bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severe Respiratory Failure, Extracorporeal Membrane Oxygenation, and Intracranial Hemorrhage*
Authors: Lockie Christopher J. A. , Gillon Stuart A. , Barrett Nicholas A. , Taylor Daniel , Mazumder Asif , Paramesh Kaggere , Rowland Katie , Daly Kathleen , Camporota Luigi , Meadows Christopher I. S. , Glover Guy W. , Ioannou Nicholas , Langrish Christopher J. , Tricklebank Stephen , Retter Andrew , Wyncoll Duncan L. A. 
Published: July 2017

Objectives:
For patients supported with veno-venous extracorporeal membrane oxygenation, the occurrence of intracranial hemorrhage is associated with a high mortality. It is unclear whether intracranial hemorrhage is a consequence of the extracorporeal intervention or of the underlying severe respiratory pathology. In a cohort of patients transferred to a regional severe respiratory failure center that routinely employs admission brain imaging, we sought 1) the prevalence of intracranial hemorrhage; 2) survival and neurologic outcomes; and 3) factors associated with intracranial hemorrhage.

Design:
A single-center, retrospective, observational cohort study.

Setting:
Tertiary referral severe respiratory failure center, university teaching hospital.

Patients:
Patients admitted between December 2011 and February 2016.

Intervention:
None.

Measurements and Main Results:
Three hundred forty-two patients were identified: 250 managed with extracorporeal support and 92 managed using conventional ventilation. The prevalence of intracranial hemorrhage was 16.4% in extracorporeal membrane oxygenation patients and 7.6% in conventionally managed patients (p = 0.04). Multivariate analysis revealed factors independently associated with intracranial hemorrhage to be duration of ventilation (d) (odds ratio, 1.13 [95% CI, 1.03–1.23]; p = 0.011) and admission fibrinogen (g/L) (odds ratio, 0.73 [0.57–0.91]; p = 0.009); extracorporeal membrane oxygenation was not an independent risk factor (odds ratio, 3.29 [0.96–15.99]; p = 0.088). In patients who received veno-venous extracorporeal membrane oxygenation, there was no significant difference in 6-month survival between patients with and without intracranial hemorrhage (68.3% vs 76.0%; p = 0.350). Good neurologic function was observed in 92%.

Conclusions:
We report a higher prevalence of intracranial hemorrhage than has previously been described with high level of neurologically intact survival. Duration of mechanical ventilation and admission fibrinogen, but not exposure to extracorporeal support, are independently associated with intracranial hemorrhage.
Differential Pulmonary Rehabilitation Outcomes in Patients With and Without COPD
Authors: Nguyen Lam-Phuong , Beck Emily , Cayetano Katherine , Li Chin-Shang , Hardin Kimberly 
Published: July 2017

Purpose:
Individuals with all forms of pulmonary disease are referred for pulmonary rehabilitation. This study examines pulmonary rehabilitation outcomes between individuals with chronic obstructive lung disease (COPD) and non-COPD disease and the impact of gender.

Methods:
This is a retrospective study at a tertiary center. The primary endpoint was the difference in 6-min walk test distance. Secondary measurements included treadmill and NuStep minutes; biceps curls and front arm raises load; quality of life measured by the St George's Respiratory Questionnaire; and University of California San Diego-Shortness of Breath Questionnaire (UCSD-SOBQ) scores.

Results:
Eighty patients were included: 38 men (23 COPD, 15 non-COPD) and 42 women (31 COPD, 11 non-COPD). There was a statistically significant improvement in 6-min walk test distances pre- to post–pulmonary rehabilitation for all participants, P = .0003. Although both the COPD and non-COPD groups demonstrated overall improvement (P < .0004 and P = .02, respectively), subgroup analysis showed no statistically significant change in the non-COPD group when divided by gender. There was a significant statistical improvement in lower and upper extremity strength in all participants. Only women with COPD showed a statistically significant improvement with respect to overall quality of life as measured by St. George's Respiratory Questionnaire (P = .01). Women showed significant improvement in their depression score, as well as a trend toward improvement in the University of California San Diego-Shortness of Breath Questionnaire, while only men with COPD showed any improvement in their sleep quality measured by the Pittsburgh Sleep Quality Index.

Conclusions:
Pulmonary rehabilitation results in different but improved outcomes regardless of gender or disease state.
The Community Balance and Mobility Scale
Authors: Martelli Luke , Saraswat Dave , Dechman Gail , Giacomantonio Nicholas B. , Grandy Scott A. 
Published: July 2017

Purpose:
Many patients participating in cardiac rehabilitation (CR) programs have decreased balance. This is a concern, as it may affect their ability to optimally perform physical exercise in CR and thus decrease CR efficacy. Despite this concern, balance is typically not assessed as part of CR intake. This may be attributable to the fact that a suitable balance assessment tool has not been identified for higher-functioning CR patients. A potential solution to this issue is using the Community Balance and Mobility Scale (CBMS), which has been used to assess balance in higher-functioning clinical populations; however, its use in a CR population has never been investigated. Therefore, the purpose of this study was to determine the reliability and validity of the CBMS for assessing balance in CR patients.

Methods:
Fifty-three participants were recruited from local CR programs to perform the CBMS. Dynamic posturography was also measured in a subset of participants (n = 31) using the Limits of Stability (LOS) test.

Results:
Analysis of CBMS scores revealed that the mean CBMS score was 61.9 ± 16.2 (out of 96) and that no floor or ceiling effects were observed for any participants. CBMS scores were significantly correlated with the LOS results (0.41-0.53). Interrater reliability between novice and expert testers was strong (r = 0.95), with all differences falling within the 95% limits of agreement.

Conclusion:
Overall, these results suggest that the CBMS is a valid tool to measure balance in CR patients and can be reliably administered by health care professionals with minimal training.
Refractive Surgery: Malpractice Litigation Outcomes
Authors: Custer Benjamin L. , Ballard Steven R. , Carroll Robert B. , Barnes Scott D. , Justin Grant A. 
Published: July 2017

Purpose:
To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes.

Methods:
The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes.

Results:
A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively.

Conclusions:
Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.
Correlation of Corneal Biomechanical Stiffness With Refractive Error and Ocular Biometry in a Pediatric Population
Authors: Matalia Jyoti , Francis Mathew , Gogri Pooja , Panmand Pratibha , Matalia Himanshu , Roy Abhijit Sinha 
Published: July 2017

Purpose:
To assess the correlation between corneal biomechanical stiffness and refractive error (RE) in the pediatric population.

Methods:
A total of 733 pediatric eyes were included in the study retrospectively. All eyes underwent corneal tomography (Pentacam), RE assessment, and air-puff deformation (Corvis-ST). Waveform analyses of deformation provided corneal stiffness (CS) and extraocular tissue stiffness (EOS). Eyes were subgrouped into emmetropia [manifest refraction spherical equivalent (MRSE) ∼ 0 D], hyperopia (MRSE > 0 D), myopia I (MRSE between 0 D and −3 D), myopia II (MRSE between −3 D and −6 D), and myopia III (MRSE greater than −6 D) for multivariate analyses. Ocular biometry variables [age, intraocular pressure (IOP), central corneal thickness (CCT), corneal astigmatism, anterior chamber depth, and RE] were used as covariates. The apparent elastic modulus (E) was defined as the ratio of CS and CCT.

Results:
All groups had similar age, CCT, and IOP (P > 0.05). CS was the only parameter to differ between all the grades of myopia (P < 0.0001). CS was lower by 3.72%, 6.84%, and 10.68% in myopia I, II, and III eyes, respectively, relative to emmetropic eyes. EOS increased by 11.15%, 22.60%, and 28.5%, respectively. Multivariate regression revealed age, IOP, CCT, corneal astigmatism, anterior chamber depth, and RE as significant predictors of CS, with a high coefficient of regression (R2 = 0.66). Corneal E negatively correlated with the grade of myopia.

Conclusions:
CS and EOS correlated negatively and positively with the grade of myopia, respectively. Ocular biometry variables were significant predictors of both CS and EOS. The decrease in CS was attributed to that in elastic modulus.
Long-Term Evaluation of Specular Microscopic Changes Following Nd:YAG Iridotomy in Chronic Primary Angle-Closure Glaucoma Eyes
Authors: Sihota Ramanjit , Agarwal Esha , James Mathew , Verma Meena , Kumar Lalit , Dada Tanuj , Gupta Viney , Kapoor Kulwant Singh 
Published: July 2017

Aim:
The aim of this study was to evaluate specular microscopy of chronic primary angle-closure glaucoma (CPACG) eyes at least 1 year after Nd:YAG iridotomy, and compare them with CPACG eyes without an iridotomy and age-matched, normal eyes.

Patients and Method:
Consecutive patients of CPACG at the Glaucoma service were screened. All patients underwent slit-lamp biomicroscopy, +90 D examination, and applanation tonometry. A total of 100 eyes of 100 consecutive patients of CPACG with an Nd:YAG iridotomy performed ≥1 year before, who met all inclusion/exclusion criteria, 60 consecutive CPACG eyes without an iridotomy, and 60 age and refraction-matched control eyes were enrolled. A specular microscopy was performed in one eye of each patient by an observer masked to diagnosis.

Results:
CPACG patients had a mean age of 62±8 years, a mean intraocular pressure of 18±5.3 mm Hg, a mean specular count of 2536±224 cells/mm2, and mean duration after iridotomy of 3.2±2 years. There was a significant correlation of specular endothelial counts with age (r=−0.39; P<0.001) and interval after iridotomy (r=−0.25; P=0.01). CPACG eyes without an iridotomy had a mean age of 62±5 years and a mean specular count of 2469±199 cells/mm2. Normal control eyes with a mean age of 61±6 years had a mean specular count of 2729±299 cells/mm2. There was no significant difference in specular count between CPACG eyes with or without an iridotomy (P=0.19); however, both CPACG groups had a specular count significantly lower than controls (P=0.01 and 0.02, respectively). There was no statistically significant difference seen in polymegathism (coefficient of variation) and pleomorphism (% of hexagonal cells) in endothelial cells among the 3 groups.

Conclusions:
An Nd:YAG iridotomy in CPACG eyes did not lead to any significant changes in central corneal specular microscopy in the long term as compared with patients who did not undergo iridotomy. Eyes with CPACG, without and after an iridotomy, had a lower specular count compared with age-matched controls.
Phenotype of Same-Day–Discharge Patients After Percutaneous Coronary Intervention
Authors: Ramharrack Donna V. , Jurgens Corrine Y. , Shlofmitz Richard A. 
Published: July 2017

Background:
Overnight observation is the standard of care for uncomplicated elective percutaneous coronary intervention (PCI). However, same-day discharge (SDD) is reportedly safe using predetermined criteria and patient risk categories. Characteristics of patients with SDD have not yet been described.

Objective:
The purpose of this study was to describe the phenotype of patients appropriate for SDD after PCI without predetermined criteria and patient risk categories.

Methods:
Analysis of PCI registry data was conducted on patients (n = 2174) who underwent elective and nonelective PCI between January 2012 and June 2014. Preliminary analysis included descriptive statistics, t tests, and χ2 tests. All variables were analyzed using random forest plot to determine importance of predictors of SDD followed by confirmatory logistic regression.

Results:
Random forest plot indicated 6 predictors of SDD. Confirmatory logistic regression using a model with all 6 predictors indicated that the model was able to distinguish between patients with SDD and overnight observation after PCI and was statistically significant (χ2(7.12, N = 2174) = 511.12, P < .005). Strongest predictors of SDD were stable angina (odds ratio, 5.93 [95% confidence interval, 1.316–26.712]; P = .020) followed by non-ST elevation myocardial infarction/high-risk unstable angina (odds ratio, 1.66 [95% confidence interval, 1.239–2.225]; P = .001). Readmission within 24 hours of SDD after PCI was low at 0.91%.

Conclusions:
Age, access site, complexity, and number of lesions stented did not preclude SDD. A broader range of patients, particularly patients in higher risk categories (non-ST elevation myocardial infarction and unstable angina), are candidates for SDD.
No Seasonal Changes in Cognitive Functioning Among High School Football Athletes: Implementation of a Novel Electrophysiological Measure and Standard Clinical Measures
Authors: Broglio Steven P. , Williams Richelle , Rettmann Ashley , Moore Brandon , Eckner James T. , Meehan Sean 
Published: July 2017

Objective:
To evaluate neuroelectric and cognitive function relative to a season of football participation. Cognitive and neuroelectric function declines are hypothesized to be present in football athletes.

Design:
Observational.

Setting:
Athletic fields and research laboratory.

Patients (or Participants):
Seventy-seven high school athletes (15.9 + 0.9 years, 178.6 + 7.2 cm, 74.4 + 14.7 kg, and 0.8 + 0.8 self-reported concussions) participating in football (n = 46) and noncontact sports (n = 31).

Interventions (or Assessment of Risk Factors):
All athletes completed preseason, midseason, and postseason assessments of cognitive and neuroelectric function, self-reported symptoms, and quality of life. All athletes participated in their respective sports without intervention, while head impact exposure in football athletes was tracked using the Head Impact Telemetry System.

Main Outcome Measures:
Cognitive performance was based on Cogstate computerized cognitive assessment tool processing speed, attention, learning, working memory speed, and working memory accuracy scores. ElMindA brain network activation amplitude, synchronization, timing and connectivity brain network activation scores demarcated neuroelectric performance. Quality of life was assessed on the Health Behavior Inventory and Satisfaction with Life Scale and symptoms on the SCAT3 inventory.

Results:
Football and control sport athletes did not show declines in cognitive or neuroelectric function, quality-of-life measures, or symptom reports across a season of sport participation.

Conclusions:
These findings refute the notion that routine football participation places athletes at risk for acute cognitive declines. The lack of impairment may be associated with no association with head impacts and cognitive function, increased physical activity offsetting any declines, and/or test sensitivity. How these findings are associated with long-term cognitive function is unknown.
Visual Processing Recruits the Auditory Cortices in Prelingually Deaf Children and Influences Cochlear Implant Outcomes
Authors: Liang Maojin , Chen Yuebo , Zhao Fei , Zhang Junpeng , Liu Jiahao , Zhang Xueyuan , Cai Yuexin , Chen Suijun , Li Xianghui , Chen Ling , Zheng Yiqing 
Published: July 2017

Objective:
Although visual processing recruitment of the auditory cortices has been reported previously in prelingually deaf children who have a rapidly developing brain and no auditory processing, the visual processing recruitment of auditory cortices might be different in processing different visual stimuli and may affect cochlear implant (CI) outcomes.

Methods:
Ten prelingually deaf children, 4 to 6 years old, were recruited for the study. Twenty prelingually deaf subjects, 4 to 6 years old with CIs for 1 year, were also recruited; 10 with well-performing CIs, 10 with poorly performing CIs. Ten age and sex-matched normal-hearing children were recruited as controls. Visual (“sound” photo [photograph with imaginative sound] and “nonsound” photo [photograph without imaginative sound]) evoked potentials were measured in all subjects. P1 at Oz and N1 at the bilateral temporal-frontal areas (FC3 and FC4) were compared.

Results:
N1 amplitudes were strongest in the deaf children, followed by those with poorly performing CIs, controls and those with well-performing CIs. There was no significant difference between controls and those with well-performing CIs. “Sound” photo stimuli evoked a stronger N1 than “nonsound” photo stimuli. Further analysis showed that only at FC4 in deaf subjects and those with poorly performing CIs were the N1 responses to “sound” photo stimuli stronger than those to “nonsound” photo stimuli. No significant difference was found for the FC3 and FC4 areas. No significant difference was found in N1 latencies and P1 amplitudes or latencies.

Conclusion:
The results indicate enhanced visual recruitment of the auditory cortices in prelingually deaf children. Additionally, the decrement in visual recruitment of auditory cortices was related to good CI outcomes.
Novel targets for anticoagulants lacking bleeding risk
Authors: Bickmann Julia K. , Baglin Trevor , Meijers Joost C.M. , Renné Thomas 
Published: July 2017

Purpose of review
Arterial and venous thromboembolic diseases are associated with significant morbidity and mortality and present a major medical burden. Currently used anticoagulants for the prevention or treatment of thromboembolic events including heparins, vitamin K-antagonists and inhibitors of thrombin or factor Xa target enzymes of the coagulation cascade that are critical for fibrin formation. However, fibrin is also necessary for hemostatic mechanisms to terminate blood loss at injury sites. As a result currently used anticoagulants substantially raise the risk of bleeding and are associated with an increase in potentially life-threatening hemorrhage, partially offsetting the benefits of reduced thrombosis.

Recent findings
Within the last decade, experimental and preclinical data have revealed the existence of coagulation mechanisms that principally differ in thrombosis and haemostasis. Some coagulation proteins including, XI and XII have a differential role in haemostasis and thrombosis. Targeting these proteins may provide an opportunity to prevent thromboembolic disease without causing bleeding.

Summary
This review summarizes recent studies on selective targeting of coagulation proteins that may allow prevention and treatment of thrombosis without causing bleeding. These novel approaches present a possibility for selective interference with fibrin formation in pathologic thrombosis that may lead to a new generation of safe anticoagulant drugs.
Physical Activity and Survival in Women With Advanced Breast Cancer
Authors: Palesh Oxana , Kamen Charles , Sharp Susan , Golden Ashleigh , Neri Eric , Spiegel David , Koopman Cheryl 
Published: July 2017

Background:
Several empirical investigations have attempted to characterize the effect of physical activity on cancer mortality, but these investigations have rarely focused on patients with advanced breast cancer.

Objective:
The current study examined the hypothesis that greater physical activity is associated with longer survival among women with advanced breast cancer.

Methods:
We conducted a secondary data analysis of a prospective study of 103 patients with stage IV (n = 100) or locally recurrent (n = 3) breast cancer involved in a group psychotherapy trial. Physical activity was assessed at baseline using the Seven-Day Physical Activity Recall questionnaire, and patients were followed until April 1, 2016, at which time 93 of 103 had died.

Results:
Greater physical activity level at baseline was significantly associated with longer subsequent survival time in a Cox proportional hazards model (hazard ratio [HR], 0.90; 95% confidence interval [CI], 0.84–0.97; P < .01). Engaging in 1 additional hour per day of moderate activity reduced the hazard of subsequent mortality by 23% (HR, 0.77; 95% CI, 0.65–0.92; P < .01). These results remained significant even after controlling for demographic, medical, cancer, depression, and cortisol variables (HR, 0.91; 95% CI, 0.84–0.99; P < .05).

Conclusions:
Women with advanced breast cancer who engaged in physical activity for 1 or more hours per day at baseline had an increased likelihood of survival compared with those who exercised less than 1 hour per day.

Implications for Practice:
Nurses should consider recommending moderate physical activity for women with advanced breast cancer. Randomized trials of physical activity interventions for this population are needed.
The Effects on Children’s Anxiety and Quality of Life of a Psychoeducational Program for Families Living With Parental Cancer and Their Network
Authors: Hauken May Aasebø , Pereira Mariana , Senneseth Mette 
Published: July 2017

Background:
Families living with parental cancer report lack of social support. The Cancer PEPSONE Program (CPP) was developed to bridge the gap between the families and their network.

Objective:
The aims of this study were to study the effect of the CPP on children’s anxiety and quality of life (QOL) and examine the association between the CPP’s effect on their well parents’ received social support, QOL, and psychological distress and the children’s anxiety and QOL.

Methods:
The CPP, a psychoeducational program for the families and their social network, was evaluated using a randomized controlled trial design. The children and their well parents completed questionnaires measuring QOL, psychological distress, and social support at baseline and after 3 and 6 months.

Results:
Thirty-five families were enrolled (18 intervention, 17 controls). The CPP stabilized the children’s family function, although the family function largely (d = 0.86) decreased in the control group (P = .018). No significant effects were found on anxiety, overall QOL, or QOL subdimensions. Significant correlations were documented between the children’s levels of anxiety and the well parents’ received social support (r = −0.196, P < .001), QOL (r = −0.138, P < .05), and psychological distress (r = 0.166, P < .05).

Conclusions:
The CPP seems to stabilize the children's perceived family function but did not target the other outcomes. Further studies with larger samples are needed.

Implications for Clinical Practice:
Optimizing social network for families living with parental cancer may support the family’s function. Actions should be initiated to increase the well parents’ social support, QOL, and psychological distress, which may also benefit the children.