkinson Ben , Smith Nicholas , Asplin Laura , Thompson Peter , Spalding Tim 
Published: August 2016

Background: Meniscal allograft transplantation (MAT) is performed to improve symptoms and function in patients with a meniscal-deficient compartment of the knee. Numerous studies have shown a consistent improvement in patient-reported outcomes, but high failure rates have been reported by some studies. The typical patients undergoing MAT often have multiple other pathologies that require treatment at the time of surgery. The factors that predict failure of a meniscal allograft within this complex patient group are not clearly defined. Purpose: To determine predictors of MAT failure in a large series to refine the indications for surgery and better inform future patients. Study Design: Cohort study; Level of evidence, 3. Methods: All patients undergoing MAT at a single institution between May 2005 and May 2014 with a minimum of 1-year follow-up were prospectively evaluated and included in this study. Failure was defined as removal of the allograft, revision transplantation, or conversion to a joint replacement. Patients were grouped according to the articular cartilage status at the time of the index surgery: group 1, intact or partial-thickness chondral loss; group 2, full-thickness chondral loss 1 condyle; and group 3, full-thickness chondral loss both condyles. The Cox proportional hazards model was used to determine significant predictors of failure, independently of other factors. Kaplan-Meier survival curves were produced for overall survival and significant predictors of failure in the Cox proportional hazards model. Results: There were 125 consecutive MATs performed, with 1 patient lost to follow-up. The median follow-up was 3 years (range, 1-10 years). The 5-year graft survival for the entire cohort was 82% (group 1, 97%; group 2, 82%; group 3, 62%). The probability of failure in group 1 was 85% lower (95% CI, 13%-97%) than in group 3 at any time. The probability of failure with lateral allografts was 76% lower (95% CI, 16%-89%) than medial allografts at any time. Conclusion: This study showed that the presence of severe cartilage damage at the time of MAT and medial allografts were significantly predictive of failure. Surgeons and patients should use this information when considering the risks and benefits of surgery.
Intron retention resulting from a silent mutation in the VWF gene that structurally influences the 5′ splice site
Authors: Yadegari Hamideh , Biswas Arijit , Akhter Mohammad Suhail , Driesen Julia , Ivaskevicius Vytautas , Marquardt Natascha , Oldenburg Johannes 
Published: August 2016

Key PointsThis study demonstrates allosteric RNA structure alteration resulting from an exonic variation, thereby interfering with splicing. This study details a novel mechanism by which silent mutation distant to the 5′ splice site could still result in intron retention.