bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality Among Confirmed Lassa Fever Cases During the 2015–2016 Outbreak in Nigeria
Authors: Buba Maryam Ibrahim , Dalhat Mahmood Muazu , Nguku Patrick Mboya , Waziri Ndadilnasiya , Mohammad Jibreel Omar , Bomoi Idriss Mohammed , Onyiah Amaka Pamela , Onwujei Jude , Balogun Muhammad Shakir , Bashorun Adebobola Toluwalashe , Nsubuga Peter , Nasidi Abdulsalami 
Published: December 2017

Objectives. To determine factors associated with mortality among confirmed Lassa fever cases. Methods. We reviewed line lists and clinical records of laboratory-confirmed cases of Lassa fever during the 2016 outbreak in Nigeria to determine factors associated with mortality. We activated an incident command system to coordinate response. Results. We documented 47 cases, 28 of whom died (case fatality rate [CFR] = 59.6%; mean age 31.4 years; SD = ±18.4 years). The youngest and the oldest were the most likely to die, with 100% mortality in those aged 5 years or younger and those aged 55 years or older. Patients who commenced ribavirin were more likely to survive (odds ratio [OR] = 0.1; 95% confidence interval [CI] = 0.03, 0.50). Fatality rates went from 100% (wave 1) through 69% (wave 2) to 31% (wave 3; χ2 for linear trend: P < .01). Patients admitted to a health care center before incident command system activation were more likely to die (OR = 4.4; 95% CI = 1.1, 17.6). The only pregnant patient in the study died postpartum. Conclusions. Effective, coordinated response reduces mortality from public health events. Attention to vulnerable groups during disasters is essential. Public Health Implications. Activating an incident command system improves the outcome of disasters in resource-constrained settings.
Effects of Alcohol Interventions on Other Drug Use in the Cherokee Nation
Authors: Livingston Melvin D. , Komro Kelli A. , Wagenaar Alexander C. , Kominsky Terrence K. , Pettigrew Dallas W. , Garrett Brady A. 
Published: December 2017

Objectives. To evaluate effects of 2 alcohol prevention interventions—Communities Mobilizing for Change on Alcohol (CMCA), a community organizing intervention designed to reduce youth alcohol access, and CONNECT, an individual-level screening and brief intervention approach—on other drug use outcomes. Methods. We conducted a community intervention trial with quarterly surveys over 3 years (2012–2015) of high school students living within the jurisdictional service area of the Cherokee Nation in Oklahoma. We used generalized estimating equations and linear probability models to examine intervention spillover effects on other drug use. Results. We found significant reductions in drug use other than alcohol attributable to CMCA and CONNECT. CMCA was associated with a 35% reduction in chewing tobacco use, a 39% reduction in marijuana use, and a 48% reduction in prescription drug misuse. CONNECT was associated with a 26% reduction in marijuana use and a 31% reduction in prescription drug misuse. Conclusions. Nonalcohol drug use was consistently reduced as a result of 2 theoretically and operationally distinct alcohol prevention strategies. Evaluations of alcohol prevention efforts should continue to include other drug use to understand the broader effects of such interventions.
Advanced Imaging Adds Little Value in the Diagnosis of Femoroacetabular Impingement Syndrome
Authors: Cunningham Daniel J. , Paranjape Chinmay S. , Harris Joshua D. , Nho Shane J. , Olson Steven A. , Mather Richard C. 
Published: December 2017

Background:
Femoroacetabular impingement (FAI) syndrome is an increasingly recognized source of hip pain and disability in young active adults. In order to confirm the diagnosis, providers often supplement physical examination maneuvers and radiographs with intra-articular hip injection, magnetic resonance imaging (MRI), or magnetic resonance arthrography (MRA). Since diagnostic imaging represents the fastest rising cost segment in U.S. health care, there is a need for value-driven diagnostic algorithms. The purpose of this study was to identify cost-effective diagnostic strategies for symptomatic FAI, comparing history and physical examination (H&P) alone (utilizing only radiographic imaging) with supplementation with injection, MRI, or MRA.

Methods:
A simple-chain decision model run as a cost-utility analysis was constructed to assess the diagnostic value of the MRI, MRA, and injection that are added to the H&P and radiographs in diagnosing symptomatic FAI. Strategies were compared using the incremental cost-utility ratio (ICUR) with a willingness to pay (WTP) of $100,000/QALY (quality-adjusted life year). Direct costs were measured using the Humana database (PearlDiver). Diagnostic test accuracy, treatment outcome probabilities, and utilities were extracted from the literature.

Results:
H&P with and without supplemental diagnostic injection was the most cost-effective. Adjunct injection was preferred in situations with a WTP of >$60,000/QALY, low examination sensitivity, and high FAI prevalence. With low disease prevalence and low examination sensitivity, as may occur in a general practitioner's office, H&P with injection was the most cost-effective strategy, whereas in the reciprocal scenario, H&P with injection was only favored at exceptionally high WTP (∼$990,000).

Conclusions:
H&P and radiographs with supplemental diagnostic injection are preferred over advanced imaging, even with reasonable deviations from published values of disease prevalence, test sensitivity, and test specificity. Providers with low examination sensitivity in situations with low disease prevalence may benefit most from including injection in their diagnostic strategy. Providers with high examination sensitivity in situations with high disease prevalence may not benefit from including injection in their diagnostic strategy. Providers should not routinely rely on advanced imaging to diagnose FAI syndrome, although advanced imaging may have a role in challenging clinical scenarios.

Level of Evidence:
Economic and Decision Analysis Level IV. See Instructions for Authors for a complete description of levels of evidence.
Intravenous and Topical Tranexamic Acid Alone Are Superior to Tourniquet Use for Primary Total Knee Arthroplasty
Authors: Huang ZeYu , Xie XiaoWei , Li LingLi , Huang Qiang , Ma Jun , Shen Bin , Kraus Virginia Byers , Pei FuXing 
Published: December 2017

Background:
Tourniquet use during primary total knee arthroplasty is thought to reduce intraoperative blood loss and improve visibility. Our goal was to investigate whether tourniquet use is necessary for controlling intraoperative blood loss when alternatives such as tranexamic acid (TXA) are available.

Methods:
One hundred and fifty patients were equally randomized to 3 groups. Group A was treated with a tourniquet as well as multiple doses of intravenous TXA (20 mg/kg 5 to 10 minutes before the skin incision and 10 mg/kg 3, 6, 12, and 24 hours later) along with 1 g of topical TXA, Group B was treated the same as Group A but without the tourniquet, and Group C was treated with the tourniquet only.

Results:
The amount of intraoperative blood loss was similar for the 3 groups. Group B had significantly less hidden blood loss than Group A (p = 0.018) and Group C (p < 0.001). No significant differences (p > 0.05) were observed between Group A and Group B with regard to total blood loss, drainage volume, intraoperative blood loss, transfusion rate, or maximum change in the hemoglobin (Hb) level. We also found significantly more benefits for Group B compared with Groups A and C with regard to postoperative swelling ratio, levels of inflammatory biomarkers, visual analog scale (VAS) pain scores, range of motion at discharge, Hospital for Special Surgery (HSS) score, and patient satisfaction. There were no significant differences (p > 0.05) in the deep venous thrombosis or pulmonary embolus rates among the 3 groups. More wound secretion was observed in the groups in which a tourniquet was used.

Conclusions:
Patients treated with multiple doses of intravenous and topical TXA without a tourniquet had less hidden blood loss, a lower ratio of postoperative knee swelling, less postoperative knee pain, lower levels of inflammatory biomarkers, better early knee function, and even better early satisfaction than those treated with a tourniquet. Long-term follow-up should be performed to evaluate the effects on prosthetic fixation and long-term survival of total knee arthroplasty performed without a tourniquet.

Level of Evidence:
Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Who Is Performing Hip Arthroscopy?
Authors: Duchman Kyle R. , Westermann Robert W. , Glass Natalie A. , Bedard Nicholas A. , Mather Richard C. , Amendola Annunziato 
Published: December 2017

Background:
Hip arthroscopy utilization has increased dramatically over the last decade. However, the lack of a formal training curriculum raises concern that inconsistent technical performance may be an issue for early-career hip arthroscopists. The purpose of the present study was to investigate hip arthroscopy utilization by early-career orthopaedic surgeons while focusing on fellowship training status to better guide future development of a hip arthroscopy training curriculum.

Methods:
The American Board of Orthopaedic Surgery (ABOS) Part-II database was used to identify candidates who had performed ≥1 hip arthroscopy procedures between 2006 and 2015. Procedures were categorized using Common Procedural Terminology (CPT) codes, and candidates were categorized by fellowship training experience. Trends in hip arthroscopy utilization were evaluated using univariate and regression analyses while stratifying by fellowship training experience.

Results:
Overall, 9.2% (643) of 6,987 ABOS candidates had performed ≥1 hip arthroscopy procedures. Over the study period, both the proportion of candidates performing hip arthroscopy and the proportion of hip arthroscopy procedures performed (relative to all procedures performed, of any type) increased (p < 0.001). Candidates performing hip arthroscopy most frequently reported sports medicine fellowship training (74.5%; 479 of 643). Also, among the candidates who performed hip arthroscopy, the proportion who had sports medicine fellowship training increased over the study period (p = 0.001). The majority of candidates performing hip arthroscopy (67.2%; 432 of 643) performed ≤5 hip arthroscopy procedures, while a small number of high-volume hip arthroscopists (6.5%; 42 of 643) performed 34.6% (1,403 of 4,054) of all hip arthroscopy procedures.

Conclusions:
The increase in hip arthroscopy utilization in this cohort appears to have been driven primarily by the increased number of candidates performing hip arthroscopy and less by an increasing number of hip arthroscopy procedures being performed by individual candidates. The majority of candidates performing hip arthroscopy were sports-medicine-fellowship trained. This information is valuable for both trainees and educators interested in improving education and defining a curriculum for future hip arthroscopy training.
Pressure while Drilling Data Improves Reservoir Drilling Performance
Authors: Ward C. D. , Andreassen E. 
Published: December 2017

Abstract
A new down-hole annular Pressure-While-Drilling (PWD) tool has recently been applied to assist drilling of the reservoir section on the Statfjord Field, offshore Norway. In these highangle wells it is critical for drilling success to maintain the mud weight and Equivalent Circulating Density (ECD) within safe operating limits defined by the formation fluid, collapse, and fracture pressures. Operating outside these limits has historically led to expensive lost circulation, differential sticking, and pack-off incidents. Monitoring the actual down-hole pressure in real-time with a PWD tool, rather than relying on inferred pressures from predictive models, has allowed the Operator to stay within and better define these operating limits. The Operator used this improved hydraulics information to avoid pressure-related hole problems, optimise drilling practices, test hydraulics models, and obtain a greater understanding of the formation pressure limits.
Organic-walled microphytoplankton assemblage of the Middle Devonian (Givetian) Arkona, Hungry Hollow and Widder formations, Ontario, Canada: biostratigraphic and palaeogeographic significance
Authors: Wicander R. , Playford G. 
Published: December 2017

A diverse and abundant organic-walled microphytoplankton assemblage, consisting of 49 species of acritarchs, prasinophyte phycomata and chitinozoans, was recovered from a 13.3 m-section of the Middle Devonian (Givetian) Arkona, Hungry Hollow and Widder formations at Hungry Hollow, Ontario, Canada. Close similarity exists between this assemblage and others described previously from the Givetian of North America. Marine palynofloras of comparable age from elsewhere in North America share between 59–96% of the species identified in the present assemblage, thus testifying to its stratigraphic-correlative applicability in a regional context. Species widely occurring in North America and typically Givetian (although not restricted therein) include: Arkonites bilixus, Cymatiosphaera canadense, Diexallophasis simplex, Duvernaysphaera angelae, D. tenuicingulata, Estiastra rhytidoa, Exochoderma arca, Gorgonisphaeridium inflatum, Hapsidopalla chela, Leiofusa pyrena, Muraticavea munifica, Oppilatala sparsa, Palacanthus ledanoisii, Polyedryxium ambitum, Staplinium cuboides, Tyligmasoma alargada, Uncinisphaera acantha, Veryhachium pastoris, Villosacapsula compta and V. rosendae. Palaeogeographically, Middle Devonian organic-walled microphytoplankton taxa display a conspicuous degree of cosmopolitanism, with many species shared with Laurasia (Laurentia, Avalonia, Baltica), Gondwana (principally Argentina, Ghana, Libya, Algerian Sahara, Western Australia) and Kazakhstan (northwestern China).
Patient Variables Associated with the Assignment of a Formal Dementia Diagnosis to Positively Screened Primary Care Patients
Authors: Eichler Tilly , Thyrian Jochen Rene , Hertel Johannes , Richter Steffen , Michalowsky Bernhard , Wucherer Diana , Dreier Adina , Kilimann Ingo , Teipel Stefan , Hoffmann Wolfgang 
Published: December 2017

Background:
Main objective was to analyze the associations of patient variables (depression,
quality of life, anti-dementia drug treatment, knowledge about dementia) with the assignment of a formal
diagnosis of dementia to community-dwelling primary care patients who have screened positive for
dementia.

Methods:
DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania)
is a general practitioner based randomized controlled intervention trial. Present analyses are based on
cross-sectional data of 319 positively screened patients (age 70+, living at home) who had not been formally
diagnosed with dementia before the screening. The medical diagnoses (ICD-10) were retrieved
from the patient's medical records. Depression (Geriatric Depression Scale; GDS), quality of life in
Alzheimer's disease (Qol-AD), knowledge about dementia, and anti-dementia drug treatment were assessed
after the screening test at the baseline examination.

Results:
At the baseline examination, 171 out of 319 patients (54%) had been formally diagnosed with
dementia after they have screened positive. Univariate comparisons showed no statistically significant
differences between diagnosed and undiagnosed patients regarding depression (GDS≥6: 11% vs. 15%;
p=0.396), quality of life (mean (SD): 2.8 (0.3) vs. 2.8 (0.4); p=0.833), and the knowledge about dementia
(75% vs. 75%; p>0.999). Patients who had received a formal diagnosis were more often treated with
anti-dementia drugs (20% vs. 11%; p=0.040). Multivariate analyses controlled for confounding variables
confirmed these findings.

Conclusion:
Present findings do not support concerns that the assignment of a formal dementia diagnosis
after screening is associated with potential harms. If confirmed in a prospective study, our data
would suggest that patients may benefit from being formally diagnosed regarding anti-dementia drug
treatment.
Acceptability and Results of Dementia Screening Among Older Adults in the United States
Authors: Harrawood Amanda , Fowler Nicole R. , Perkins Anthony J. , LaMantia Michael A. , Boustani Malaz A. 
Published: December 2017

Objectives:
To measure older adults acceptability of dementia screening and assess screening
test results of a racially diverse sample of older primary care patients in the United States.

Design:
Cross-sectional study of primary care patients aged 65 and older.

Setting:
Urban and suburban primary care clinics in Indianapolis, Indiana, in 2008 to 2009.

Participants:
Nine hundred fifty-four primary care patients without a documented diagnosis of dementia.

Measurements:
Community Screening Instrument for Dementia, the Mini-Mental State Examination,
and the Telephone Instrument for Cognitive Screening.

Results:
Of the 954 study participants who consented to participate, 748 agreed to be screened for dementia
and 206 refused screening. The overall response rate was 78.4%. The positive screen rate of the
sample who agreed to screening was 10.2%. After adjusting for demographic differences the following
characteristics were still associated with increased likelihood of screening positive for dementia: age,
male sex, and lower education. Patients who believed that they had more memory problems than other
people of their age were also more likely to screen positive for dementia.

Conclusion:
Age and perceived problems with memory are associated with screening positive for dementia
in primary care.
The Clinical Significance of Incidental Parotid Uptake in a PET/CT Study: A Diagnostic Algorithm
Authors: Üstün Funda , Taştekin Ebru , Taş Abdullah , Altun Gülay Durmuş 
Published: December 2017

Background:
Patients diagnosed with cancer do not have sufficient clinical data for the
management of incidental parotid lesions. We aimed to reveal the importance of randomized parotid
lesions encountered during oncologic F-18 fluorodeoxyglucose positron emission tomography
(FDG PET/CT) imaging in our clinical practice and the diagnostic algorithm of such lesions.

Methods:
We performed a database search of PET/CT records generated from 2009 to 2015 for
“parotid” in reports of patients who underwent PET/CT examination for a known malignancy
elsewhere, or cancer screening.

Results:
Incidental parotid FDG uptake on PET/CT had a prevalence of 1.1%. The incidence of parotid
metastasis in our series was 36.4%, and 75% of them had malign melanoma metastasis. Of
the 11 cases, 5 were of Warthin tumours, and Warthin tumours showed stronger GLUT1 expression
than metastatic parotid lesions.

Conclusion:
In patients with malignancy elsewhere, focal involvement of FDG by the parotid
gland, especially if malignant melanoma or SCC is absent, should not be considered a metastatic
disease without histopathologic confirmation. If parotid disease would change the patient’s treatment
plan and disease stage, the parotid lesion should be evaluated by additional methods, such as
fine needle aspiration biopsy.
Literature Evidence and ARRIVE Assessment on Neuroprotective Effects of Flavonols in Neurodegenerative Diseases' Models
Authors: Bombardi Duarte Ana Carolina , Santana Maycon Giovani , di Camilo Orfali Guilherme , de Oliveira Carlos Tadeu Parisi , Priolli Denise Goncalves 
Published: December 2017

Background and Objective: This paper was based on a literature search of PubMed and
Scielo databases using the keywords “Flavonoids, Neuroprotection, Quercetin, Rutin, Isoquercitrin,
Alzheimer, Parkinson, Huntington” and combinations of all the words.

Method:
We collected relevant publications, during the period of 2000 to 2016, emphasizing in vivo
and in vitro studies with neurological assessment of flavonol's potentials, as well as classifying studies
according to evidence levels, in order to elucidate evidence-based literature and its application on
clinical research. In addition, we highlight the importance of flavonols in modern research fields, indicating
their neuroprotective potential and use thereof as preventive and therapeutic treatment of numerous
neurodegenerative disease. Neurodegenerative diseases, such as Alzheimer's disease, Parkinson's
disease and Huntington's disease, represent worldwide a major health problem with great financial
impact. They are multifactorial diseases, hallmarked by similar pathogenesis that covers conditions
such as oxidative stress, formation of free radicals, abnormal protein dynamics (degradation and
aggregation), mitochondrial dysfunction, lipid peroxidation and cellular death or senescence. Flavonols
are polyphenolic compounds, widely distributed in the plant kingdom and found in high concentrations
in vegetables, fruits and teas. Their neuroprotective effects are mainly related to their antioxidant,
anti-proliferative and anti-inflammatory properties.

Conclusion:
It was this paper's intention to contribute with an evidence analysis of recent studies approaching
neuroprotective effects of flavonols and the potential to conduct human clinical studies.
Diabetes Is Associated With Reduced Stress Hyperlactatemia in Cardiac Surgery
Authors: Greco Giampaolo , Kirkwood Katherine A. , Gelijns Annetine C. , Moskowitz Alan J. , Lam David W. 
Published: December 2017

OBJECTIVE
Hyperglycemia and hyperlactatemia are associated with increased morbidity and mortality in critical illness. We evaluated the relationship among hyperlactatemia, glycemic control, and diabetes mellitus (DM) after cardiac surgery.

RESEARCH DESIGN AND METHODS
This was a retrospective cohort study of 4,098 cardiac surgery patients treated between 2011 and 2015. Patients were stratified by DM and glucose-lowering medication history. Hyperglycemia (glucose &gt;180 mg/dL), hypoglycemia (&lt;70 mg/dL), and the hyperglycemic index were assessed postoperatively (48 h). The relationship between lactate and glucose levels was modeled using generalized linear regression. Mortality was analyzed using an extended Cox regression model.

RESULTS
Hyperglycemia occurred in 26.0% of patients without DM (NODM), 46.5% with DM without prior drug treatment (DMNT), 62.8% on oral medication (DMOM), and 73.8% on insulin therapy (DMIT) (P &lt; 0.0001). Hypoglycemia occurred in 6.3%, 9.1%, 8.8%, and 10.8% of NODM, DMNT, DMOM, and DMIT, respectively (P = 0.0012). The lactate levels of all patients were temporarily increased with surgery. This increase was greater in patients who also had hyperglycemia or hypoglycemia and was markedly attenuated in patients with DM. Peak lactate was 5.8 mmol/L (95% CI 5.6, 6.0) in NODM with hyperglycemia vs. 3.3 (95% CI 3.2, 3.4) without hyperglycemia; in DMNT: 4.8 (95% CI 4.4, 5.2) vs. 3.4 (95% CI 3.1, 3.6); in DMOM: 3.8 (95% CI 3.5, 4.1) vs. 2.9 (95% CI 2.7, 3.1); and in DMIT: 3.3 (95% CI 3.0, 3.5) vs. 2.7 (95% CI 2.3, 3.0). Increasing lactate levels were associated with increasing mortality; increasing glucose reduced this effect in DM but not in NODM (P = 0.0069 for three-way interaction).

CONCLUSIONS
Stress hyperlactatemia is markedly attenuated in patients with DM. There is a three-way interaction among DM, stress hyperlactatemia, and stress hyperglycemia associated with mortality after cardiac surgery.