bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of Exercise- and Sports-Related Injuries in a Population of Young, Physically Active Adults
Authors: Hauret Keith G. , Bedno Sheryl , Loringer Kelly , Kao Tzu-Cheg , Mallon Timothy , Jones Bruce H. 
Published: September 2015

Background: Numerous studies document the health benefits of a physically active lifestyle, but relatively few document the hazards of physical activity. Because of the requirement for physical fitness to complete their mission, the United States military services have a vested interest in understanding the benefits and risks of physical activity including exercise and sports. One of these risks is injury. Rates and proportion of injuries caused by exercise- and sports-related (ESR) activities have not been reported previously across the services. Purpose: The purposes of this population survey were to (1) document the rates and proportion of all injuries caused by ESR activities among military personnel, (2) compare rates across the military services, and (3) describe the causes and types of ESR injuries as well as associated days of limited activity. Study Design: Descriptive epidemiology study. Methods: The Defense Manpower Data Center administered the web-based 2008 Status of Forces Survey of Active Duty Service Members to a random sample of active-duty personnel. In all, 10,692 servicemembers completed the survey, which included questions about injuries from any cause and from exercise and sports during the previous year. Responses were weighted to produce population estimates for injury rates (any injury and ESR injury). Percentage distributions were used to describe activities, injury types, days of limited activity, and contributing factors for ESR injuries. Results: There were 49% of servicemembers who sustained an injury from any cause in the previous year; 25% had an ESR injury. Thus, 52% of all injuries were ESR injuries. ESR injury rates ranged from 20% for the Navy to 33% for the Marine Corps. Running accounted for 45% of ESR injuries. Forty percent of ESR injuries were sprains and strains. As an indicator of injury severity, 35% of ESR injuries required more than 2 weeks of limited activity. Conclusion: This study quantified the overall incidence of injuries and the large proportion that are caused by exercise and sports among military personnel, a population of healthy, physically active adults. Prevention strategies should focus on running, weight training, basketball, and football. Recommendations include adherence to evidence-based practices to reduce the occurrence of ESR injuries.
The relationships between access to and use of a patient-centered medical home and healthcare utilization and costs: A cohort study using Medical Expenditure Panel Survey data from 2007 to 2010
Authors: Xin Haichang , Kilgore Meredith L , Menachemi Nir , Sen Bisakha (Pia) 
Published: September 2015

Objective The patient-centered medical home has emerged as an innovative healthcare delivery model that holds the conceptual promise to improve healthcare quality while reducing costs. This study is among the first to examine how patient perceived patient-centered medical home is related to utilization and costs for emergency department and inpatient care nationwide in the U.S. Methods This retrospective cohort study used data from the 2007–2010 Medical Expenditure Panel Survey. This study focused upon insured individuals aged 18 and older. In each two-year cohort, we measured and identified a full patient-centered medical home group, a partial patient-centered medical home group (with a usual source of care but not a patient-centered medical home), and an unknown patient-centered medical home group. Using negative binomial regression and generalized linear models, we conducted the analysis while controlling for covariates at baseline. Given the nature of the complex survey design, we adjusted weights and variance. Results The study sample consisted of 15,595 individuals, representing a total of 368 million people in the U.S. In the trend of outcome changes from the baseline to the follow-up year, the full and partial patient-centered medical home groups demonstrated reduced efficiency for the 2007–2008 cohort, but increased efficiency for the 2009–2010 cohort, as compared to the no regular provider group. Conclusions Overall, the empirical evidence does not indicate whether patient-centered medical home models reduce healthcare utilization and costs, but it does suggest their potential as mechanisms for achieving healthcare system efficiency, when primary care practices have grown from early to middle stage of patient-centered medical home transformation. A longer observation window and holistic view on all stages of patient-centered medical home growth may be more informative on patient-centered medical home’s efficiency.
Reactive arthritis at the Sydney Sexual Health Centre 1992–2012: declining despite increasing chlamydia diagnoses
Authors: Mason E , Wray L , Foster R , Jamil MS , Guy R , McNulty A , Donovan B 
Published: September 2015

Summary Reactive arthritis is an under-studied complication of genital Chlamydia trachomatis infection (chlamydia). We assessed trends and risk factors for reactive arthritis in a large urban sexual health clinic. Using a case-control design, data on reactive arthritis cases and controls at the Sydney Sexual Health Centre over the period 1992–2012 were extracted and multivariate analyses were performed. Trend analyses were performed on reactive arthritis diagnoses. Over the 1992–2012 study period, 85 reactive arthritis cases were diagnosed at Sydney Sexual Health Centre. The rate of reactive arthritis diagnoses decreased over time (23 in 1992–1996 to one in 2007–2011 and none in 2012), while chlamydia diagnoses increased (770 in 1992–1996 to 2257 in 2007–2011). In multivariate analysis, factors independently associated with a reactive arthritis diagnosis were: being male (adjusted odds ratio [aOR] 3.27; 95% confidence interval [CI] 1.04–10.32; p = 0.043) or born overseas (aOR 2.69; 95% CI 1.27–5.70; p = 0.010), while a past sexually transmitted infection other than chlamydia or non-gonococcal urethritis was protective (aOR 0.21; 95% CI 0.10–0.45; p < 0.001). Reactive arthritis was not associated with current or recent chlamydia infection ( p = 0.184) but was marginally associated with past non-gonococcal urethritis ( p = 0.080). This study found a decline in reactive arthritis diagnoses despite an increase in chlamydia diagnoses.
Socioeconomic inequalities in breast and cervical screening coverage in England: are we closing the gap?
Authors: Douglas Elaine , Waller Jo , Duffy Stephen W , Wardle Jane 
Published: September 2015

Objective Health policy in the UK is committed to tackling inequalities in cancer screening participation. We examined whether socioeconomic inequalities in breast and cervical cancer screening participation in England have reduced over five years. Methods Cross-sectional analyses compared cervical and breast screening coverage between 2007/8 and 2012/13 in Primary Care Trusts (PCTs) in England in relation to area-level income deprivation. Results At the start and the end of this five year period, there were socioeconomic inequalities in screening coverage for breast and cervical screening. Inequalities were highest for breast screening. Over time, the coverage gap between the highest and lowest quintiles of income deprivation significantly reduced for breast screening (from 12.3 to 8.3 percentage points), but not for cervical screening (5.3 to 4.9 percentage points). Conclusions Efforts to reduce screening inequalities appear to have resulted in a significant improvement in equitable delivery of breast screening, although not of cervical screening. More work is needed to understand the differences, and see whether broader lessons can be learned from the reduction of inequalities in breast screening participation.
A Formal Palliative Care Service Improves the Quality of Care in Patients with Stage IV Cancer and Bowel Obstruction
Authors: Gabriel Emmanuel , Kukar Moshim , Groman Adrienne , Alvarez-Perez Amy , Schneider Jaclyn , Francescutti Valerie 
Published: September 2015

Background: Patients with stage IV cancer and bowel obstruction present a complicated management problem. The aim of this study was to evaluate the role of the palliative care service (PC) in the management of this complex disease process. Methods: A retrospective analysis was conducted of all patients admitted to Roswell Park Cancer Institute with stage IV cancer and bowel obstruction from 2009 to 2012 after the institution of a formal PC. This cohort was matched to similar patients from 2005 to 2008 (no palliative care service or NPC). Patient characteristics and outcomes included baseline demographics, comorbid conditions, do-not-resuscitate (DNR) status, laboratory parameters, medical and surgical management, length of stay, symptom relief, and disposition status. Results: A total of 19 patients were identified in the PC group. Based on the PC group baseline characteristics, 19 patients were identified for the NPC group using matched values. Regarding outcomes, there were significant differences in the medication regimens (narcotics, octreotide, and Decadron) between the 2 groups. In the PC group, 14 of 19 patients showed improvement compared to 9 of 19 in the NPC group. Nearly 60% of patients in the PC group had a formal DNR order versus 10.5% in NPC ( P = .002). A significantly higher percentage of patients were discharged to hospice in the PC group (47.4% vs 0.0%, P = .006). Conclusion: Palliative care consultation improves the quality of care for patients with stage IV cancer and bowel obstruction, with particular benefits in symptom management, end-of-life discussion, and disposition to hospice.
The Effect of Obesity on Functional Outcomes and Complications in Total Ankle Arthroplasty
Authors: Gross Christopher E. , Lampley Alexander , Green Cynthia L. , DeOrio James K. , Easley Mark , Adams Samuel , Nunley James A. 
Published: September 2015

Background: The prevalence of obesity in the United States is staggering. Currently, the effect of obesity on third-generation total ankle replacement (TAR) is unknown. Methods: We prospectively identified a consecutive series of 455 primary TARs operated between May 2007 and September 2013 who had a minimum follow-up of 2 years. We identified 266 patients with a body mass index (BMI) <30 (control), 116 with a BMI between 30 and 35 (Obese I), and 73 with a BMI >35 (Obese II). Clinical outcomes including wound issues, infection rate, complications, and failure rates were compared. Functional outcomes including American Orthopaedic Foot & Ankle Society hindfoot score, Short Form–36 (SF-36), Short Musculoskeletal Function Assessment (SMFA), Foot and Ankle Disability Index (FADI), and Foot and Ankle Outcome Score (FAOS) were compared. Average patient follow-up in the Obese I group was 44.7 ± 17.3 months, Obese II was 42.7 ± 16.4 months, and 45.2 ± 17.4 months in the control group. Results: Age, race, and smoking history in the obese group were not significantly higher than the control group; however, sex was significantly related to BMI. There was no difference in complication, infection, or failure rates between the groups. Preoperatively, the Obese II group had significantly lower SF-36 scores and higher SMFA function, FADI, and FAOS Symptoms scores. For each of the Obese I, Obese II, and control groups, all functional outcome scores 1 year postoperatively and at most recent follow-up were significantly improved. However, at most recent follow-up, Obese II patients had lower FAOS Pain and SF-36 scores and higher FADI and SMFA Functional scores. Conclusion: Total ankle arthroplasty in obese patients was a relatively safe procedure. Although obese patients after TAR had lower functional outcome scores compared to their nonobese counterpart, they did experience significant functional and pain improvements at most recent follow-up. Level of Evidence: Level III, comparative series.
Influence of two administration rates of alfaxalone at induction on its relative potency in cats: a pilot study
Authors: Bauquier Sébastien H , Warne Leon N , Carter Jennifer E , Whittem Ted , Beths Thierry 
Published: September 2015

Objectives The aim of the study was to evaluate, in a controlled, randomised, masked clinical trial, the influence of administration rate of alfaxalone at induction on its relative potency in cats and to report the incidence of cardiorespiratory adverse effects. Methods Twelve healthy female domestic cats admitted for ovariohysterectomy were premedicated with buprenorphine 20 µg/kg intramuscularly and alfaxalone 3.0 mg/kg subcutaneously. Sedation scores were established (using a published scale ranging from 1 [no sedation] to 5 [profound sedation]) prior to anaesthesia induction with alfaxalone intravenously at 2 mg/kg/min (group A2; n = 6) or 0.5 mg/kg/min (group A0.5; n = 6) to effect until orotracheal intubation was achieved. Sedation scores and alfaxalone induction doses were compared between the groups, using a Mann–Whitney exact test. Results are reported as median and range. Presence of apnoea (no breathing for more than 30 s) or hypotension (mean arterial blood pressure <60 mmHg) within 5 mins postintubation was also reported. Results Although sedation scores (1.5 [range 1.0–3.0] and 2.5 [range 1.0–3.0] for A2 and A0.5, respectively) were not significantly different ( P = 0.32), cats in group A2 required significantly more alfaxalone (4.3 mg/kg [range 3.4–7.0 mg/kg]) than group A0.5 (2.1 mg/kg [range 1.5–2.5 mg/kg]) ( P = 0.002). Two cats in each group presented postinduction apnoea, and two cats in group A2 and three cats in group A0.5 presented postinduction hypotension. Conclusions and relevance The use of a slower induction infusion rate resulted in an increase in the alfaxalone relative potency without obvious cardiorespiratory benefit.
Tele-health services for the elderly: A novel southern Italy family needs-oriented model
Authors: De Cola Maria C , De Luca Rosaria , Bramanti Alessia , Bertè Francesco , Bramanti Placido , Calabrò Rocco S 
Published: September 2015

Introduction The world population is aging. By 2050, the global population aged over 65 years will have doubled, leading to big societal challenges for ensuring healthy, independent, and productive lives for older people. Thus, innovative local and national initiatives for e-health services are growing in an attempt to overcome such problems. Methods We examined the effects of a telehealth system, i.e. tele-monitoring of vital parameters and neurological/psychological tele-counseling, within a family-centred service provided by a local day centre. We evaluated the clinical and neurobehavioral symptoms of 18 elderly patients (aged 65 years and over) and the care burden of their 20 caregivers, besides the usability of the tool. Results The one-way repeated analysis revealed a significant worsening in daily living activities ( p < 0.01 and p = 0.02, respectively for Activities of Daily Living (ADL) and Independent IADL (IADL)) versus a significant improvement of the patients' psychiatric condition ( p < 0.001), besides a significant gradual reduction of the caregivers burden ( p < 0.001). Health status perception increased through time (from an average score of 5.67 ± 1.08 at baseline to 7.72 ± 1.32 at the end of the study). Discussion It appears that a telehealth system integrated in a local health care service may significantly improve elderly persons’ behaviour, and also reduce the caregivers’ burden.
Using mobile technology to motivate adolescents with type 1 diabetes mellitus: A systematic review of recent literature
Authors: Deacon Anthony J , Edirippulige Sisira 
Published: September 2015

Introduction Behavioural interventions have been shown to improve outcomes in patients with type 1 diabetes mellitus (T1DM). There are a small number of studies that suggest text-messages (TM), native mobile applications (NMAs), and other mobile tools may be useful platforms for delivering behavioural interventions to adolescents. Aim The aim of this study was to explore, by way of a systematic review of available literature, (a) the outcomes of interventions using mobile technology for youth with T1DM and (b) what mobile technologies, functional design elements and aesthetic design elements have the best evidence to support their use. Methods A search of six online databases returned 196 unique results, of which 13 met the inclusion criteria. Results Four studies were randomised controlled trials (RCTs), and all others prospective cohort studies. TM (10) was the most common intervention technology, while NMAs were used in four studies. The most common outcome measured was HbA1c (9); however, only three studies showed a significant decrease. Similarly, the results reported for other outcome measures were mixed. The studies included in this review suggest that interventions which have data collection and clinician support functionality may be more effective in improving adherence and glycaemic control, but more evidence is needed. Further, the evidence base supporting the use of NMAs in T1DM management for adolescents is weak, with most studies adopting TM as the intervention tool. Overall, the studies lack adequate descriptions of their methodology, and better quality studies are required to inform future intervention design.
Tendon Graft Healing in Multiligament Reconstructed Knee Detected by FDG-PET/CT: A Pilot Study
Authors: Itälä A. , Alihanka S. , Kosola J. , Kemppainen J. , Ranne J. , Kajander S. 
Published: September 2015

Background and Aims: The detection of graft viability is challenging in the multiligament reconstructed knee. Magnetic resonance imaging gives structural information but lacks the capability to assess biological activity of the grafts. 18F-labeled fluorodeoxyglucose positron emission tomography combined with computer tomography is shown to be a sensitive method for imaging tissue metabolism and viability. The aim of the present study was to evaluate the feasibility of fluorodeoxyglucose positron emission tomography combined with computer tomography imaging in the detection of the replacement graft metabolism in multiligament reconstructed knees. Materials and Methods: Seven patients (17–44 years) with multiligament reconstructed knee underwent fluorodeoxyglucose positron emission tomography combined with computer tomography to evaluate the biological activity of replacement grafts. The degree of fluorodeoxyglucose uptake reported as standard uptake values from the region of interest was analyzed 3–24 months postoperatively. Results: In all patients, the fluorodeoxyglucose positron emission tomography combined with computer tomography showed increased fluorodeoxyglucose uptake in all replacement grafts at different follow-up time points. Furthermore, fluorodeoxyglucose was higher at femoral condyles of operated knees compared to contralateral reference values. Conclusion: This pilot study shows a significant increase in tendon graft metabolism during two first years of postoperative healing. The fluorodeoxyglucose positron emission tomography combined with computer tomography imaging seems to be adequate method of assessment of graft metabolism and viability during postoperative healing. The clinical value of fluorodeoxyglucose positron emission tomography combined with computer tomography imaging, however, warrants further evaluation with longitudinal studies with a larger patient population.
Tibial Fractures in Alpine Skiing and Snowboarding in Finland: A Retrospective Study on Fracture Types and Injury Mechanisms in 363 Patients
Authors: Stenroos A. , Pakarinen H. , Jalkanen J. , Mälkiä T. , Handolin L. 
Published: September 2015

Background and Aim: Alpine skiing and snowboarding share the hazards of accidents accounting for tibial fractures. The aim of this study was to evaluate the fracture patterns and mechanisms of injury of tibial fractures taking place in downhill skiing and snowboarding. Materials and methods: All patients with tibial fracture due to alpine skiing or snowboarding accident treated in four trauma centers next to the largest ski resorts in Finland were analyzed between 2006 and 2012. The hospital records were retrospectively reviewed for data collection: equipment used (skis or snowboard), age, gender, and mechanism of injury. Fractures were classified according to AO-classification. Results: There were 342 skiing and 30 snowboarding related tibial fractures in 363 patients. Tibial shaft fracture was the most common fracture among skiers (n = 215, 63%), followed by proximal tibial fractures (n = 92, 27%). Snowboarders were most likely to suffer from proximal tibial fracture (13, 43%) or tibial shaft fracture (11, 37%). Snowboarders were also more likely than skiers to suffer complex AO type C fractures (23% vs 9%, p < 0.05). Adult skiers had both wider variety of fractures and higher prevalence of proximal tibial fractures compared to children (49% vs 16%, p < 0.05). Skiers typically got injured due to falling down on the same level (70%) and snowboarders due to loss of control while jumping (46%). Conclusion: The most important finding was the relatively high number of the tibial plateau fractures among adult skiers. The fracture patterns between snowboarding and skiing were different; the most common fracture type in skiers was spiral tibial shaft fracture compared to proximal tibial fractures in snowboarders. Children had more simple fractures than adults.
Rehabilitation Charges Associated With Anterior Cruciate Ligament Reconstruction
Authors: Zhang Joanne Y. , Cohen Jeremiah R. , Yeranosian Michael G. , Lord Elizabeth L. , Wang Jeffrey C. , Petrigliano Frank A. , McAllister David R. 
Published: September 2015

Background: Pre- and postoperative rehabilitation are important to the management of patients with anterior cruciate ligament (ACL) reconstruction, but little attention has been given to the costs. This study evaluated the pre- and postoperative rehabilitation charges in patients with ACL reconstruction in the United States. Hypothesis: Patients receive preoperative rehabilitation less commonly than postoperative rehabilitation. Study Design: Retrospective database study. Level of Evidence: Level 4. Methods: Using the PearlDiver database, we identified patients undergoing ACL reconstruction from 2007 through 2011 using Current Procedural Terminology codes. The associated rehabilitation charges billed to insurance providers for 90 days preoperatively and 6 months postoperatively were categorized as physical therapy or as durable medical equipment (DME). The charges were examined by year and geographic region and represented as per-patient average charges (PPACs). Results: A total of 92,179 patients were identified in the study period. The PPAC for rehabilitation was $241 during the 90-day preoperative period and $1876 for the 6-month postoperative period. Patients averaged 2 preoperative sessions for physical therapy, with 44% of patients receiving preoperative rehabilitation in contrast with an average of 17 postoperative sessions per patient in 93% of patients. Rehabilitation charges were greater postoperatively than preoperatively ( P < 0.05). Preoperatively, 24% of patients received a DME, while 35% received a DME postoperatively. Preoperative rehabilitation PPACs were highest in the Northeast, followed by Midwest, South, and West ( P < 0.05). There were no significant differences in postoperative rehabilitation PPACs for geographic region ( P = 0.43). Conclusion: Preoperative rehabilitation charges were lower than postoperative charges. A patient undergoing ACL reconstruction typically received 9 times more sessions of postoperative physical therapy than preoperative. Clinical Relevance: This study found that preoperative supervised rehabilitation for patients with ACL reconstruction was infrequent across the United States.