bluuebunny/crossref_metadata_2025 huggingface dataset:
Agreement between self-reports, proxy-reports and the National Patient Register regarding diagnoses of cardiovascular disorders and diabetes mellitus in a population-based sample of 80-year-olds
Authors: Rydén Lina , Sigström Robert , Nilsson Johan , Sundh Valter , Falk Erhag Hanna , Kern Silke , Waern Margda , Östling Svante , Wilhelmson Katarina , Skoog Ingmar
Published: March 2019

Background

cognitive impairment is common among older adults, necessitating the use of collateral sources in epidemiological studies involving this age group. The objective of this study was to evaluate agreement between self- and proxy-reports of cardiovascular disorders and diabetes mellitus in a population-based sample of 80-year-olds. Further, both self- and proxy-reports were compared with hospital register data.

Methods

data were obtained from the Gothenburg H70 Birth Cohort Studies in Sweden. The study had a cross-sectional design and information was collected through semi-structured interviews in 2009–2012 from participants born in 1930 (N = 419) and their proxy informants. The National Patient Register provided diagnoses registered during hospital stays. Agreement was measured with Kappa values (K).

Results

agreement between self- and proxy-reports was substantial for diabetes mellitus (K = 0.79), atrial fibrillation (K = 0.61), myocardial infarction (K = 0.75), angina pectoris (K = 0.73) and hypertension (K = 0.62), and fair for intermittent claudication (K = 0.38) and heart failure (K = 0.40). Compared to the National Patient Register, a large proportion of those with a hospital discharge diagnosis were also self- and proxy-reported.

Conclusions

proxy informants can be an important source of information, at least for well-defined conditions such as myocardial infarction, angina pectoris and diabetes mellitus.
An Unpaid Debt to Society: How ‘Punishment Debt’ Affects Reintegration and Desistance From Crime in Norway
Authors: Todd-Kvam John
Published: March 2019

The Scandinavian exceptionalism literature has highlighted the relatively progressive and rehabilitative nature of imprisonment in Norway, with the Norwegian Correctional Services taking the view that those convicted of crimes have paid their debt to society at the end of their sentence. However, other parts of the Norwegian state take a more stringent view, imposing and enforcing significant and persistent debts on offenders. This article, based on official documents and interviews with Norwegian desisters and probation caseworkers, analyses how living with debt poses a major challenge for reintegration and desistance. Referred to informally as ‘punishment debt’, this pervasive but less visible aspect of Norwegian penality demonstrates the need to broaden the penal exceptionalism research agenda beyond the confines of the prison.
Screen, Ration and Churn: Demand Management and the Crisis in Children’s Social Care
Authors: Hood Rick , Goldacre Allie , Gorin Sarah , Bywaters Paul
Published: March 2019

This article presents findings from a quantitative study of the national data-sets for statutory children’s social care services in England. The aim of the study was to examine how demand management varied in local authorities with differing levels of area deprivation. About 152 local authorities census returns and other statistical indicators covering the period 2014–2017 were combined into a single data-set. Statistical analysis was undertaken to explore trends over time and correlations between indicators that might indicate patterns in the way demand was managed. Findings showed that high levels of deprivation have continued to be strongly linked to high levels of activity and that local authorities have continued to increase their use of protective interventions relative to referrals. Evidence was found for three interconnected mechanisms, through which local authorities tended to manage demand for services: screening, rationing and workforce churn. The article describes these mechanisms and comments on their significance for the current crisis of demand in the sector.
Stronger Functional Connectivity in the Default Mode and Salience Networks Is Associated With Youthful Memory in Superaging
Authors: Zhang Jiahe , Andreano Joseph M , Dickerson Bradford C , Touroutoglou Alexandra , Barrett Lisa Feldman
Published: March 2019

“Superagers” are older adults who, despite their advanced age, maintain youthful memory. Previous morphometry studies revealed multiple default mode network (DMN) and salience network (SN) regions whose cortical thickness is greater in superagers and correlates with memory performance. In this study, we examined the intrinsic functional connectivity within DMN and SN in 41 young (24.5 ± 3.6 years old) and 40 older adults (66.9 ± 5.5 years old). Superaging was defined as youthful performance on a memory recall task, the California Verbal Learning Test (CVLT). Participants underwent a resting-state functional magnetic resonance imaging (fMRI) scan and performed a separate visual–verbal recognition memory task. As predicted, within both DMN and SN, superagers had stronger connectivity compared with typical older adults and similar connectivity compared with young adults. Superagers also performed similarly to young adults and better than typical older adults on the recognition task, demonstrating youthful episodic memory that generalized across memory tasks. Stronger connectivity within each network independently predicted better performance on both the CVLT and recognition task in older adults. Variation in intrinsic connectivity explained unique variance in memory performance, above and beyond youthful neuroanatomy. These results extend our understanding of the neural basis of superaging as a model of successful aging.
Prognostic impact of lymphovascular invasion in lymph node-negative superficial esophageal squamous cell carcinoma
Authors: Oguma J , Ozawa S , Kazuno A , Yamamoto M , Ninomiya Y , Yatabe K , Makuuchi H , Ogura G
Published: March 2019

The relationship between lymphovascular invasion (LVI) and prognosis in patients with superficial esophageal squamous cell carcinoma (SESCC) is unclear. The aim of this study is to evaluate prognostic factors in patients with lymph node-negative SESCC. A total of 195 patients with pathologically confirmed T1a-MM, T1b, and lymph node-negative SESCC were retrospectively reviewed in this study. Overall, the disease-free survival (DFS) rate was poorer in the lymphatic invasion-positive group than in the lymphatic invasion-negative group (p = 0.002) and a multivariate analysis suggested that lymphatic invasion was the only independent prognostic factor of DFS in patients with lymph node-negative SESCC (HR = 4.075, p = 0.005). Distant organ recurrence occurred in one patient (1/52, 1.9%) in the T1b-SM2 group and in six patients (6/61, 9.7%) in the T1b-SM3 group; all of these patients had LVI. LVI-positive patients had a poorer DFS than invasion-negative patients in the T1b-SM2 and SM3 groups (p = 0.026), and a multivariate analysis suggested that LVI was the only independent prognostic factor of DFS in patients with lymph node-negative SM2 and SM3 SESCC (HR = 5.165, p = 0.031). Lymph node-positive patients had a significantly poorer DFS rate than lymph node negative and LVI positive patients among the SM2 and SM3 SESCC patients (p = 0.018). The present results suggested that LVI was an independent prognostic factor in patients with SM2 and SM3 lymph node-negative SESCC; however their prognosis was not worse than that of patients with lymph node-positive SM2 and SM3 SESCC, for whom adjuvant therapy is indicated as a standard treatment.
Heparin dosing in uninterrupted anticoagulation with dabigatran vs. warfarin in atrial fibrillation ablation: RE-CIRCUIT study
Authors: Calkins Hugh , Willems Stephan , Verma Atul , Schilling Richard , Hohnloser Stefan H , Okumura Ken , Nordaby Matias , Kleine Eva , Bis Branislav , Gerstenfeld Edward P
Published: March 2019

Aims

To describe heparin dosing requirements in patients who underwent catheter ablation of atrial fibrillation with uninterrupted anticoagulation using dabigatran etexilate (dabigatran) or warfarin to attain therapeutic activated clotting time (ACT) in the RE-CIRCUIT® study. The RE-CIRCUIT study showed significantly fewer major bleeding events in the dabigatran vs. warfarin treatment group. Unfractionated heparin was administered during the procedure to maintain ACT >300 s.

Methods and results

Patients were randomly assigned to dabigatran 150 mg bid or international normalized ratio-adjusted warfarin. Ablation was performed with uninterrupted anticoagulation and continued for 8 weeks after the procedure. Heparin was administered after placement of femoral sheaths before or immediately after transseptal puncture. Ablation was performed in 635 patients (dabigatran, 317; warfarin, 318); data were available from 396 patients administered heparin (dabigatran, 191; warfarin, 205). Most frequent time window from last dose of study drug to septal puncture was 0 to <4 h in the dabigatran (41.3%) and 16 to <24 h in the warfarin arms (44.7%). Overall mean (standard deviation) heparin dose was similar between the dabigatran and warfarin groups [12 402 (10 721) vs. 11 910 (8359) IU, respectively]. Heparin dosing requirement to reach therapeutic ACT was lowest when time from last dose of dabigatran to septal puncture was 0 to <4 h.

Conclusion

Patients treated with dabigatran required a similar amount of unfractionated heparin as those treated with warfarin to achieve an ACT of >300 s during ablation. More heparin units were required when the time from the last dose of dabigatran to septal puncture increased.
Socioeconomic Status and Parenting Style From Childhood: Long-Term Effects on Cognitive Function in Middle and Later Adulthood
Authors: Liu Yujun , Lachman Margie E
Published: March 2019

Objectives

This study assesses whether childhood socioeconomic status (SES) is related to cognitive function and cognitive change at mid and later life and explores the buffering effects of parenting style and adulthood SES.

Method

Data were derived from the 3 waves of the Midlife in the United States (MIDUS) study, a national survey including 7,108 participants aged from 24 to 75 years at baseline. We used multiple regression and multilevel models to investigate the associations between childhood SES, adulthood SES, and cognitive performance and change at midlife and the role of parents’ affection and discipline.

Results

Low childhood SES was associated with lower cognitive function and more cognitive decline at mid and later life. Adulthood SES moderated the effect of childhood SES on cognitive function. Interactions showed that paternal discipline was positively related to cognitive function among participants with low childhood SES, and negatively related to cognitive function among participants with high childhood SES. High paternal affection was associated with less cognitive decline at mid and later life.

Discussion

The findings advance the understanding of the long-term consequences of SES and psychosocial factors in early life that can lead to optimal cognitive function in middle and old age.
Effect of light-emitting diodes (LEDs) on snow crab catch rates in the Barents Sea pot fishery
Authors: Nguyen Khanh Q , Humborstad Odd-Børre , Løkkeborg Svein , Winger Paul D , Bayse Shannon M
Published: March 2019

Snow crab (Chionoecetes opilio) has become an important species for the Norwegian seafood industry since its first commercial harvest in 2012. However, periodically catch rates can be low, causing a financial strain on the fishery. Thus, improving the catch rate of existing pot designs has the potential to significantly improve the profitability of fishing enterprises. In this study, we investigated whether the addition of low-powered purple and white light-emitting diode (LED) fishing lights inside the pots could improve catch rates of snow crab in the Barents Sea. Results showed that pots with purple lights harvested a 12.8% higher catch per unit effort (CPUE; number of crab per pot) of legal-sized crab, which was significantly more than the control pots (p = 0.035); pots with white lights did not catch significantly more crab (p > 0.05). Pots equipped with only light (no bait) caught very few crabs and were not considered a viable alternative. Although purple LEDs increased snow crab capture, the economic benefits of using underwater lights in pots remains unclear given the high capital investment required.
The Loewner Energy of Loops and Regularity of Driving Functions
Authors: Rohde Steffen , Wang Yilin
Published: March 2019

Loewner driving functions encode simple curves in 2D simply connected domains by real-valued functions. We prove that the Loewner driving function of a $C^{1,\beta }$ curve (differentiable parametrization with $\beta$-Hölder continuous derivative) is in the class $C^{1,\beta -1/2}$ if $1/2<\beta \leq 1$, and in the class $C^{0,\beta + 1/2}$ if $0 \leq \beta \leq 1/2$. This is the converse of a result of Carto Wong [26] and is optimal. We also introduce the Loewner energy of a rooted planar loop and use our regularity result to show the independence of this energy from the basepoint.
Autoimmunity and immunological tolerance in autoimmune bullous diseases
Authors: Takahashi Hayato , Iriki Hisato , Mukai Miho , Kamata Aki , Nomura Hisashi , Yamagami Jun , Amagai Masayuki
Published: March 2019

Autoimmune diseases are devastating conditions in which the immune system is directed against the host, leading to life-threatening destruction of organs. Although autoantigens are ill-defined in most autoimmune diseases, this is not the case in the skin. Autoimmune bullous diseases have been extensively studied with detailed characterization of autoantigens, the epitopes that are targeted, and the mechanisms of action that mediate autoimmune tissue destruction. Pemphigus is an autoimmune bullous disease caused by circulating IgG that targets two desmosomal proteins, desmoglein 1 and 3, which are crucial for cell–cell adhesion of keratinocytes. Binding of auto-antibodies to desmogleins impairs keratinocyte adhesion, leading to severe blistering disease. Mouse models that recapitulate the human disease have been instrumental in elucidating the detailed pathophysiology. Taking advantage of the fact that desmogleins are specifically targeted in pemphigus, studying humoral and cellular autoimmunity against these autoantigens provides us with an opportunity to understand not only the effector mechanisms of B and T cells in mediating pathology but also how autoreactive lymphocytes are regulated during development in the thymus and post-development in the periphery. This review introduces pemphigus and its subtypes as prototypic autoimmune diseases from which recent basic and translational developments should provide insight into how autoimmunity develops.
Investigating the Impact of Adding Plan Reminders on Implementation Intentions to Support Behaviour Change
Authors: Wicaksono Adhi , Hendley Robert , Beale Russell
Published: March 2019

The use of reminders in habit-formation apps could lead to dependency towards the reminders and hinder the automaticity of the behaviour. Implementation intentions (if–then plan) have been found to be an effective technique that can be used to support forming new habits/breaking unwanted habits. However, implementation intentions could suffer due to forgetfulness and lack of strong intention. In this study, we investigated how adding plan reminders could impact implementation intentions by conducting a 4-week study on daily mood report task. Our findings suggest that adding plan reminders leads to better compliance and better recall of the plan but not necessarily increased automaticity. We also discuss how plan reminders of implementation intentions can be improved.

RESEARCH HIGHLIGHTS

Implementation intentions are specific action planning that have been found to be powerful in supporting behaviour change by helping someone to break unwanted habits or form new habits. Implementation intentions could have a weak effect when there is no strong motivation to perform the intended behaviour. Existing habit formation/behaviour change apps focus on using reminders. This could lead to dependency towards the reminder. We propose an alternative approach by sending specific reminders of implementation intention (plan reminders) in advance before the actual action happens. Adding plan reminders on implementation intentions leads to better compliance, however, it is not necessarily the same in term of automaticity.
Purpose
Authors: Kakoullis Emily , Ikehara Yoshikazu
Published: March 2019

This chapter examines Article 1 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The article sets out the purpose of the CRPD and describes its target group. It enshrines a ‘paradigm shift’ in approach to the concept of ‘disability’ in international human rights law: a shift from an approach underpinned by a ‘medical model of disability’ that views persons with disabilities as ‘objects’ of medical treatment and in need of charity; to a ‘social model of disability’, which views persons with disabilities as ‘subjects’ with rights and focuses on the barriers persons with disabilities face that may hinder their societal participation.
Equality and Non-Discrimination
Authors: Corsi Jessica Lynn
Published: March 2019

This chapter examines Article 5 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which sets out the concepts of equality and non-discrimination. It explores the myriad advances embodied in Article 5 and analyses the legal import of each paragraph. It also considers the potential challenges to implementing Article 5, including clashes between the CRPD Committee’s interpretation and that of states parties, and conflicts between equality rights, such as the right to abortion and arguments that non-discrimination under the CRPD requires bans on aborting disabled foetuses. What emerges is a picture of equality and non-discrimination born of ‘a three-dimensional view of the reality of life as a person with a disability’.
Accessibility
Authors: Lawson Anna
Published: March 2019

This chapter examines Article 9 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which articulates rights to accessibility. The chapter is divided into three main sections in addition to the introduction. The first of these focuses on the Ad Hoc Committee debates that shaped Article 9. This will be organized thematically under four distinct headings so as to facilitate analysis of key recurring issues. The second and third sections deal with the current text of Article 9 (paragraphs 9(1) and 9(2) respectively), its implications, and the way in which it has been understood and applied, particularly by the CRPD Committee. Cross-cutting themes will be highlighted throughout as will any relevant domestic case law.
Equal Recognition before the Law
Authors: Nilsson Anna , Series Lucy
Published: March 2019

This chapter examines Article 12 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Article 12 of the CRPD is concerned with how legal systems enable and disable people as legal actors. In the view of the UN Committee on the Rights of Persons with Disabilities and many of those involved in negotiating Article 12, it introduces a new paradigm of ‘universal legal capacity’ that cannot be limited on grounds of disability or mental incapacity. The Committee maintains that this requires the abolition of all forms of substitute decision-making. This interpretation of Article 12 is contested in the literature, but for many involved in the disability movement, ending guardianship and other forms of substitute decision-making is central to wider advocacy goals of ending institutionalization, forced treatment, and loss of fundamental citizenship rights such as the ability to vote, marry, and own property.
Protection against Torture and Cruel or Inhuman or Degrading Treatment or Punishment
Authors: Fennell Phil
Published: March 2019

This chapter examines Article 15 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which prohibits torture and cruel, inhuman, or degrading treatment or punishment (CIDTP), irrespective of the circumstances and the victim’s behaviour. Article 15 rights overlap with rights under other CRPD articles, including the right to legal capacity on an equal basis with others under Article 12; the right to liberty and security under Article 14; the right to protection against violence, exploitation and abuse under Article 16; the right to physical and mental integrity under Article 17 and; the right to health care on an equal basis with others and based on informed consent under Article 25.
Liberty of Movement and Nationality
Authors: Mute Lawrence
Published: March 2019

This chapter examines Article 18 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which establishes the rights of persons with disabilities to liberty of movement, residence, as well as to a nationality. These rights are cardinal to the full realization of the CRPD and play critical twin roles. Firstly, they establish actionable distinct rights while, secondly, they play indispensable facilitative functions for enabling persons with disabilities to have full and equal enjoyment of all human rights and fundamental freedoms. The chapter explains the principles and norms that informed the drafting of Article 18. It discusses the specific meanings of the various elements of the article. It also assesses how international and domestic jurisdictions have begun to interpret Article 18.
Personal Mobility
Authors: Kovudhikulrungsri Lalin , Hendriks Aart
Published: March 2019

This chapter examines Article 20 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Personal mobility is a prerequisite for inclusion in a society. According to the European Court of Human Rights, to be mobile and to have access to transport, housing, cultural activities, and leisure is a precondition for the ‘right to establish and develop relations with other human beings’, ‘in professional or business contexts as in others’. The CRPD does not establish new rights for persons with disabilities. It is merely thought to identify specific actions that states and others must take to ensure the effectiveness and inclusiveness of all human rights and to protect against discrimination on the basis of disability. However, the fact that there is no equivalent of the right to personal mobility in any other human rights treaty makes it particularly interesting to examine the genesis and meaning of this provision.
Reports by States Parties
Authors: Kanter Arlene
Published: March 2019

This chapter examines Article 35 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD), which sets out the requirements for reporting by states parties to the CRPD Committee. It begins with an overview of the background and travaux préparatoires of Article 35. Although the reporting requirements were discussed at several sessions of the Ad Hoc Committee, it was not until the sixth session, in August of 2005, when the Committee considered the substantive proposals related to Article 35. The following sections of the chapter discuss each paragraph of Article 35, including what constitutes a ‘comprehensive’ country report, as required under Article 35(4). The final section compares the language of Article 35 with the reporting requirements of other human rights treaties, followed by a conclusion.
The Secretary-General of the United Nations Shall Be the Depositary of the Present Convention
Authors: Bantekas Ilias
Published: March 2019

This chapter examines Article 41 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). In accordance with article 76(1) of the Vienna Convention on the Law of Treaties, the designation of the depositary of a treaty may be made by the negotiating states, either in the treaty itself or in some other manner. Practice, as is the case with Article 41 CRPD, suggests that depositories are designated in the body of the treaty. The depositary is expected to undertake certain functions and assume several powers under customary international law, none of which are explained in the depositary provisions of multilateral treaties. The functions and powers of the depositary should be distinguished from other functions and powers entrusted to the same entity under other provisions of the same treaty.
Accessible Format
Authors: Varney Eliza
Published: March 2019

This chapter examines Article 49 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). The importance of Article 49 CRPD is threefold. Firstly, it facilitates the dissemination of the CRPD by requiring that the Convention be made available in accessible formats. Secondly, this provision has the potential to set a benchmark for the accessibility of the CRPD text, but also of CRPD-related materials, such as CRPD educational materials. Thirdly, the impact of this article has the potential to go beyond the CRPD and in the development of an accessibility standard for all treaties. The chapter explores these issues in more depth. It also discusses the connection between Article 49 CRPD and other provisions of the Convention, including Article 8 (awareness-raising), Article 9 (accessibility), Article 21 (freedom of expression and opinion and access to information), Article 24 (education), Article 29 (participation in political and public life), and Article 33 (national implementation and monitoring).
Evaluating a Real World Ban on Menthol Cigarettes: An Interrupted Time-Series Analysis of Sales
Authors: Chaiton Michael , Schwartz Robert , Shuldiner Jennifer , Tremblay Gabrielle , Nugent Robert
Published: March 2019

Background

Menthol in cigarettes has been shown to increase regular cigarette smoking and nicotine dependence, and decrease success in smoking cessation. Owing to these reasons, in May 2015, the province of Ontario introduced a menthol ban on tobacco products that came into effect in January 2017 prior to a Federal Canadian Ban in October 2017. The objective of this article was to assess the effect of a provincial menthol ban on cigarette wholesale sales in Ontario.

Methods

Wholesale data submitted by tobacco manufacturers to Health Canada pursuant to the federal Tobacco Reporting Regulations from October 2012 to September 2017 were analyzed using interrupted time-series analysis. Changes in sales of cigarettes with and without menthol were estimated, using the province of British Columbia as a comparison. Analyses were seasonally adjusted.

Results

Sales of menthol and nonmenthol cigarettes increased from 2013 until the implementation of the 2017 provincial ban. Subsequently, a sharp decline of 55 million menthol cigarettes and 128 million total cigarettes was observed in Ontario. As a comparison, no significant changes were observed in British Columbia.

Conclusion

This study supports the conclusion that implementation of a menthol ban in Ontario was associated with significant reduction of menthol cigarette sales and total cigarettes sales, compared to British Columbia where there was no provincial menthol ban. This suggests that menthol regulations in jurisdictions with a larger percentage of menthol smokers are likely to be highly effective.

Implications

The 2017 menthol ban was associated with significant reduction of menthol cigarette sales and total cigarette sales suggesting that menthol regulations will have important effects on cigarette consumption.
Pharmacokinetic Profile of Spectrum Reduced Nicotine Cigarettes
Authors: Kamens Helen M , Silva Constanza P , Nye Russell T , Miller Carley N , Singh Nayantara , Sipko Joseph , Trushin Neil , Sun Dongxiao , Branstetter Steven A , Muscat Joshua E , Richie John P , Foulds Jonathan
Published: March 2019

Introduction

Spectrum research cigarettes have been developed with varying nicotine content for use in studies evaluating the effects of a regulatory policy reducing the permissible nicotine content in cigarettes. This study aimed to characterize the nicotine pharmacokinetic profile of Spectrum cigarettes.

Methods

Twelve daily smokers attended four sessions and had blood nicotine, exhaled carbon monoxide, and subjective effects measured before and after smoking either a single cigarette of their preferred brand or high (10.9 mg/cigarette), medium (3.2 mg/cigarette), or low (0.2 mg/cigarette) nicotine content Spectrum research cigarettes, in a double-blind design with order counterbalanced.

Results

The boost in blood nicotine concentration was dose-dependent, with a boost of 0.3, 3.9, and 17.3 ng/mL for low-, medium-, and high-nicotine content Spectrum cigarettes. The high dose Spectrum had a similar nicotine boost to the “preferred brand” cigarettes (19 ng/mL). Subjects took longer puffs on the low nicotine cigarettes, but smoked these cigarettes faster than other cigarette types. High nicotine Spectrum cigarettes reduced the urge to smoke more than other cigarette types.

Conclusions

This study shows that Spectrum research cigarettes produce blood nicotine absorption in a dose-dependent manner, and therefore, are appropriate for use in studies of nicotine reduction in cigarettes.

Implications

This is the first study to determine the pharmacokinetic profile of Spectrum reduced nicotine content research cigarettes following an overnight abstinence. These data could provide evidence to regulatory agencies about the effects of reduced nicotine cigarettes when considering regulations on tobacco reduction.
FOREST Unbiased Galactic Plane Imaging Survey with the Nobeyama 45 m telescope (FUGIN). V. Dense gas mass fraction of molecular gas in the Galactic plane
Authors: Torii Kazufumi , Fujita Shinji , Nishimura Atsushi , Tokuda Kazuki , Kohno Mikito , Tachihara Kengo , Inutsuka Shu-ichiro , Matsuo Mitsuhiro , Kuriki Mika , Tsuda Yuya , Minamidani Tetsuhiro , Umemoto Tomofumi , Kuno Nario , Miyamoto Yusuke
Published: March 2019

Recent observations of the nearby Galactic molecular clouds indicate that the dense gas in molecular clouds has quasi-universal properties on star formation, and observational studies of extra-galaxies have shown a galactic-scale correlation between the star formation rate (SFR) and the surface density of molecular gas. To reach a comprehensive understanding of both properties, it is important to quantify the fractional mass of dense gas in molecular clouds, fDG. In particular, for the Milky Way (MW) there are no previous studies resolving fDG disk over a scale of several kpc. In this study, fDG was measured over 5 kpc in the first quadrant of the MW, based on the CO J = 1–0 data in l = 10°–50° obtained as part of the FOREST Unbiased Galactic plane Imaging survey with the Nobeyama 45 m telescope (FUGIN) project. The total molecular mass was measured using 12CO, and the dense gas mass was estimated using C18O. The fractional masses, including fDG, in the region within ±30% of the distances to the tangential points of the Galactic rotation (e.g., the Galactic Bar, Far-3 kpc Arm, Norma Arm, Scutum Arm, Sagittarius Arm, and inter-arm regions) were measured. As a result, an averaged fDG of $2.9^{+2.6}_{-2.6}$% was obtained for the entirety of the target region. This low value suggests that dense gas formation is the primary factor in inefficient star formation in galaxies. It was also found that fDG shows large variations depending on the structures in the MW disk. In the Galactic arms, fDG was estimated to be ∼4%–5%, while in the bar and inter-arm regions it was as small as ∼0.1%–0.4%. These results indicate that the formation/destruction processes of the dense gas and their timescales are different for different regions in the MW, leading to differences in Star formation efficiencies.
A Brief Mindfulness Intervention for Medically Hospitalized Patients with Acute Pain: A Pilot Randomized Clinical Trial
Authors: Miller-Matero Lisa R , Coleman Joseph P , Smith-Mason Christine E , Moore David A , Marszalek Deanna , Ahmedani Brian K
Published: March 2019

Objective. Mindfulness interventions may be beneficial for patients with chronic pain; however, the effects for acute pain are not understood. The purpose of this study was to pilot test a brief mindfulness intervention for acute pain and stress for patients in an inpatient medical setting. Design. Pilot randomized clinical trial. Setting. An inpatient Acute Care Surgery service at an urban hospital. Subjects. Sixty patients with acute pain were randomly selected and agreed to participate. Methods. Interested patients consented to the study and were randomized to the 10-minute intervention (i.e., mindfulness strategy) or comparison group (i.e., education on the Gate Control Theory of Pain). Participants completed pre- and post-assessment measures on pain severity and stress. Results. Preliminary results showed that within the intervention and comparison groups, participants experienced decreases in pain from pre- to post-intervention (P = 0.002 and 0.005, respectively). Within the intervention group, there was a significant decrease in stress from pre- to post-intervention (P = 0.001). There were no significant changes for stress within the comparison group (P = 0.32). There were no significant differences between the intervention and comparison groups for pain (P = 0.44) or stress (P = 0.07) at post-intervention, although Cohen’s d effect sizes were small to medium for pain and stress, respectively. Conclusions. A brief mindfulness intervention for medically hospitalized patients with acute pain may decrease pain and stress. Future research should examine this intervention with a fully powered, larger sample to examine efficacy.
People With Aneurysmal Subarachnoid Hemorrhage Have Low Physical Fitness and Can Be Predisposed to Inactive and Sedentary Lifestyles
Authors: Harmsen Wouter J , Khajeh Ladbon , Ribbers Gerard M , Heijenbrok-Kal Majanka H , Sneekes Emiel , van Kooten Fop , Neggers Sebastian , van den Berg-Emons Rita J
Published: March 2019

Background

Physical inactivity, sedentary lifestyles, and low functional outcome are thought to impact the level of physical fitness in patients with aneurysmal subarachnoid hemorrhage (a-SAH). However, changes in fitness over time and associated factors have not been studied in a-SAH.

Objective

The objective was to evaluate the level of physical fitness in the first year after a-SAH and explore longitudinal relations with physical activity, sedentary behavior, and functional outcome. Additionally, we evaluated whether physical fitness could be predicted by disease-related characteristics (ie, severity of a-SAH, location of the aneurysm, treatment procedure, pituitary dysfunction, and complications).

Design

This was a prospective 1-year follow-up study.

Methods

Fifty-two participants performed exercise testing at 6 and 12 months after a-SAH. Cardiopulmonary exercise testing and isokinetic dynamometry were applied to determine the peak oxygen uptake $({\rm{\dot{V}}}{{\rm{o}}_{2{\rm{peak}}}})$ and the peak torque of the knee extensors (PText) and flexors (PTflex). In addition, physical activity and sedentary behavior were evaluated by accelerometer-based activity monitoring. The functional outcome was assessed by the Functional Independence Measure and Functional Assessment Measure. Disease-related characteristics were collected at hospital intake.

Results

At both 6 and 12 months, all fitness parameters were lower compared with predicted values (ranging from 18% to 28%). Physical activity is related to both ${\rm{\dot{V}}}{{\rm{o}}_{{\rm{2peak}}}}$ and PTflex. The Functional Independence Measure and Functional Assessment Measure scores was related to PText and PTflex. Further, participants who underwent surgical clipping had lower ${\rm{\dot{V}}}{{\rm{o}}_{{\rm{2peak}}}}$ and PTflex.

Limitations

Longitudinal observations cannot confirm causality.

Conclusions

Levels of physical fitness remain low over the first year after a-SAH. Participants who were physically more active had higher levels of physical fitness, whereas participants with impaired functional outcome or who were treated with surgical clipping were at risk of low physical fitness. Exercise interventions are warranted and should focus on the promotion of physical activity and target patients with impaired functional outcome or those who have been treated with surgical clipping.
MAGNETO-THERAPY IN PHYSIOTHERAPY UNITS: INTRODUCTION OF QUALITY CONTROL PROCEDURE DUE TO LACK OF MAINTENANCE
Authors: Koutsojannis Constantinos , Andrikopoulos Andreas , Seimenis Ioannis , Adamopoulos Adam
Published: March 2019

Rehabilitation practice for many patients consisting of a combined use of magneto therapy resulting emission of low frequency magnetic fields to the patient, elicit concerns about occupational exposure to electromagnetic radiation (EMR) for the operators. The time extended use of the device periodically leads to mechanical failures or troubleshooting of the machine which, in most cases, are not perceived by the operator of the device. All device’s efficient functionality have a major impact on the completion of the treatment procedure in a large percentage of specific clinical conditions. If the device’s operating condition is technically out of order or in a mode of over-activity, operators are mainly seeking solutions by reviewing the clinical case of the patient. This eliminates their contribution during the primary therapeutic plan or increases the treatment sessions. In this work, an extended survey is presented including 75 physiotherapy centres concerning usability and maintenance issues of magneto therapy devices throughout Greek territory combined with extended measurements of Electromagnetic Radiation in the unit room were performed. Physiotherapists’ perceptions revealed lack of technical support, maintenance and safe use of magneto therapy devices that extract auxiliary observations upon their clinical practice routines. Additionally safety measurements have not revealed field strengths over International Reference Levels which could result health risks for users and coexisting patients. The pilot survey that conducted in Attica and Western Greece confirms that magnetic fields strength that are measured are in accordance with the statutory legislation but will, at the same time, revealed lack of maintenance of the devices. Deficiency in topics such as proper equipment function will necessitate the creation of quality safety protocols, concerning the use of magneto-therapy, with the main aim the improvement of treatment procedures for the higher performance of therapeutic rehabilitation services to patients. Finally in this work, the proposal of a QC protocol for magnetotherapy devices is proposed for evaluation.
‘You Can’t Dismiss that as Being Less Happy, You See it is Different’. Sexual Counselling in 1950s England
Authors: Rusterholz Caroline
Published: March 2019

This article uses the audio recordings of sexual counselling sessions carried out by Dr Joan Malleson, a birth control activist and committed family planning doctor in the early 1950s, which are held at the Wellcome Library in London as a case study to explore the ways Malleson and the patients mobilised emotions for respectively managing sexual problems and expressing what they understood as constituting a ‘good sexuality’ in postwar Britain. The article contains two interrelated arguments. First, it argues that Malleson used a psychological framework to inform her clinical work. She resorted to an emotion-based therapy that linked sexual difficulties with unconscious, repressed feelings rooted in past events. In so doing, Malleson actively helped to produce a new form of sexual subjectivity where individuals were encouraged to express their feelings and emotions, breaking with the traditional culture of emotional control and restraint that characterized British society up until the fifties. Second, I argue that not only Malleson but also her patients relied on emotions. The performance of mainly negative emotions reveals what they perceived as the ‘normal’ and sexual ‘ideal’. Sexual therapy sessions reflected the seemingly changing nature of the self towards a more emotionally aware and open one that adopted both the language of emotions and that of popular psychology to articulate his or her sexual difficulties.
Clinical outcomes related to molecular allergy diagnosis
Authors: Melioli Giovanni , Puggioni Francesca , Racca Francesca , Descalzi Desideria , Canonica Giorgio Walter , Heffler Enrico
Published: March 2019

Purpose of review

Aim of this review is the description of the medical conditions in which the support of molecular allergy diagnostics (MAD) has an impact on the clinical outcomes, such as laboratory diagnostics, prognosis, and therapy of allergic diseases.

Recent findings

The review of the literature of the last 2 years generated a wide number of results on this topic. As expected, not all were obtained by the use of MAD, but, in general, a clear trend is evident.

Within the large number of works available, laboratory allergy diagnostics seems to be the most frequently discussed topic, in particular considering the complexity of the biological environment where these assays are used. Some interesting news arrive from the prognostic potential of MAD, whereas for allergen immunotherapy, waiting for a well-conducted prospective randomized clinical study, data from retrospective studies still confirms the added values of MAD in the management of the allergic patients.
An Electronic Medical Record Training Conversion for Onboarding Inpatient Nurses
Authors: Smailes Paula S. , Zurmehly Joyce , Schubert Carolyn , Loversidge Jacqueline M. , Sinnott Loraine T.
Published: March 2019

In recent times, policies stemming from the American Recovery and Reinvestment Act of 2009 have served as a stimulus for healthcare organizations to adopt an electronic medical record. As a result, nurses are now more knowledgeable of and experienced with an electronic medical record. In August 2016, our facility converted from instructor-led training to electronic learning for inpatient nurse electronic medical record training, hoping to capitalize on previous experience with the clinical information system. However, a complete program evaluation of this transition had yet to be conducted. The purpose of this study was to evaluate electronic learning usability and the return on investment of an electronic medical record training conversion. Evaluations of electronic medical record electronic learning training were collected from 75 newly hired, inpatient nurses from November and December 2017, and compared to our instructor-led program. Results showed that users found it effective and were satisfied with this training method. The electronic learning had superior efficiency, reducing training time by ~50% compared to instructor-led training, while proving to yield effectiveness and satisfaction. The return on investment was $18 540, with a gain of 593.25 hours in nursing time during the study period of two months. These results support the organizational decision to convert to electronic learning, further supporting the conversion for other clinical roles.
Dose-response Analysis in the Presence of Shared and Unshared Uncertainties of the Dose Values
Authors: Hofer Eduard
Published: March 2019

The dose values used in dose-response analyses are often the result of a computer model. Epistemic uncertainties of the model application make it necessary to perform an uncertainty analysis. Such uncertainties are model parameters, model formulations, and input data subject to either classical or Berkson additive or multiplicative measurement error. Epistemic uncertainties are often shared among the computed dose values of all individuals in a cohort or among groups thereof. The effect of these uncertainties on the estimate of the dose-response parameter in least-squares linear regression is difficult to judge. Additive classical error is known to bias the estimate towards lower values (attenuation). The method suggested in this paper is applicable in situations where any combination of uncertainties mentioned above is involved. All it requires is a random sample of dose vectors taken from their joint subjective probability distribution. Such a sample is the output of a Monte Carlo uncertainty analysis of the model application. The covariance matrix of the vectors is used in the computation of correction factors that are possibly true, given the dose vector used in the estimation of the dose-response parameter. The efficiency of the method is demonstrated with five cases. They differ by the combination of uncertainties involved in the uncertainty analysis of a small illustrative dose reconstruction model.
MACULAR CAPILLARY DROPOUT IN FAMILIAL EXUDATIVE VITREORETINOPATHY AND ITS RELATIONSHIP WITH VISUAL ACUITY AND DISEASE PROGRESSION
Authors: Zhang Juan , Jiang Chen , Ruan Lu , Yang Qian , Chang Qing , Huang Xin
Published: March 2019

Purpose:

To quantitatively detect the macular microvascular alterations of eyes with familial exudative vitreoretinopathy (FEVR) and analyze their associations with the severity and visual acuity of FEVR.

Methods:

A case–control study comprising 62 patients (62 eyes) with FEVR and 21 age-matched healthy individuals (21 eyes) with normal vision was conducted. Parafoveal vascular density (VD) was measured using optical coherence tomography angiography. Visual acuity, intraocular pressure, and axial length were recorded.

Results:

Parafoveal VD of eyes with FEVR was lower than that of the controls (P < 0.05). Parafoveal VD decreased with increasing FEVR stages (P < 0.05), and decreased VD in superficial capillary plexus (SCP) was independently correlated with FEVR severity (odds ratio: 1.558, P < 0.001) after controlling for other confounding variables. Vascular density in eyes with FEVR and decreased visual acuity was lower than eyes with FEVR and normal visual acuity (SCP, P < 0.001; deep capillary plexus, P = 0.001). Moreover, VD loss had independent association with visual loss in FEVR (SCP: odds ratio: 0.817, P = 0.019; deep capillary plexus: odds ratio: 0.763, P = 0.016).

Conclusion:

There may be parafoveal microvascular defects in FEVR and that VD loss in SCP may be correlated with the severity of FEVR. In addition, VD loss in SCP and deep capillary plexus may be associated with the visual loss in FEVR.
NOD-like receptor protein 3 inflammasome drives postoperative mechanical pain in a sex-dependent manner
Authors: Cowie Ashley M. , Menzel Anthony D. , O'Hara Crystal , Lawlor Michael W. , Stucky Cheryl L.
Published: March 2019

Postoperative pain management continues to be suboptimal because of the lack of effective nonopioid therapies and absence of understanding of sex-driven differences. Here, we asked how the NLRP3 inflammasome contributes to postoperative pain. Inflammasomes are mediators of the innate immune system that are responsible for activation and secretion of IL-1β upon stimulation by specific molecular signals. Peripheral IL-1β is known to contribute to the mechanical sensitization induced by surgical incision. However, it is not known which inflammasome mediates the IL-1β release after surgical incision. Among the 9 known inflammasomes, the NLRP3 inflammasome is ideally positioned to drive postoperative pain through IL-1β production because NLRP3 can be activated by factors that are released by incision. Here, we show that male mice that lack NLRP3 (NLRP3KO) recover from surgery-induced behavioral and neuronal mechanical sensitization faster and display less surgical site inflammation than mice expressing NLRP3 (wild-type). By contrast, female NLRP3KO mice exhibit minimal attenuation of the postoperative mechanical hypersensitivity and no change in postoperative inflammation compared with wild-type controls. Sensory neuron-specific deletion of NLRP3 revealed that in males, NLRP3 expressed in non-neuronal cells and potentially sensory neurons drives postoperative pain. However, in females, only the NLRP3 that may be expressed in sensory neurons contributes to postoperative pain where the non-neuronal cell contribution is NLRP3 independent. This is the first evidence of a key role for NLRP3 in postoperative pain and reveals immune-mediated sex differences in postoperative pain.