bluuebunny/crossref_metadata_2025_split huggingface dataset:
Co-constructing engagement in stroke rehabilitation: a qualitative study exploring how practitioner engagement can influence patient engagement
Authors: Bright Felicity AS , Kayes Nicola M , Cummins Christine , Worrall Linda M , McPherson Kathryn M 
Published: February 2017

Objective:To explore how practitioner engagement and disengagement occurred, and how these may influence patient care and engagement.Design:A qualitative study using the Voice Centred Relational Methodology. Data included interviews, focus groups and observations.Setting:Inpatient and community stroke rehabilitation services.Subjects:Eleven people experiencing communication disability after stroke and 42 rehabilitation practitioners.Interventions:Not applicable.Results:The practitioner’s engagement was important in patient engagement and service delivery. When patients considered practitioners were engaged, this helped engagement. When they considered practitioners were not engaged, their engagement was negatively affected. Practitioners considered their engagement was important but complex. It influenced how they worked and how they perceived the patient. Disengagement was taboo. It arose when not feeling confident, when not positively impacting outcomes, or when having an emotional response to a patient or interaction. Each party’s engagement influenced the other, suggesting it was co-constructed.Conclusions:Practitioner engagement influenced patient engagement in stroke rehabilitation. Practitioner disengagement was reported by most practitioners but was often a source of shame.
Depletion of microglia exacerbates postischemic inflammation and brain injury
Authors: Jin Wei-Na , Shi Samuel Xiang-Yu , Li Zhiguo , Li Minshu , Wood Kristofer , Gonzales Rayna J , Liu Qiang 
Published: February 2017

Brain ischemia elicits microglial activation and microglia survival depend on signaling through colony-stimulating factor 1 receptor (CSF1R). Although depletion of microglia has been linked to worse stroke outcomes, it remains unclear to what extent and by what mechanisms activated microglia influence ischemia-induced inflammation and injury in the brain. Using a mouse model of transient focal cerebral ischemia and reperfusion, we demonstrated that depletion of microglia via administration of the dual CSF1R/c-Kit inhibitor PLX3397 exacerbates neurodeficits and brain infarction. Depletion of microglia augmented the production of inflammatory mediators, leukocyte infiltration, and cell death during brain ischemia. Of note, microglial depletion-induced exacerbation of stroke severity did not solely depend on lymphocytes and monocytes. Importantly, depletion of microglia dramatically augmented the production of inflammatory mediators by astrocytes after brain ischemia . In vitro studies reveal that microglia restricted ischemia-induced astrocyte response and provided neuroprotective effects. Our findings suggest that neuroprotective effects of microglia may result, in part, from its inhibitory action on astrocyte response after ischemia.
Early abnormal liver enzyme levels may increase the prevalence of human cytomegalovirus antigenaemia after hematopoietic stem cell transplantation
Authors: Ye Baning , Zhao Hong 
Published: February 2017

Objective Human cytomegalovirus (HCMV) infection is common after bone marrow transplantation (BMT), and it increases morbidity and mortality for transplant recipients. HCMV infection may cause hepatitis and elevate the liver enzymes aspartate transferase (AST) and alanine transferase (ALT). This study aimed to analyse the associations between liver enzyme levels and infection with HCMV antigenaemia after BMT. Methods Data from 30 patients after BMT were collected at different time points (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 4.0, 5.0, and 6.0 months post-transplantation). The patients were divided into the HCMV antigenaemia-positive and HCMV antigenaemia-negative groups according to a peripheral blood pp65 antigen assay. Immunohistochemistry was used to identify HCMV pp65 antigen and conventional methods were used to detect liver enzyme levels. Results Twelve patients were pp65 antigenaemia-positive and 10 patients were positive in the first 3 months post-transplant. Liver enzyme levels were increased after positivity for HCMV antigenaemia (p = 0.034 and p = 0.018 for ALT and AST, respectively). One month before antigenaemia, AST levels were higher in the HCMV antigenaemia-positive group compared with the negative group (p = 0.006). Conclusion HCMV antigenaemia mostly occurs in the early stage of post-BMT and early abnormal liver enzyme levels may increase the chance of HCMV antigenaemia after BMT.
Effect of treatment dose reductions in the setting of hand-foot syndrome on survival outcomes in patients with metastatic renal cell carcinoma treated with vascular endothelial growth factor receptor inhibitors
Authors: Bailey Erin B , Merriman Joseph , Maughan Benjamin , Poole Austin , Tantravahi Srinivas K , Agarwal Archana M , Batten Julia A , Patel Shiven B , Pal Sumanta K , Stenehjem David D , Agarwal Neeraj 
Published: February 2017

Purpose Hand-foot syndrome is a common dose limiting toxicity of vascular endothelial growth factor receptor tyrosine kinase inhibitors used for treatment of patients with metastatic renal cell carcinoma. The effect of treatment dose reductions, in the context of hand-foot syndrome, on survival outcomes is reported. Methods This was a retrospective case series of patients receiving vascular endothelial growth factor receptor tyrosine kinase inhibitors from 1 January 2004 to 31 October 2013. The main outcomes were progression-free and overall survival in these patients experiencing hand-foot syndrome and undergoing treatment dose reductions. Univariate and multivariate analyses were conducted utilizing Kaplan-Meier method and COX Proportional Hazard model with landmark analyses at 2 months. Results Of the 120 patients evaluated, treatment dose reductions for any reason were required in 68 (56.7%) patients. The most common reasons for treatment dose reductions were mucositis, hand-foot syndrome, and fatigue. The median progression-free survival and overall survival were significantly longer in patients with hand-foot syndrome with or without treatment dose reductions as compared to those without hand-foot syndrome. Conclusions An improvement in survival outcomes was observed in metastatic renal cell carcinoma patients with treatment-associated hand-foot syndrome despite treatment dose reductions. These data need validation in a larger cohort to confirm the hypothesis that treatment dose reductions in the setting of hand-foot syndrome do not negatively impatient survival.
Optimization of high-dose busulfan dosing in bone marrow transplant patients
Authors: Partyka James S. , Tate Cheryl 
Published: February 2017

Objective. To review the pharmacokinetics profile of (HD-BU) high-dose busulfan, review published phar macodynamic relationships of high-dose busulfan and discuss clinical considerations of monitoring patients receiving high-dose busulfan. Data Sources. A MEDLINE search of articles published from 1985 to 1996 and a Cancerlit search of articles published from 1988 to 1996, using the Mesh headings "Busulfan (subheading: pharmacokinetics)," "Bone Marrow Transplantation" and "Hepatic Veno occlusive Disease." Study Selection. All human trials evaluating the pharmacokinetic profile and the pharmacodynamic relationships of high-dose busulfan in bone marrow transplant patients. Data Synthesis. Busulfan disposition has been extensively studied in both children and adults receiv ing high doses followed by stem cell rescue. Sample sizes ranged from 7 to 28 patients, with patients ranging from 0.3 to 60 years of age. Busulfan total doses ranged from 14 mg/kg to 640 mg/m2. A large interpatient variability has been reported in busulfan pharmacokinetics parameters for both children and adults. In adults, the maximum concentration (Cmax) achieved after the first oral dose of HD-BU ranged from 249 to 1512 ng/mL, the apparent volume of distribution (Vd) ranged from 0.56 to 0.66 L/kg, the total plasma clearance (CL) of busulfan ranged from 2.49 to 3.26 mL/min/kg, and the area under the time versus concentration curve (AUC) ranged from 103 to 21,120 ng h/mL. In children, the Cmax ranged from 577 to 1258 ng/mL, the Vd ranged from 0.74 to 1.42 L/kg, the CL of busulfan ranged from 3.26 to 8.91 mL/min/kg, and the AUC ranged from 309 to 13,129 ng h/mL. Several investigators have reported in creased busulfan CL, larger Vd and lower Cmax in children as compared to adults. In addition, children have lower AUCs as compared with adults when administered a fixed busulfan dose based on body weight. Lower busulfan AUCs in children appear to be the result of an increased systemic clearance and a larger volume of distribution as compared to adults. In adults, HD-BU systemic exposure have been corre lated to efficacy and toxicity in some studies; no prospective studies in children have established a clear role for routinely monitoring busulfan concen trations. Conclusions. Although routine monitoring with dosage adjustment of busulfan is probably warranted in some patients with extremely high or low busulfan plasma concentrations, clinical studies should con tinue to further define a therapeutic range for HD-BU.
Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis
Authors: Craig Andrew , Witte Philip G , Moody Tristram , Harris Karen , Scott Harry W 
Published: February 2017

Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012–2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats’ ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.
Physical activity is associated with a decreased multiple sclerosis risk: The EnvIMS study
Authors: Wesnes Kristin , Myhr Kjell-Morten , Riise Trond , Cortese Marianna , Pugliatti Maura , Boström Inger , Landtblom Anne-Marie , Wolfson Christina , Bjørnevik Kjetil 
Published: February 2017

Background: The lifestyle factors smoking and obesity have been associated with the risk of multiple sclerosis (MS). Physical activity (PA) may also be of importance. Objective: To examine the association between PA and MS risk in Italy, Norway, and Sweden and to evaluate the possible influence by established risk factors. Methods: In this case–control study, 1904 cases and 3694 controls were asked to report their average weekly amounts of light and vigorous PA during adolescence on a scale ranging from none to more than 3 hours activity. We used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) and adjusted for potential confounders. Results: Vigorous PA was inversely associated with MS risk in the pooled analysis ( p-trend < 0.001) with an age- and sex-adjusted OR of 0.74 (95% CI: 0.63–0.87) when comparing the highest and lowest levels. Adjusting for outdoor activity, infectious mononucleosis, body size, and smoking yielded similar results. The association was present in all countries and was not affected by exclusion of patients with early disease onset. Light PA was not associated with the risk of MS. Conclusion: Our findings suggest that vigorous PA can modify the risk of developing MS independent of established risk factors.
Exploring service users’, carers’ and professionals’ perspectives and experiences of current antipsychotic prescribing: A qualitative study
Authors: Harris Kamelia , Brooks Helen , Lythgoe Garry , Bee Penny , Lovell Karina , Drake Richard J 
Published: February 2017

Objectives Shared decision-making is the pinnacle of patient-centred care; mental health stakeholders value shared decision-making but find it difficult to enact. The objective was to compare and synthesise mental health stakeholder views on antipsychotic prescribing in one NHS Trust, to understand potential reasons for the difficult enactment of shared decision-making in practice. Methods We conducted 12 interviews and 5 focus groups with 33 mental health stakeholders, after obtaining their informed consent. They shared their experiences in and perceptions of antipsychotic prescribing and were recruited from Manchester Mental Health and Social Care Trust. Results Stakeholders agreed that successful shared decision-making demands a collaborative approach. We elucidated a striking divergence in views of the decision-making process and understanding of collaboration. Nurses, consultants and the pharmacist seemed most satisfied with the amount of collaboration but most pessimistic about the scope for it. Carers and most service users did not feel that there was any collaboration. Discussion Comparison of perspectives demonstrated the complexity of shared decision-making which is not addressed in current operational definitions or policy or nursing practice initiatives. The findings have the potential to progress initiatives in the mental health field from those that emphasise the need for shared decision-making to those that develop tools to promote shared decision-making.
Diagnostic performance of reformatted isotropic thin-section helical CT images in the detection of superior semicircular canal dehiscence
Authors: Sparacia Gianvincenzo , Iaia Alberto 
Published: February 2017

Purpose The purpose of this article is to assess the diagnostic performance of computed tomography (CT) reformatted images for detection of superior semicircular canal (SSC) dehiscence. Material and methods Forty-two patients, with sound- and/or pressure-induced vestibular symptoms, and 42 control participants underwent helical CT examination with a highly collimated beam (0.5 mm). Reformatted images of the vestibular labyrinth were obtained in the standard axial and coronal planes (group A images), and in a plane parallel and perpendicular to the SSC (group B images). Diagnostic performance obtained by evaluating the group A images alone and the group B images alone was analyzed by using the area under the receiver operating characteristic curve (AUC). Results The diagnostic performance of group A images was AUC = 0.929 with an overall accuracy of 92.9%. The diagnostic performance of group B images was AUC = 0.988 with an overall accuracy of 98.8%. The evaluation of group B images alone showed an improved diagnostic performance over the group A images alone. Conclusion Thin-section 0.5-mm collimation CT with reformatted images oriented in the plane parallel and perpendicular to the SSC improves diagnostic accuracy in assessing for SSC dehiscence in comparison to CT images with reconstructions limited to traditional axial and coronal planes.
Biomechanical comparison between cortical screw–rod construct versus pedicle screw–rod construct in transforaminal lumbar interbody fusion
Authors: Yin Wei Chris Chan , Haw Sem Sei , Bashir Elrofai Suliman , Beng Saw Lim , Shanmugam Rukmanikanthan , Keong Kwan Mun 
Published: February 2017

Objective: To compare construct stiffness of cortical screw (CS)-rod transforaminal lumbar interbody fusion (TLIF) construct (G2) versus pedicle screw (PS)-rod TLIF construct (G1) in the standardized porcine lumbar spine. Methods: Six porcine lumbar spines (L2–L5) were separated into 12 functional spine units. Bilateral total facetectomies and interlaminar decompression were performed for all specimens. Non-destructive loading to assess stiffness in lateral bending, flexion and extension as well as axial rotation was performed using a universal material testing machine. Results: PS and CS constructs were significantly stiffer than the intact spine except in axial rotation. Using the normalized ratio to the intact spine, there is no significant difference between the stiffness of PS and CS: flexion (1.41 ± 0.27, 1.55 ± 0.32), extension (1.98 ± 0.49, 2.25 ± 0.44), right lateral flexion (1.93 ± 0.57, 1.55 ± 0.30), left lateral flexion (2.00 ± 0.73, 2.16 ± 0.20), right axial rotation (0.99 ± 0.21, 0.83 ± 0.26) and left axial rotation (0.96 ± 0.22, 0.92 ± 0.25). Conclusion: The CS-rod TLIF construct provided comparable construct stiffness to a traditional PS-rod TLIF construct in a ‘standardized’ porcine lumbar spine model.
Perceived risk factors for nonunion following foot and ankle arthrodesis
Authors: Thevendran Gowreeson , Shah Kalpesh , Pinney Stephen J , Younger Alastair SE 
Published: February 2017

Background: A major complication of foot and ankle arthrodesis is nonunion, which occurs in approximately 12% of cases. Various factors influence a patient’s risk for nonunion following foot and ankle arthrodesis. We surveyed international foot and ankle surgeons to determine (1) risk factors perceived most important for nonunion, (2) factors considered absolute contraindications for arthrodesis, and (3) differences among expert groups regarding perceived risk factors and their stratification. Methods: A questionnaire was e-mailed to members of a major foot and ankle journal editorial board and four foot and ankle society executive committees. The relative risk of 18 potential nonunion risk factors was rated from 1 to 10, using smoking 1 pack/day as a benchmark score of 5.00. Results: The response rate was 72% (100/139); 81% declared foot and ankle surgery encompasses >90% of their practice. The highest perceived risk factors ( p < 0.001) were smoking 2 packs/day (mean score 8.69), lack of fusion site stability (8.66), and poor local vascularity (7.66). The least important risk factors ( p < 0.001) were perceived to be age >60 years (mean score 2.54), rheumatoid arthritis (3.05), and osteoporosis (3.56). The most frequently cited absolute contraindications to arthrodesis surgery were local infection (46%), poor local vascularity (41%), and smoking (32%). Conclusion: To improve arthrodesis outcomes, resource allocation and patient and surgeon education should focus on smoking, construct stability, and local vascularity. Development of an objective nonunion risk assessment tool to identify patients at risk for nonunion using these results could help maximize the efficiency of available resources.
Measurement of Personality through Modified Instrument: A Study of Young Consumers of India
Authors: Sofi Shakeel Ahmad , Nika Fayaz Ahmad 
Published: February 2017

Purpose The present work on personality of a consumer focuses on revising and building a comprehensive framework that would help ascertain personality of an individual from consumer behaviour perspective. It proposes a relook at the validation and reconsideration of earlier developed scales in the subject of personality with special reference to Big Five Personality Framework. A sample of 624 was chosen for this study and multi-stage sampling was adopted in view of layer wise spread of population. Based on the results of exploratory factor analysis (EFA), some of the dimensions of Big Five Personality Framework have been retained whereas few emerging constructs were adopted for their relevance to consumer behaviour. Emotional stability and conscientiousness were left unchanged, whereas extraversion, agreeableness and openness were transformed to new constructs for their foundation in organisational behaviour and having relevance of newly adopted constructs in consumer behaviour. One more construct ‘conserving propensity’ was appended to Big Five Model of personality to make it Big Six from Consumer Behaviour Perspective. Background The number of questionnaires either developed or simply used for exploring the personality of an individual has increased in manifolds in recent years. While the rigour applied to the questionnaire development process may be improving, but there still emerges need to make the use of sophisticated procedures to determine the realistic reliability and validity of the instrument, particularly in the field of consumer behaviour and consumer personality. Design/Methodology/Approach The research design was exploratory in nature that helped the researcher in identifying the items falling in the particular construct. EFA was applied for identifying items and constructs. Furthermore, CFA was employed to determine the reliability and validity of the proposed instrument. The quantitative data was collected through structured questionnaire from young consumers being part of higher educational institutes vis-a-vis colleges and universities of J&K state. A collection of prominent tools like Cronbach’s alpha, principal component analysis and structural equation modelling was applied for validation and development of the modified scale. Results Overall results have shown that scale is highly reliable and possesses both discriminant and convergent validity. Furthermore, other reliability forms are on higher side which supports the consistency of the scale. The present scale would have greater credence for researcher in the field of organisational behaviour, consumer behaviour and interdisciplinary areas of both the subjects.