bluuebunny/crossref_metadata_2025_split huggingface dataset:
Baseline Time to Stabilization Identifies Anterior Cruciate Ligament Rupture Risk in Collegiate Athletes
Authors: DuPrey Kevin M. , Liu Kathy , Cronholm Peter F. , Reisman Andrew S. , Collina Steven J. , Webner David , Kaminski Thomas W. 
Published: February 2016

Background: There is a need for successful screening methods to identify athletes at increased risk of anterior cruciate ligament (ACL) injury. Previous research showed that collegiate athletes with ACL tears demonstrated slower time to stabilization during jump landing after reconstruction. Hypothesis: Collegiate athletes with baseline deficiencies in time to stabilization are at increased risk of subsequent ACL rupture. Study Design: Case-control study; Level of evidence, 3. Methods: A total of 278 National Collegiate Athletic Association Division I college athletes (166 men, 112 women; mean age, 18.5 years; height, 178.8 cm; mass, 79.9 kg) in the high-risk sports of men’s football; women’s volleyball and field hockey; and men’s and women’s lacrosse, basketball, and soccer were measured to obtain baseline time to stabilization for backward, forward, medial, and lateral single-legged jump landing tasks. Athletes were followed for ACL rupture over a 4-year period. Independent t tests were used to evaluate differences in time to stabilization for each jump landing task between athletes with subsequent ACL rupture and uninjured athletes. Logistic regression models were used to assess time to stabilization as a predictor for ACL rupture. Results: Nine athletes sustained noncontact ACL ruptures (5 men, 4 women). These 9 athletes took significantly longer to stabilize compared with uninjured athletes during baseline backward jump landing (1.58 ± 0.39 and 1.09 ± 0.52 seconds, respectively; P = .0052). The odds of ACL rupture increased 3-fold (odds ratio, 2.95; 95% CI, 1.28-6.77) for every second increase in backward time to stabilization observed between injured and uninjured athletes. Conclusion: Collegiate athletes with slower baseline backward time to stabilization were at increased risk of ACL rupture.
Epidemiology of Injuries in United States High School Track and Field
Authors: Pierpoint Lauren A. , Williams Claire M. , Fields Sarah K. , Comstock R. Dawn 
Published: February 2016

Background: Track and field is one of the most popular high school sports among boys and girls, but epidemiological research on the sport and its individual events has been limited. Purpose: To describe injury rates and patterns in boys’ and girls’ high school track and field. Study Design: Descriptive epidemiology study. Methods: A retrospective epidemiological analysis of injury and exposure data from a longitudinal national high school sports injury surveillance system was conducted. Results: From 2008-2009 through 2013-2014, 2485 track and field injuries occurred during 2,962,308 athlete exposures (0.84 injuries per 1000 athlete exposures). Injury rates were higher in competition versus practice for both sexes. Girls had higher injury rates than boys overall (rate ratio, 1.37; 95% CI, 1.27-1.48) and in practice (rate ratio, 1.60; 95% CI, 1.46-1.76), but competition injury rates did not differ. Overuse/chronic injuries accounted for 27.5% and 36.2% of boys’ and girls’ track and field injuries, respectively. The majority of injuries were to the lower extremity. Sprints, distance running, and jumps accounted for over 65% of all track injuries. Boys sustained a greater proportion of injuries in relay events (injury proportion ratio, 2.02; 95% CI, 1.69-2.36) but fewer in hurdle events (injury proportion ratio, 0.51; 95% CI, 0.23-0.78). Conclusion: Injury rates varied by event, sex, and competition versus practice exposure. To increase effectiveness, targeted strategies for injury prevention should be driven by an understanding of such differences. Because many track and field injuries are overuse/chronic across sexes and for both competitions and practices, coaches and athletic trainers should be adept at recognizing early injury symptoms, intervene to treat minor injuries in order to prevent severe injuries, and ensure the prompt diagnosis and management of all injuries.
Adherence to Antiretroviral Therapy and Its Determinants Among HIV-Infected Patients in Nigeria
Authors: Odili Valentine Uche , Obieche Anthonia Obumneke , Amibor Kingsley Chiedu 
Published: February 2016

Purpose: The study investigated the level of adherence and factors affecting adherence to antiretroviral treatment (ART). Methods: The study sample consisted of 300 HIV-infected patients who received ART in the Antiretroviral Clinic of Central Hospital, Agbor, Delta State, Nigeria. Self-reported adherence to ART in the previous 1 month prior to the study as well as determinants of adherence were assessed using a questionnaire. Results: The most frequently used ART regimen was zidovudine + lamivudine + nevirapine. On the whole, a total of 33 (11%) respondents missed 3 doses or less in the previous month prior to the survey. There was a statistically significant association between adherence to ART and marital status, source of income, and occupation ( P < .05). The most commonly reported reasons for missed doses were forgetfulness (60.4%), busy daily task (18.3%), and avoiding being seen while taking medications (11%). Conclusion: The prevalence of adherence among the participants was high. However, more serious efforts are needed to reduce the number of in-adherent patients. Interventions to improve adherence to ART should address challenges such as forgetfulness among the patients and frequent occurrence of adverse effects and consider specific patient-related factors such as daily tasks.
Gender differences in disease activity and clinical features in newly diagnosed systemic lupus erythematosus patients
Authors: Muñoz-Grajales C , González L A , Alarcón G S , Acosta-Reyes J 
Published: February 2016

Objective The objective of this paper is to compare disease activity and clinical features at diagnosis in male and female patients with systemic lupus erythematosus (SLE). Methods This was a cross-sectional study in which every male patient ( n = 40) was matched with three female patients of the same age (±5 years) and racial/ethnic group; disease activity as per the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and disease manifestations at the time of diagnosis were compared. Results Alopecia and anti-Ro antibodies were more frequent in female patients. No statistically significant difference in any other disease characteristics was found. However, male gender was associated with a risk of severe disease activity at the time of diagnosis (as determined by SLEDAI ≥12 score) independent of age, racial/ethnic group, anti-Ro positivity or time to criteria accrual (OR: 3.11 95% CI, 1.09–8.92; p = 0.035). Conclusion In newly diagnosed SLE patients, male gender is associated with higher disease activity despite the fact that male and female patients seem to experience similar overall disease manifestations.
Severe vitamin D deficiency increases the risk for moderate to severe disease activity in Chinese patients with SLE
Authors: Gao C-C , Liu S-Y , Wu Z-Z , Li T-F , Gao G-M , Liu Z-S , Zheng Z-H 
Published: February 2016

Objective We aimed to investigate the prevalence of vitamin D deficiency in Chinese lupus patients and to assess the association between vitamin D levels and disease severity. Methods Serum levels of 25OHD3 in 121 patients with systemic lupus erythematosus (SLE) and 150 healthy controls were measured by electrochemiluminescence immunoassay. Data regarding demographics and clinical parameters were collected. Disease activity of SLE was evaluated according to the SLE Disease Activity Index (SLEDAI) score and irreversible organ damage by the Systemic Lupus International Collaborating Clinic/American College of Rheumatology, SLICC/ACR Damage Index (SDI). The multivariate logistic regression model was used to investigate the association between the degree of vitamin D deficiency and SLEDAI or SDI scores. Results The prevalence of vitamin D insufficiency (25OHD3 <30 ng/ml) and severe deficiency (25OHD3 <10 ng/ml) in SLE patients was 62.81% and 34.71%, respectively. Logistic regression analysis indicated that the cut-off point of 25OHD3 concentration was 10 ng/ml where its level was correlated with increased SLEDAI (OR 6.420, p = 0.006), but not with the SDI. In addition, hydroxychloroquine treatment lowered the SLEDAI increased by the severe 25OHD3 deficiency (OR 0.280, p = 0.008). Moreover, long disease duration (OR 1.014, p = 0.008) predicted moderate to severe organ damage. Conclusions Vitamin D deficiency is highly prevalent in patients with SLE. Severe deficiency increases the risk for moderate to severe disease activity, but not for organ damage.
A Proof-of-Concept Study of Game-Based Learning in Higher Education
Authors: Crocco Francesco , Offenholley Kathleen , Hernandez Carlos 
Published: February 2016

Background. Much literature has theorized on the potential educational benefits offered by game-based learning (GBL). However, recent meta-data analyses of studies conducted on the efficacy of GBL offer mixed results. Furthermore, many of the studies available rely more on close reading, inference, small sample sizes, and qualitative responses than on quantitative, data-driven analyses. Aim. This article describes a proof-of-concept study designed to assess the effects of GBL on enjoyment, engagement, and learning in higher education using a large sample size and quantitative measures. Method. The study uses a large data set (n = 440) involving English, Math and Science undergraduate courses. For the first semester, faculty participants were trained in how to implement game-based pedagogy and created analog game-based lessons. In the following semester, each professor taught one section of a course using games and another section of the same course without games. Students in the game-based and control groups were given attitude surveys about the subject at the beginning of the semester, a post-lesson survey after the game or regular lesson, and a post-lesson quiz with separate questions to assess surface learning and deep learning. Results. Enjoyment correlated with improvements in deep learning in both the game and non-game classes. Games increased reported enjoyment levels, especially in subjects where students reported the greatest anxiety about learning, and this increase in enjoyment correlated positively with improvements in deep learning and higher-order thinking. These results may have particular impact on non-traditional students. Conclusion. While further investigation is necessary to assess the specific affordances and long-term effects of GBL in higher education, this study offers preliminary support for the claim that GBL can improve deep learning in this setting, by increasing enjoyment.
Anger Proneness and Prognostic Pessimism in Men With Prostate Cancer
Authors: Gerhart James , Schmidt Eric , Lillis Teresa , O’Mahony Sean , Duberstein Paul , Hoerger Michael 
Published: February 2016

Aim: Anger is a common reaction to cancer diagnosis which may impact patients’ perceptions of their prognosis and goals of care. This study tested the hypothesis that men with prostate cancer who are anger prone are pessimistic regarding their cancer prognosis. Methods: Two hundred and twelve men with a history of prostate cancer completed measures of personality traits, their prostate cancer prognosis, and their perception of their doctor’s assessment of their prognosis. Anger proneness was operationally defined by the presence of high levels (ie, above the medians) of neuroticism and disagreeableness. Results: One in 4 men with prostate cancer disagreed with their doctor about prognosis. Anger-prone participants endorsed more pessimistic perceptions of prognosis ( P = .041). This significant association was maintained after accounting for potential confounders. Conclusion: Greater attention paid to patient anger regulation style and pessimistic perceptions will improve discussions about prognosis and goals of care among men with prostate cancer. Given recent calls for wider distress screening and earlier palliative care intervention in cancer settings, providers have an unprecedented opportunity to assess and respond to anger in the clinical setting. Communication could be improved through empathic statements that convey realistic optimism when appropriate, a commitment to the patient–provider relationship and a willingness to explore and address patient needs.
Prevalence of feline herpesvirus-1, feline calicivirus, Chlamydophila felis and Mycoplasma felis DNA and associated risk factors in cats in Spain with upper respiratory tract disease, conjunctivitis and/or gingivostomatitis
Authors: Fernandez Mireia , Manzanilla Edgar G , Lloret Albert , León Marta , Thibault Jean-Christophe 
Published: February 2016

Objectives Our objective was to perform the first multicentric study in Spain to evaluate the prevalence of feline herpesvirus-1 (FHV-1), feline calicivirus (FCV), Chlamydophila felis and Mycoplasma felis in cats with upper respiratory tract disease (URTD), conjunctivitis and/or gingivostomatitis (GS) compared with control cats; and to evaluate risk factors for these clinical conditions. Methods Conjunctival and oropharyngeal swabs were collected and a questionnaire regarding signalment, lifestyle, vaccination history and clinical signs was obtained for each cat. Swabs were tested for each pathogen by real-time PCR. Results The study population consisted of 358 cats, including 98 control cats. Among the 260 diseased cats, 127 cats presented with URTD, 149 cats had conjunctivitis, 154 cats were suffering GS; many cats presented more than one clinical condition. The prevalence observed of FHV-1, FCV, C felis and M felis was, respectively, 28.3%, 48.0%, 20.5% and 46.5% in cats with URTD; 24.2%, 43.6%, 19.5% and 38.3% in cats with conjunctivitis; and 15.6%, 58.4%, 9.1% and 37.7% in cats with GS. Prevalences in the control group were 6.1%, 15.3%, 2.0% and 20.4%, respectively. Coinfections were common among all groups of cats. Risk factors were identified for all groups. FHV-1, FCV and C felis were associated with URTD and conjunctivitis. FCV was strongly associated with GS. M felis was present in a high percentage of the population in all groups, but its role in these clinical conditions remains uncertain. Vaccination was protective for URTD and GS but not for conjunctivitis. Conclusions and relevance This epidemiological study describes, for the first time, prevalence for FHV-1, FCV, C felis and M felis in Spain. In general, the prevalences found are similar to those reported in other countries. Factors associated with disease expression were also identified, which are relevant for practitioners.
Fatigue predicts disease worsening in relapsing-remitting multiple sclerosis patients
Authors: Cavallari Michele , Palotai Miklos , Glanz Bonnie I , Egorova Svetlana , Prieto Juan Carlos , Healy Brian C , Chitnis Tanuja , Guttmann Charles RG 
Published: February 2016

Background: It is unclear whether fatigue is a consequence or a predictive trait of disease worsening. Objective: To investigate the predictive value of fatigue toward conversion to confirmed moderate–severe disability in patients with relapsing-remitting multiple sclerosis (RRMS). Methods: We retrospectively selected from the Comprehensive Longitudinal Investigations in MS at the Brigham and Women’s Hospital (CLIMB) study cohort RRMS patients who converted to confirmed (⩾2 years) Expanded Disability Status Scale (EDSS) score ⩾3 within a follow-up period ⩾3 years. We contrasted the Modified Fatigue Impact Scale (MFIS) score of 33 converters, obtained at least 1 year before conversion to EDSS ⩾3, with that of 33 non-converter RRMS patients matched for baseline characteristics. Results: Total MFIS score was higher in converter versus non-converter MS patients (median 37 vs 13; p < 0.0001). EDSS and Center for Epidemiological Studies Depression scale (CES-D) scores were also higher in the converters (median EDSS 1.5 vs 0, p < 0.0001; median CES-D 30 vs 24, p < 0.0001) and were both associated with MFIS score (EDSS: rho = 0.42, p = 0.0005; CES-D: rho = 0.72, p < 0.0001). After adjusting for EDSS and CES-D in multivariate analysis, MFIS remained a significant predictor of subsequent conversion to confirmed EDSS ⩾3. Conclusion: Fatigue is a promising indicator of risk for conversion to confirmed moderate–severe disability in RRMS patients.
Cognitive impairment differs between neuromyelitis optica spectrum disorder and multiple sclerosis
Authors: Kim Su-Hyun , Kwak Kichang , Jeong In Hye , Hyun Jae-Won , Jo Hyo-Jin , Joung AeRan , Yu Eun-Seung , Kim Ji-Hee , Lee Sang Hyun , Yun Sooin , Joo Jungnam , Lee Dong-kyun , Lee Jong-Min , Kim Ho Jin 
Published: February 2016

Objective: To compare the frequency and pattern of cognitive impairment (CI) between patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS). Methods: A total of 82 NMOSD patients, 58 MS patients, and 45 healthy controls (HCs) underwent a neuropsychological assessment. Results: CI was observed in 29% of NMOSD and 50% of MS patients ( p < 0.001); CI was considered present if a patient scored lower than the fifth percentile compared with HCs in at least three domains. A lower frequency of CI was consistently found when CI was indicated by at least two failed tests ( p < 0.001). MS patients performed worse than did NMOSD patients on verbal learning and verbal and visual memory tests. Levels of education and depression and the interval from disease onset to treatment were associated with a negative influence on cognition in patients with NMOSD. Conclusion: CI in patients with NMOSD may be not as common as in patients with MS. MS patients exhibited severe impairment, particularly on learning and memory tests, compared with NMOSD patients. Differential prevalence and patterns of CI between NMOSD and MS patients suggest that the two diseases have different mechanisms of brain injury.
Aortic arch and common carotid artery plaques with soft components pose a substantial risk of cerebral embolization during carotid stenting
Authors: Szikra Péter , Boda Krisztina , Rarosi Ferenc , Thury Attila , Barzó Pál , Németh Tamás , Vörös Erika 
Published: February 2016

Objectives A higher rate of embolization is considered a disadvantage of carotid stenting (CAS), when compared with carotid endarterectomy. Plaques in the aortic arch (AA) and the common carotid artery (CCA) may be additional sources of embolization to stented internal carotid plaques during CAS. In this study, we aimed to investigate the relationship between these plaques and intracerebral embolization. Methods We analyzed the occurrence and composition of plaques in the AA and CCA by computed tomography angiography (CTA) in 101 consecutive cases of CAS. Cases of peri-procedural embolization were detected on diffusion-weighted imaging as lesions demonstrating diffusion restriction. We applied the χ2 and Fisher’s exact tests, as well as logistic regression models. Results The occurrence of plaques in the AA and CCA was significantly related to the appearance of new diffusion-weighted imaging lesions ( p = 0.013 and p = 0.004, respectively). Patients with soft plaques in the AA or CCA had a significantly higher risk of embolization than those without plaques ( p = 0.012 and p = 0.006, respectively). In contrast, homogeneously calcified plaques did not pose significantly higher risks. Conclusions Soft plaques in the AA and CCA result in a substantial risk of embolization during CAS. Use of a CTA examination of the AA and the CCA in patients with carotid stenosis may help to select lower-risk patients for CAS.
Adverse cardiovascular events in acute coronary syndrome with indications for anticoagulation
Authors: Knight Stacey , McCubrey Raymond O. , Yuan Zhong , Woller Scott C. , Horne Benjamin D. , Bunch T. Jared , Le Viet T. , Mills Roger M. , Muhlestein Joseph B. 
Published: February 2016

Objectives: Randomized acute coronary syndrome (ACS) trials testing various antithrombotic (AT) regimens have largely excluded patients with coexisting conditions and indications for anticoagulation (AC). The purpose of this study is to examine the 2-year clinical outcomes of patients with ACS with indication for AC due to venous thromboembolism (VTE) during hospitalization for the ACS event or a prior or new diagnosis of atrial fibrillation (AF) with a CHADS2 (Congestive heart failure; Hypertension; Age; Diabetes; previous ischemic Stroke) score ⩾2. Methods: ACS patients with AC indication from 2004 to 2009 were identified ( n = 619). A Cox proportional hazards model was used to examine the primary efficacy outcome of major adverse cardiovascular events (MACE) including all-cause death, myocardial infarction (MI) or stroke. The primary explanatory variable was at-discharge antithrombotic strategy [single antiplatelet ± AC, dual antiplatelet (DAP) ± AC or AC only; referent DAP + AC]. Results: A total of 261 (42.2%) patients had a MACE event. AT strategy was not a significant factor for MACE (all p > 0.09). The factors associated with MACE were high mortality risk score [hazard ratio (HR)=1.87, 95% confidence interval (CI): 1.39– 2.52; p < 0.001), prior MI (HR = 1.44, 95% CI: 1.03–2.01; p= 0.033) and presentation of ST elevation MI (HR = 2.70, 95% CI: 1.61–4.51; p < 0.001) or non-ST elevation MI (HR = 1.70, 95% CI: 1.15–2.49; p < 0.001) compared with angina. Conclusions: In this real world observational study, the at-discharge AT strategy was not significantly associated with the 2-year risk of MACE. These findings do not negate the need for randomized trials to generate evidence-based approaches to management of this important population.
Attributes Influencing Insulin Pen Preference Among Caregivers and Patients With Diabetes Who Require Greater Than 20 Units of Mealtime Insulin
Authors: Wang Tao , Conrad Kenneth A. , van Brunt Kate , Rees Tina M. 
Published: February 2016

Background: This study compared patient preference for Humalog® KwikPen™ 200 units/mL (insulin lispro; hereafter, IL 200 pen; Eli Lilly and Company, Indianapolis, IN) versus the Humalog KwikPen 100 units/mL (insulin lispro; hereafter, IL 100 pen; Eli Lilly and Company, Indianapolis, IN) in patients with diabetes requiring >20 units of mealtime insulin and diabetes caregivers. This study also determined which attributes had the greatest influence on pen preference selection. Methods: In this 2-period, crossover, simulated-use study, 106 participants were randomized to 1 of 8 sequences that varied the pen order (IL 100 pen or IL 200 pen) and dosing order (15 units = low dose or 50 units = high dose) for a total of 4 simulated injections. Participants then completed a self-administered questionnaire to select their overall preference between the 2 pens and then rated the importance of 11 pen attributes in contributing to their overall preference. Results: Of the 90 participants expressing an overall preference, significantly more preferred the IL 200 pen to the IL 100 pen (IL 200 pen: 80 respondents; IL 100 pen: 10 respondents; 95% confidence interval [0.81, 0.94], P < .0001). The total amount of insulin in the pen, the ease in pressing the injection button, and the amount of fluid injected were key attributes influencing IL 200 pen preference. Conclusions: Based on these key attributes, the IL 200 pen was significantly preferred over the IL 100 pen by patients with diabetes who require >20 daily mealtime insulin units or diabetes caregivers and may improve the injection experience for these patients.