bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in Arterial Access Site and Association With Mortality in the United Kingdom
Authors: Mamas Mamas A. , Nolan James , de Belder Mark A. , Zaman Azfar , Kinnaird Tim , Curzen Nick , Kwok Chun Shing , Buchan Iain , Ludman Peter , Kontopantelis Evangelos 
Published: March 2016

Background—
The transradial access (TRA) site has become the default access site for percutaneous coronary intervention in the United Kingdom, with randomized trials and national registry data showing reductions in mortality associated with TRA use. This study evaluates regional changes in access site practice in England and Wales over time, examines whether changes in access site practice have been uniform nationally and across different patient subgroups, and provides national estimates for the potential number of lives saved or lost associated with regional differences in access site practice.

Methods and Results—
Using the British Cardiovascular Intervention Society database, we investigated outcomes for growth of TRA in different regions in England and Wales in 448 853 patients who underwent percutaneous coronary intervention from 2005 to 2012. Multiple logistic regression was used to quantify the effect of TRA on 30-day mortality and quantify lives saved and lost by differences in TRA adoption. TRA use increased from 14.0% to 58.6% in 417 038 PCI patients with large variations in different parts of the country. TRA was independently associated with a decreased risk of 30-day mortality (odds ratio=0.70; 95% confidence interval=0.66–0.74), with significant but small differences observed across different regions. The number of estimated lives saved was 450 (95% confidence interval=275–650), and we estimate that an additional 264 (95% confidence interval=153–399) lives would have been saved if TRA adoption were uniform nationally.

Conclusions—
TRA has become the dominant percutaneous coronary intervention approach in the United Kingdom, with a wide variation in different parts of the country. Changes in practice have contributed to mortality reductions, and inequalities have resulted in missed opportunities for further improvements.
Use of Oral Anticoagulants for Stroke Prevention in Patients With Atrial Fibrillation Who Have a History of Intracranial Hemorrhage
Authors: Chao Tze-Fan , Liu Chia-Jen , Liao Jo-Nan , Wang Kang-Ling , Lin Yenn-Jiang , Chang Shih-Lin , Lo Li-Wei , Hu Yu-Feng , Tuan Ta-Chuan , Chung Fa-Po , Chen Tzeng-Ji , Lip Gregory Y. H. , Chen Shih-Ann 
Published: March 2016

Background—
The risk of further intracranial hemorrhage (ICH) and the benefit of stroke risk reduction with the use of oral anticoagulants for patients who have atrial fibrillation with a history of ICH remain unclear. We aimed to investigate the risks and benefits in patients who have atrial fibrillation with a previous ICH treated with warfarin or antiplatelet drugs in comparison with no antithrombotic therapies.

Methods and Results—

This study used the National Health Insurance Research Database in Taiwan. Among 307 640 patients who have atrial fibrillation with a CHA
2
DS
2
-VASc score ≧2, 12 917 patients with a history of ICH were identified and were assigned to 1 of 3 groups, that is, no treatment, antiplatelet therapy, and warfarin. Among patients with previous ICH, the rate of ICH and ischemic stroke in untreated patients was 4.2 and 5.8 per 100 person-years, respectively. The annual ICH and ischemic stroke rates in warfarin users were 5.9% and 3.4%, respectively. Among users of antiplatelet agents, the rates were 5.3% per year and 5.2% per year, respectively. The number needed to treat for preventing 1 ischemic stroke was lower than the number needed to harm for producing 1 ICH with warfarin use for patients with a CHA
2
DS
2
-VASc score ≧6 (37 versus 56). The number needed to treat was higher than the number needed to harm for patients with a CHA
2
DS
2
-VASc score <6 (63 versus 53).

Conclusions—

Warfarin use may be beneficial for patients who have atrial fibrillation with a previous ICH having a CHA
2
DS
2
-VASc score ≧6. Whether the use of non–vitamin K antagonist oral anticoagulants could lower the threshold for treatment deserves further study.
Long-term Voice Outcomes of Early Thyroplasty for Unilateral Vocal Fold Paralysis Following Aortic Arch Surgery
Authors: Kwak Paul E. , Tritter Andrew G. , Donovan Donald T. , Ongkasuwan Julina 
Published: March 2016

Objective: To describe this institution’s experience with and the long-term outcomes of early type 1 thyroplasty for unilateral vocal fold paralysis (UVFP) following surgery on the aortic arch. Study Design: Retrospective chart review with telephone questionnaire. Setting: Academic tertiary care center. Subjects and Methods: Three hundred forty-eight patients with UVFP following surgery on the aortic arch since 1999 were identified; 40 were available for follow-up. The number of revision procedures following initial thyroplasty was ascertained, and the Voice Handicap Index (VHI) was administered by telephone. The hypothesis that early thyroplasty produced voice outcomes and revision rates comparable to injection laryngoplasty was established prior to the initiation of data collection. Results: Six out of the 40 patients (15%) required revision thyroplasty following their initial procedure. Mean VHI of all patients was 36.0 (SD, 27.2). Mean VHI was significantly different in the 18 to 39 age group (13.1) when compared to the 40 to 59 (51.8) and 60+ (37.7) age groups ( P = .013). Mean follow-up since initial thyroplasty was 46.5 months (SD, 42.2). Conclusions: In the setting of aortic arch surgery with injury to the recurrent laryngeal nerve, early thyroplasty produces voice outcomes comparable to those achieved in the literature with repeated injection and delayed thyroplasty and can be considered in select populations.
Compound Motor Action Potential Quantifies Recurrent Laryngeal Nerve Innervation in a Canine Model
Authors: Bhatt Neel K. , Park Andrea M. , Al-Lozi Muhammad , Paniello Randal C. 
Published: March 2016

Objective: The compound motor action potential (CMAP) is the summated action potential from multiple muscle fibers activated by a single nerve impulse. The utility of laryngeal muscle CMAP for quantifying innervation following recurrent laryngeal nerve (RLN) injury was investigated. Method: In a series of 21 canine hemi-laryngeal preparations, RLNs were exposed and a stimulating electrode placed. Maximum CMAP amplitudes and area under the curve from the thyroarytenoid (TA) muscles were obtained at baseline and at 6 months following injury to the RLN. Injury mechanisms included crush, stretch, cautery, and complete transection with microsuture repair. Results: Prior to injury, baseline CMAP amplitudes and area under the curve were 15.81 mV and 15.49mVms, respectively. Six months following injury, CMAP amplitude and area under curve were 105.1% and 102.1% of baseline for stretch, 98.7% and 112.7% for crush, 93.3% and 114.3% for cautery. The CMAP amplitude and area under the curve in the transection/repair group had a 54.3% and 69.4% recovery, respectively, which were significantly different than baseline ( P < .01, P < .05). These values were correlated with vocal fold motion. Conclusion: The CMAP is a measure of vocal fold innervation. The technique could be further developed for clinical and experimental applications.
People, Nature, and Climate
Authors: Cid-Aguayo Beatriz E. 
Published: March 2016

A Latourian actor-network analysis of social narratives about climate change in the city of Concepción and the strategies of collective adaptation to climate change deployed by two social groups shows a difference in people’s relationships with nature. The discourses of climate change in the city view it as a backdrop about which not much can be done and hold more powerful others responsible for causing it and for dealing with it. In contrast, in the settlement of Agüita de la Perdiz and among the peasants of the agro-ecological movement in the Bío-Bío Region, climate change is not simply a backdrop but a threat to their quality of life and subsistence, an actant that brings agency to their socio-techno-natural networks, and they have developed measures to control its potential destructive effects. Un análisis actor-red latouriano de narrativas sociales sobre el cambio climático en la ciudad de Concepción y las estrategias de adaptación colectiva al cambio climático empleadas por dos grupos sociales muestran una diferencia en las relaciones de las personas con la naturaleza. Los discursos sobre el cambio climático en la ciudad lo presentan como un trasfondo sobre el cual no se puede hacer mucho, y declaran responsables a otros más poderosos por causarlo y por tratarlo. En contraste, en el asentamiento de Agüita de la Perdiz y entre los campesinos del movimiento agro-ecológico en la Región Bío-Bío, el cambio climático no es simplemente un trasfondo sino una amenaza a su calidad de vida y subsistencia, un activador que otorga agencia a sus redes socio-tecno-naturales, y han elaborado medidas para controlar sus potenciales efectos destructivos.
Measurement of Intellectual Capital in the Indian Banking Sector
Authors: Chahal Hardeep , Bakshi Purnima 
Published: March 2016

Executive Summary Intellectual capital has recently been receiving increased attention from both academic communities and practitioners, and is identified as an important strategic asset which provides sustainability and yields better performance. It also gives rise to the view that the organizations which possess skilled, creative, and distinctive knowledgeable employees along with supportive organizational structures and systems, and maintains cordial customer relations contribute in achieving superior organizational position. Hence, it is important to understand to what extent intellectual capital is efficiently utilized by specific sectors in creating value for organizations ( Kamath, 2007 ). The present study aims to develop, establish, and empirically validate the intellectual capital scale in the banking sector, in the context of emerging economies like India. Data were collected from three executives each (including one manager and two senior employees) from 144 branches of 21 public and seven private commercial banks operating in Jammu city, India. The three senior most executives were purposively selected because of being more knowledgeable and experienced. The study established the intellectual capital scale as a multidimensional scale comprising human capital, relational capital, and structural capital. All the three dimensions were found to significantly contribute to the intellectual capital, among which relational capital contributed relatively more, followed by human capital and structural capital. Relational capital consists of important items like meeting with customers, customer feedback, and knowledge and regular customer interaction. Similarly, human capital dimension consists of significant items like employee creativity, devoted staff, training and education, experience, attitude, and innovative employees. Structural capital is a composite of valuable items like structure, systems, information technology, capabilities, culture, empowerment, and service quality which helps in developing intellectual capital. The research findings can help bank managers in determining how to generate value using human, structural, and relational capital. For instance, the study findings offer valuable insight into how the managers can improve bank’s structural capital by encouraging innovation ability among employees, positive culture, and strengthening information technology in terms of continuously updating software and hardware. The study is limited to public and private commercial banks operating in Jammu city. In future, the scale validation can be undertaken to investigate whether the three-dimensional intellectual capital scale can be generalized for other industries and countries.
Direct brain infusion can be enhanced with focused ultrasound and microbubbles
Authors: Wang Shutao , Karakatsani Maria E , Fung Christine , Sun Tao , Acosta Camilo , Konofagou Elisa 
Published: March 2016

The delivery of most therapeutic agents is rendered ineffective for the treatment of brain diseases due to the presence of the blood–brain barrier (BBB). The goal of this study was to investigate the effect of pre-infusion focused ultrasound (FUS) and microbubbles on the distribution of direct brain infusion in vivo. A single-element FUS transducer was used in all sonications, which were carried out immediately prior to direct infusion procedures. Mice received direct infusion of either Gadolinium-labeled albumin (Gd-albumin, 74 kDa) or adeno-associated virus (AAV, ∼4 MDa). The volumes of Gd-albumin at 30 min were deemed comparable ( P = 0.334) between the direct infusion (DI)-only group and the FUS + DI group. At 120 min, the FUS + DI group showed significantly higher contrast-enhanced volume (9.76 ± 0.74 mm3) than the DI-only group (7.14 ± 0.34 mm3). For mice infused with AAV, the total volume of transduction was estimated as GFP-positive regions and FUS + DI group demonstrated significantly higher ( P = 0.017) transduction efficiency in vivo. In conclusion, enhanced bio-distribution of directly infused agents was observed when the targeted region was pre-conditioned with FUS and microbubbles. Focused ultrasound has the potential, as an adjuvant technique, to significantly enhance direct brain infusion and achieve the desired therapeutic outcomes.
Do current vocational evaluation practices in traumatic brain injury align with best practices? Strengths, challenges and recommendations
Authors: Stergiou-Kita Mary , Grigorovich Alisa , Dawson Deirdre , Bottari Carolina , Hebert Debbie 
Published: March 2016

Introduction To support implementation of the Inter-professional Guideline for Vocational Evaluation Following Traumatic Brain Injury we compared current practices to best practices as outlined in the guideline. Method We recruited health/vocational professionals who do vocational evaluation of traumatic brain injury survivors to participate in qualitative semi-structured interviews. We also conducted a document review of internal clinical and provincial workers’ compensation insurance documents. All data were analyzed using directed content analysis. Results Thirteen individuals participated and three types of documents were reviewed. Practices that were found to be frequently aligned with the Inter-professional Guideline for Vocational Evaluation Following Traumatic Brain Injury included: (a) identification of evaluation purpose; (b) obtaining informed consent; (c) gathering background information; (d) assessing persistent symptoms and abilities; (e) analyzing and synthesizing results; and (f) developing return to work recommendations. Practices partially aligned included: (a) incorporating the worker’s perspectives into the evaluation; (b) observing work behaviors in naturalistic settings (c) assessing available supports; and (d) assessing occupational/job demands in context. Practices that did not align with the guideline included: (a) evaluation of the workplace environment and workplace supports; (b) accommodation potential; and (c) assessment of workplace safety. Conclusion To support implementation of the guideline and enhance successful vocational outcomes, additional attention and resources should be dedicated to evaluating workplace-based factors and assessing workplace-based risks.
Return to Play After Periacetabular Osteotomy for Treatment of Acetabular Dysplasia in Adolescent and Young Adult Athletes
Authors: Heyworth Benton E. , Novais Eduardo N. , Murray Kerri , Cvetanovich Gregory , Zurakowski David , Millis Michael B. , Kim Young-jo 
Published: March 2016

Background: The Bernese periacetabular osteotomy (PAO) is an effective surgical treatment option for symptomatic acetabular dysplasia. Little evidence exists regarding the results of PAO and rates of return to play (RTP) in an athletic population. Hypothesis: The majority of athletes will demonstrate improvements in functional outcome measures, such as the modified Harris Hip Score and Hip Disability and Osteoarthritis Outcome Score, and will be able to return to sports after PAO. Study Design: Case series; Level of evidence, 4. Methods: A comprehensive surgical hip database at an academic referral center was used to identify a subpopulation of athletes on whom PAO was performed. Data analyzed included preceding surgeries, reoperations, and RTP timing and features. Standard pre- and postoperative radiologic parameters and validated functional outcome measures were assessed, and a regression model assessed risk factors for prolonged time to RTP. Results: Of 245 PAOs performed over the 5-year study period, 46 were performed in 41 patients who met inclusion criteria for being an athlete (mean age, 26.2 years; range, 13-41 years; 36 females; 19% of all PAOs), representing a variety of sports. Prior surgery had been performed on 9 hips (20%). Only 1 post-PAO procedure (2%), excision of heterotopic ossification, was performed during the study period. At final follow-up (median, 3.1 years; range, 1.2-4.4 years), significant mean improvements were observed in modified Harris Hip Score (from 71 to 90; P < .001) and Hip Disability and Osteoarthritis Outcome Score (from 64 to 89; P < .001). The University of California–Los Angeles Activity Scale scores were maintained at a high level (range, 8.0-8.2; P = .28). RTP was reported in 80% of patients (37 of 46) at a median of 9 months postoperatively, with increased postoperative pain as the only independent predictor of longer time to RTP. Of these 37 athletes, 27 (73%) returned to the same level, although this was significantly less common ( P = .06) in competitive athletes (11 of 19; 58%) than in recreational athletes (16 of 18; 89%). Among those who did return at the same level, 23 of 27 (85%) were able to maintain this level over time, but this was not significantly different between competitive (8 of 11; 73%) and recreational (15 of 16; 94%) athletes ( P = .27). Conclusion: Most athletic patients undergoing PAO are female patients and show postoperative improvements in function and return to athletic play. However, although there was no decline in overall activity level at a mean of 3 years, self-assessed athletic performance was attained and maintained in approximately one-half of the study population.
Development and Validation of the Hospice Professionals’ Understanding of Preparatory Grief Scale
Authors: Prost Stephanie Grace 
Published: March 2016

Purpose: It is critical to assess hospice professionals’ discrimination between adaptive and maladaptive reactions to terminal illness in persons at the end-of-life to assure targeted intervention aimed at maintaining quality of life. The proposed measure, the Hospice Professionals Understanding of Preparatory Grief scale (HPPG), contains affective, behavioral, and cognitive reactions to terminal illness and asks respondents to identify which reflect adaptive and maladaptive responses. Methods: Hospice professionals across three states ( n = 196) completed the novel HPPG via online survey. Results: Initial evidence via expert panel review, confirmatory factor analysis, and domain restructuring suggests good content and factorial validity. Final reliability (α stratified = .861) indicates good internal consistency. Discussion: The HPPG is the first measure to assess hospice professionals’ understanding of reactions to terminal illness and serves as an initial examination of this critical skill in hospice professionals including social workers. The HPPG can be used as a self-assessment or measure of continuing education.
Use of an embedded, micro-randomised trial to investigate non-compliance in telehealth interventions
Authors: Law Lisa M , Edirisinghe Nuwani , Wason James MS 
Published: March 2016

Background/aims: Many types of telehealth interventions rely on activity from the patient in order to have a beneficial effect on their outcome. Remote monitoring systems require the patient to record regular measurements at home, for example, blood pressure, so clinicians can see whether the patient’s health changes over time and intervene if necessary. A big problem in this type of intervention is non-compliance. Most telehealth trials report compliance rates, but they rarely compare compliance among various options of telehealth delivery, of which there may be many. Optimising telehealth delivery is vital for improving compliance and, therefore, clinical outcomes. We propose a trial design which investigates ways of improving compliance. For efficiency, this trial is embedded in a larger trial for evaluating clinical effectiveness. It employs a technique called micro-randomisation, where individual patients are randomised multiple times throughout the study. The aims of this article are (1) to verify whether the presence of an embedded secondary trial still allows valid analysis of the primary research and (2) to demonstrate the usefulness of the micro-randomisation technique for comparing compliance interventions. Methods: Simulation studies were used to simulate a large number of clinical trials, in which no embedded trial was used, a micro-randomised embedded trial was used, and a factorial embedded trial was used. Each simulation recorded the operating characteristics of the primary and secondary trials. Results: We show that the type I error rate of the primary analysis was not affected by the presence of an embedded secondary trial. Furthermore, we show that micro-randomisation is superior to a factorial design as it reduces the variation caused by within-patient correlation. It therefore requires smaller sample sizes – our simulations showed a requirement of 128 patients for a micro-randomised trial versus 760 patients for a factorial design, in the presence of within-patient correlation. Conclusion: We believe that an embedded, micro-randomised trial is a feasible technique that can potentially be highly useful in telehealth trials.