bluuebunny/crossref_metadata_2025 huggingface dataset:
Post pulmonary embolism syndrome: a common, underdiagnosed complication that is not well recognised
Authors: Sanders Alexander , Matonhodze Max
Published: February 2019

A 56-year-old man developed chronic breathlessness which persisted for years after he suffered acute pulmonary embolism (PE) despite all investigations being subsequently normal. This case illustrates a very common complication which occurs in up to half of all patients after an acute PE which has been labelled ‘post pulmonary embolism syndrome’, yet it is not well recognised and at present there is not much research into the prevention or even possible treatment options for patients who develop these symptoms.
Oesophageal atresia with tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease: outcome of a rare phenotype
Authors: Santos Liliana Pimenta , Coimbra Diana , Cunha Catarina , Lopes Maria Francelina
Published: February 2019

Oesophageal atresia with or without tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease are surgical malformations of the gastrointestinal tract typically diagnosed early in the neonatal period and varying in severity and prognosis. This report describes a full-term male newborn presenting simultaneous oesophageal atresia with distal tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease. In addition to the complex types of gastrointestinal malformations involved, the combination of ileal atresia and Hirschsprung’s disease, as well as ganglion cells distal to intestinal atresia, resulted in a challenging diagnosis. Despite a successful outcome, the patient presented increased morbidity and prolonged hospitalisation. We highlight some important findings that may aid the early diagnosis of Hirschsprung’s disease in this clinical setting. To our knowledge, the association of oesophageal atresia/tracheo-oesophageal fistula, ileal atresia and Hirschsprung’s disease has not been previously reported.
Stroke in a young man: a late complication of radiation therapy
Authors: Jiang Zhaozhi , Elkind Mitchell , Lucky Matthew , Fekete Zoltan
Published: February 2019

This 37-year-old man presented with left sided facial warmth and numbness associated with new sudden-onset right hemiparesis. The patient first developed sudden numbness of his left lip and warmth in left ear which travelled to the rest of left face. His past medical history was significant for hypertension, Hodgkin lymphoma treated with radiation therapy at the age of 10, and sleeve gastrectomy for obesity 1 year ago complicated by bilateral ischaemic cerebral infarctions with residual left hemiparesis. No acute infarcts were found on MRI. Transesophageal echocardiography revealed a complex atheroma near the sinotubular junction in ascending aorta.
Optical coherence tomography angiography findings in fellow eyes of choroidal neovascularisation associated with central serous chorioretinopathy
Authors: Mandadi Spoorti Krishna Reddy , Singh Sumit Randhir , Sahoo Niroj Kumar , Mishra Sai Bhakti , Sacconi Riccardo , Iovino Claudio , Berger Lieselotte , Munk Marion R , Querques Giuseppe , Peiretti Enrico , Chhablani Jay
Published: February 2019

Aim

To evaluate the optical coherence tomography angiography (OCTA) features of fellow eyes of patients with unilateral choroidal neovascularisation (CNV) associated with chronic central serous chorioretinopathy (CSCR).

Methods

Medical records of patients with chronic CSCR who had undergone OCT angiography of both the eyes were reviewed. Patients with evidence of unilateral CNV detected by conventional imaging (OCT, fluorescein angiography and/or indocyanine green angiography) were included in the study. The OCT and OCTA characteristics of fellow eyes were analysed.

Results

Forty patients (80 eyes—40 fellow eyes) with chronic CSCR with evidence of CNV in one eye were included. Mean age of the patients was 54.9±9.9 years and 82.5 % were males. Twenty-five (62.5%) fellow eyes had flat irregular pigment epithelial detachment on OCT, out of which 21 had internal hyper-reflectivity. A definite vascular network was picked up by OCTA in 9 of these 40 fellow eyes (22.5%) which was not detected on conventional imaging. In addition, two eyes had an ill-defined hyper-reflectivity, which could not be classified as a definite network at that point of time. The networks detected on OCTA in fellow eyes were mostly inactive, suggesting a subclinical neovascularisation.

Conclusion

One-fourth of fellow eyes showed vascular network which could not be diagnosed on conventional imaging which highlights the importance of imaging both the eyes of chronic CSCR for early detection of CNV using OCTA. Further longitudinal studies are needed to assess the clinical course of such subclinical vascular networks in CSCR.
Delivering integrated care after sexual violence in the Democratic Republic of the Congo
Authors: Bress Joshua , Kashemwa Givano , Amisi Christine , Armas Jean , McWhorter Cindy , Ruel Theodore , Ammann Arthur J , Mukwege Denis , Butler Lisa M
Published: February 2019

In the eastern Democratic Republic of the Congo, ongoing armed conflict increases the incidence of gender-based violence (GBV) and presents a distinct and major barrier to care delivery for all survivors of GBV. A specific challenge is providing emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections to all survivors within 72 hours of violence. To address the multiple barriers to providing this time-sensitive medical care, Global Strategies and Panzi Hospital implemented the Prevention Pack Program. The Prevention Pack is a pre-packaged post-rape medical kit containing antiretroviral post-exposure prophylaxis, antibiotics for treatment of sexually transmitted infections and emergency contraception. The Prevention Pack Program combines community sensitisation about post-rape medical care with the provision of Prevention Packs and the implementation of a cloud-based and Global Positioning System (GPS)–enabled inventory management system. The Panzi Hospital gender-based violence team implemented the Prevention Pack Program at Panzi Hospital and 12 rural clinics in the South Kivu Province. The data manager took GPS coordinates of each site, provided an initial stock of Prevention Packs and then called all sites daily to determine demand for post-rape care and Prevention Pack consumption. Inventory data were entered into the GPS-enabled cloud-based inventory management system. Project personnel used the consumption rate, trends and geolocation of sites to guide Prevention Pack restocking strategy. Between 2013 and 2017, a total of 8206 individuals presented for care following rape at the study sites. Of the 1414 individuals who presented in the rural areas, 1211 (85.6%) did so within the first 72 hours of reported rape. Care was delivered continuously and without a single stockout of medication across all sites. The Prevention Pack Program provided timely and consistent access to emergency contraception, HIV prophylaxis and treatment for sexually transmitted infections for rape survivors in the eastern Democratic Republic of the Congo.
Experiential knowledge of risk and support factors for physician performance in Canada: a qualitative study
Authors: Kain Nicole Allison , Hodwitz Kathryn , Yen Wendy , Ashworth Nigel
Published: February 2019

Objective

To identify, understand and explain potential risk and protective factors that may influence individual and physician group performance, by accessing the experiential knowledge of physician-assessors at three medical regulatory authorities (MRAs) in Canada.

Design

Qualitative analysis of physician-assessors’ interview transcripts. Telephone or in-person interviews were audio-recorded on consent, and transcribed verbatim. Interview questions related to four topics: Definition/discussion of what makes a ‘high-quality physician;’ factors for individual physician performance; factors for group physician performance; and recommendations on how to support high-quality medical practice. A grounded-theory approach was used to analyse the data.

Setting

Three provinces (Alberta, Manitoba, Ontario) in Canada.

Participants

Twenty-three (11 female, 12 male) physician-assessors from three MRAs in Canada (the College of Physicians & Surgeons of Alberta, the College of Physicians and Surgeons of Manitoba and the College of Physicians and Surgeons of Ontario).

Results

Participants outlined various protective factors for individual physician performance, including: being engaged in continuous quality improvement; having a support network of colleagues; working in a defined scope of practice; maintaining engagement in medicine; receiving regular feedback; and maintaining work-life balance. Individual risk factors included being money-oriented; having a high-volume practice; and practising in isolation. Group protective factors incorporated having regular communication among the group; effective collaboration; a shared philosophy of care; a diversity of physician perspectives; and appropriate practice management procedures. Group risk factors included: a lack of or ineffective communication/collaboration among the group; a group that doesn’t empower change; or having one disruptive or ‘risky’ physician in the group.

Conclusions

This is the first qualitative inquiry to explore the experiential knowledge of physician-assessors related to physician performance. By understanding the risk and support factors for both individual physicians and groups, MRAs will be better-equipped to tailor physician assessments and limited resources to support competence and enhance physician performance.
Cohort profile: Children in Need Census (CIN) records of children referred for social care support in England
Authors: Emmott Emily H , Jay Matthew A , Woodman Jenny
Published: February 2019

Purpose

The Children in Need Census (CIN) is a case-based administrative dataset on children referred to social care services in England. CIN includes information on the ‘needs’ of children, and whether they received social care support. Local and national government bodies in England currently use CIN for evaluation purposes. Data are accessible to researchers under certain conditions, allowing researchers to investigate the health implications of adverse childhood experiences. However, CIN suffers from lack of metadata, meaning it can be challenging for researchers to process and interpret data, particularly if researchers are unfamiliar with the English children’s social care system. To address this issue, we provide the background to CIN and describe the available data from 2008 to 2016.

Participants

CIN is derived from case records held by English local authorities on all children referred to children’s social care for a ‘needs assessment’, regardless of whether they are eventually assessed as ‘in need of social care support’. Local authorities submit these case records to the UK Department for Education for collation. CIN holds information on an estimated 2.76 million children from October 2008 to March 2016. Since 2013/2014, just under 900 000 children have been recorded in the CIN annually, equivalent to around 8% of children in England (annual prevalence). Approximately, 650 000 children enter or renter the dataset each year, equivalent to 5% of children in England (annual incidence).

Data summary

Of the estimated 2.76 million children in the data, 50% are male and 47% female. 45% are referred to children’s social care services due to abuse or neglect. 10.7% of children in CIN went onto a child protection plan, meaning they were judged to be (at risk of) suffering significant harm.

Future plans

CIN data collection is annual and ongoing. Data from the most recent census period typically become available for researchers in the following Spring.
Author misrepresentation of institutional affiliations: protocol for an exploratory case study
Authors: Bachelet Vivienne C , Uribe Francisco A , Díaz Ruben A , Vergara Alonso F , Bravo-Córdova Fabiana , Carrasco Víctor A , Lizana Francisca J , Meza-Ducaud Nicolás , Navarrete María S
Published: February 2019

Introduction

University ranking systems and the publish-or-perish dictum, among other factors, are driving universities and researchers around the world to increase their research productivity. Authors frequently report multiple affiliations in published articles. It is not known if the reported institutional affiliations are real affiliations, which is when the universities have contributed substantially to the research conducted and to the published manuscript. This study aims to establish whether there is an empirical basis for author affiliation misrepresentation in authors with multiple institutional affiliations.

Methods and analysis

This individual secondary data exploratory analysis on Scopus-indexed articles for 2016 will search all authors who report multiple institutional affiliations in which at least one of the affiliations is to a Chilean university. We will consider that misrepresentation of an affiliation is more likely when it is not possible to verify objectively a link between the author and the mentioned institution through institutional websites. If we cannot corroborate the author affiliation, we will consider this a finding of potential misrepresentation of the affiliation. We will summarise results with descriptive statistics.

Ethics and dissemination

The study protocol was approved by the institutional ethics committee of Universidad de Santiago de Chile, Resolution No. 261, and dated January 15, 2018. Results will be submitted to the World Conference on Research Integrity, among other meetings on publication ethics and research integrity, and will be published in scientific, peer-reviewed journals.
Risk of adverse pregnancy outcomes associated with short and long birth intervals in Bangladesh: evidence from six Bangladesh Demographic and Health Surveys, 1996–2014
Authors: Nisha Monjura Khatun , Alam Ashraful , Islam Mohammad Tajul , Huda Tanvir , Raynes-Greenow Camille
Published: February 2019

Objective

To examine the effect of short (<36 months) and long (≥60 months) birth intervals on adverse pregnancy outcomes in Bangladesh.

Design, setting and participants

We analysed data from six Bangladesh Demographic and Health Surveys (1996–1997, 1999–2000, 2004, 2007, 2011 and 2014). We included all singleton non-first live births, most recently born to mothers within 5 years preceding each survey (n=21 382). We defined birth interval according to previous research which suggests that a birth interval between 36 and 59 months is the most ideal interval. Bivariate and multivariable analyses were conducted to obtain the crude and adjusted ORs (aOR) respectively to assess the odds of first-day neonatal death, early neonatal death and small birth size for both short (<36 months) and long (≥60 months) spacing between births.

Main outcome measures

First-day neonatal death, early neonatal death and small birth size.

Results

In the multivariable analysis, compared with births spaced 36–59 months, infants with a birth interval of <36 months had increased odds of first-day neonatal death (aOR: 2.11, 95% CI: 1.17 to 3.78) and early neonatal death (aOR: 1.58, 95% CI: 1.13 to 2.22). Compared with births spaced 36–59 months, infants with a birth interval of ≥60 months had increased odds of first-day neonatal death (aOR: 2.02, 95% CI: 1.10 to 3.73) and small birth size (aOR: 1.17, 95% CI: 1.02 to 1.34). When there was a history of any previous pregnancy loss, there was an increase in the odds of first-day and early neonatal death for both short and long birth intervals, although it was not significant.

Conclusions

Birth intervals shorter than 36 months and longer than 59 months are associated with increased odds of adverse pregnancy outcomes. Care-providers, programme managers and policymakers could focus on promoting an optimal birth interval between 36 and 59 months in postpartum family planning.
Aussiedler Mortality (AMOR): cohort studies on ethnic German migrants from the Former Soviet Union
Authors: Winkler Volker , Kaucher Simone , Deckert Andreas , Leier Valentina , Holleczek Bernd , Meisinger Christa , Razum Oliver , Becher Heiko
Published: February 2019

Purpose

The Aussiedler Mortality cohorts represent the unique migrant group of ethnic Germans (resettlers) from the former Soviet Union who migrated to Germany mainly after the fall of the iron curtain in 1989. Resettlers are the second largest migrant group in Germany and their health status was largely unknown before the cohorts were set up.

Participants

Four retrospective register-based cohorts were set up in different federal states of Germany, each focussing on different health aspects. In total, the cohorts include 92 362 resettlers (men: 51.5%, women: 48.5%) who immigrated between 1990 and 2005 with a mean age at immigration of 36.6 years (range 0–105 years). Resettlers are of German ancestry and they are immediately granted the German citizenship with all rights and duties.

Findings to date

Vital status and causes of death (International Classification of Diseases codes based on death certificates or record linkage) were collected for three cohorts as well as cancer incidence and incidence of acute myocardial infarction in three of the cohorts. Currently, an observation period of 20 years (1990–2009) is covered. Overall mortality among resettlers was surprisingly lower in comparison to the German population with standardised mortality ratios of 0.87 (95% confidence limits 0.84–0.91) for women and 0.96 (0.92–0.99) for men, and even stronger for cardiovascular diseases (women: 0.84 (0.79–0.89); men: 0.80 (0.75–0.86). However, observed differences can neither be explained by the ‘healthy migrant effect’ nor by common behavioural risk factors and may be related to factors which have not yet been studied.

Future plans

The existing cohorts will be continued and prospective studies on resettlers are underway: one cohort will be followed-up prospectively and two other large prospective cohort studies in Germany will be used for a detailed assessment of lifestyle, environmental and genetic/epigenetic factors on the mortality and morbidity pattern of resettlers.
Protocol for a prospective, longitudinal mixed-methods case study: supporting a Model of Care for Healthier Adolescents (The MoCHA study)
Authors: Hayes Claire , Palmer Victoria J , Simmons Magenta , Hamilton Bridget , Simons Christine , Hopwood Malcolm
Published: February 2019

Introduction

Improving mental healthcare for adolescents is a global policy priority. Despite demands for community-based services, many adolescents require more intensive interventions, such as an inpatient admission. This is typically at a point of crisis, often accompanied by intense emotional dysregulation, impairment of coping function and impulsivity. However, limited evidence exists on how best to support this group while they are in inpatient care, aside from pharmacological treatments which have a limited role in adolescents. Little is known about the models of care (MoC) offered in inpatient units, whether adolescents perceive these as helpful and the perspectives of caregivers and clinicians. Here, we describe a protocol which aims to explore and evaluate an inpatient MoC.

Methods and analysis

We designed a longitudinal, mixed-methods, case study. The population consists of adolescents, caregivers and clinicians at a single inpatient unit in Melbourne, Australia. Standardised outcome measures, including semi- structured interviews, will be administered to adolescents at three time-points, T1 (admission), T2 (discharge) and T3 (6 months post discharge). Caregivers will also be interviewed at T1, T2 and T3. Clinicians will be interviewed once. The measures include: Life Problems Inventory, Quick Inventory of Depressive Symptomatology, Kessler Psychological Distress Scale and the Youth Self-Report. Health of the Nation Outcome Scales for Children and Adolescents will be collected at T1 and T2. Quantitative analysis will include descriptive statistics and paired t-tests summarising adolescents admitted to the unit, clinical characteristics and longitudinal data on symptomatology. Qualitative data will be analysed using both thematic and trajectory analysis. Data collection began in May 2017 and will cease with T3 interviews by October 2018.

Ethics and dissemination
Healthcare professionals’, students’, patients’ and donors’ perceptions of stem cell research and therapy: a systematic review protocol
Authors: Shaw Malissa Kay , Babovič Mojca , Monrouxe Lynn Valerie
Published: February 2019

Introduction

Stem cell research (SCR) and the biomedical potential of developing therapies are crucial topics in biomedicine. Like other biotechnologies, stem cells are context specific entities understood through local conceptualisations of culture, politics, nationhood, as well as their perceived therapeutic efficacy. There is a need to recognise how these developments are understood within the healthcare community and by those who may use them. This protocol describes a systematic literature review that aims to explore healthcare professionals’, healthcare students’, patients’, and donors’ perceptions of SCR and therapy (SCR/T) and the factors that influence their perceptions.

Methods and analysis

Following Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines a systematic review will be undertaken. Web of Science, Scopus, Medline+Journals @Ovid and Ariti Library will be systematically searched for studies on healthcare professionals’, healthcare students’, patients’ and donors’ perceptions of SCR and developing therapies. All articles will be screened by a researcher for inclusion and evaluation based on 12 criteria for evaluating qualitative research. At least 20% of articles will also be reviewed by a second researcher and any disagreement will be solved via consensus. Data extracted from the articles will be analysed using thematic synthesis enabling the identification of concepts across studies and the development of new theory.

Ethics and dissemination

As part of a larger research project, ethical approval has been provided by the Institutional Research Board (IRB) at Chang Gung Memorial Hospital. This review will be able to determine the impact that certain perceptions of SCR/T will have on the development of future medical knowledge and practice. The results of the study will be published in a peer-reviewed journal and disseminated at relevant conferences.

PROSPERO registration number

CRD42018103627.
Absolute risk and risk factors for stroke mortality in patients with end-stage kidney disease (ESKD): population-based cohort study using data linkage
Authors: De La Mata Nicole Louise , Alfaro-Ramirez Maria , Kelly Patrick J , Masson Philip , Al-Shahi Salman Rustam , Webster Angela C
Published: February 2019

Introduction

People with end-stage kidney disease (ESKD) have up to 30-fold higher risk of stroke than the general population.

Objective

To determine risk factors associated with stroke death in the ESKD population.

Methods

We identified all patients with incident ESKD in Australia (1980–2013) and New Zealand (1988–2012) from the Australian and New Zealand Dialysis and Transplant Registry (ANZDATA) registry. We ascertained underlying cause of death from data linkage with national death registries and risk factors from ANZDATA. Using a competing risks multivariable regression model, we estimated cumulative incidence of stroke and non-stroke deaths, and risk factors for stroke deaths (adjusted sub-HR, SHR).

Results

We included 60 823 people with ESKD. There were 941 stroke deaths and 33 377 non-stroke deaths during 381 874 person-years of follow-up. Overall, the cumulative incidence of stroke death was 0.9% and non-stroke death was 36.8% 5 years after starting ESKD treatment. The risk of stroke death was higher at older ages (SHR 1.92, 95% CI 1.45 to 2.55), in females (SHR 1.41, 95% CI 1.21 to 1.64), in people with cerebrovascular disease (SHR 2.39, 95% CI 1.99 to 2.87), with ESKD caused by hypertensive/renovascular disease (SHR 1.39, 95% CI 1.09 to 1.78) or polycystic kidney disease (SHR 1.38, 95% CI 1.00 to 1.90), with earlier year of ESKD treatment initiation (SHR 1.93, 95% CI 1.56 to 2.39) and receiving dialysis (transplant vs haemodialysis SHR 0.27, 95% CI 0.09 to 0.84).

Conclusion

Patients with ESKD with higher risk of stroke death are older, women, with cerebrovascular disease, with hypertensive/renovascular or polycystic kidney disease cause of ESKD, with earlier year of ESKD treatment and receiving dialysis. These groups may benefit from targeted stroke prevention interventions.
Do hospitals influence geographic variation in admission for preventable hospitalisation? A data linkage study in New South Wales, Australia
Authors: Falster Michael O , Leyland Alastair H , Jorm Louisa R
Published: February 2019

Objective

Preventable hospitalisations are used internationally as a performance indicator for primary care, but the influence of other health system factors remains poorly understood. This study investigated between-hospital variation in rates of preventable hospitalisation.

Setting

Linked health survey and hospital admissions data for a cohort study of 266 826 people aged over 45 years in the state of New South Wales, Australia.

Method

Between-hospital variation in preventable hospitalisation was quantified using cross-classified multiple-membership multilevel Poisson models, adjusted for personal sociodemographic, health and area-level contextual characteristics. Variation was also explored for two conditions unlikely to be influenced by discretionary admission practice: emergency admissions for acute myocardial infarction (AMI) and hip fracture.

Results

We found significant between-hospital variation in adjusted rates of preventable hospitalisation, with hospitals varying on average 26% from the state mean. Patients served more by community and multipurpose facilities (smaller facilities primarily in rural areas) had higher rates of preventable hospitalisation. Community hospitals had the greatest between-hospital variation, and included the facilities with the highest rates of preventable hospitalisation. There was comparatively little between-hospital variation in rates of admission for AMI and hip fracture.

Conclusions

Geographic variation in preventable hospitalisation is determined in part by hospitals, reflecting different roles played by community and multipurpose facilities, compared with major and principal referral hospitals, within the community. Care should be taken when interpreting the indicator simply as a performance measure for primary care.
Nicotine dependence in community-dwelling Chinese patients with schizophrenia
Authors: Li Yan , Hou Cai-Lan , Ma Xin-Rong , Zang Yu , Jia Fu-Jun , Lai Kelly Y C , Ungvari Gabor S , Ng Chee H , Cai Mei-Ying , Xiang Yu-Tao
Published: February 2019

Background

Smoking is a serious public health problem. Patients with schizophrenia usually have a higher prevalence of smoking than the general population, but the level of nicotine dependence is seldom studied, especially for patients living in the communities.

Aims

This study aimed to examine the level of nicotine dependence in Chinese community-dwelling patients with schizophrenia and explored its associated sociodemographic and clinical factors.

Methods

A total of 621 patients with schizophrenia treated in the primary care centres of Guangzhou were consecutively recruited. The level of nicotine dependence was assessed with the Chinese version of the Fagerström Test for Nicotine Dependence (FTND).

Results

148 patients with schizophrenia were current smokers, and the mean (SD) score of FTND was 5.06 (2.55) for all the current smokers. The prevalence of nicotine addiction was 48.0% (95% CI: 40.0%-56.0%) in patients with current smoking. The patients with schizophrenia had a significantly higher level of nicotine dependence than the Chinese general population. Multiple linear regression analysis revealed that male gender, being unemployed, having a family history of psychiatric disorders, having major medical conditions, first illness episode and less severe positive symptoms were significantly associated with a higher level of nicotine dependence.

Conclusion

Community-dwelling patients with schizophrenia in China, especially male patients, had a higher level of nicotine dependence than the general population.
Biomarkers for the diagnosis of Alzheimer’s disease, dementia Lewy body, frontotemporal dementia and vascular dementia
Authors: Maclin Joshua Marvin Anthony , Wang Tao , Xiao Shifu
Published: February 2019

Background

Dementia is a chronic brain disorder classified by four distinct diseases that impact cognition and mental degeneration. Each subgroup exhibits similar brain deficiencies and mutations. This review will focus on four dementia subgroups: Alzheimer’s disease, vascular dementia, frontotemporal dementia and dementia Lewy body.

Aim

The aim of this systematic review is to create a concise overview of unique similarities within dementia used to locate and identify new biomarker methods in diagnosing dementia.

Methods

123 300 articles published after 2010 were identified from PubMed, JSTOR, WorldCat Online Computer Library and PALNI (Private Academic Library Network of Indiana) using the following search items (in title or abstract): ‘Neurodegenerative Diseases’ OR ‘Biomarkers’ OR ‘Alzheimer’s Disease’ OR ‘Frontal Temporal Lobe Dementia’ OR ‘Vascular Dementia’ OR ‘Dementia Lewy Body’ OR ‘Cerebral Spinal Fluid’ OR ‘Mental Cognitive Impairment’. 47 studies were included in the qualitative synthesis.

Results

Evidence suggested neuroimaging with amyloid positron emission tomography (PET) scanning and newly found PET tracers to be more effective in diagnosing Alzheimer’s and amnesiac mental cognitive impairment than carbon-11 Pittsburgh compound-B radioisotope tracer. Newly created methods to make PET scans more accurate and practical in clinical settings signify a major shift in diagnosing dementia and neurodegenerative diseases.

Conclusion

Vast improvements in neuroimaging techniques have led to newly discovered biomarkers and diagnostics. Neuroimaging with amyloid PET scanning surpasses what had been considered the dominant method of neuroimaging and MRI. Newly created methods to make PET scans more accurate and practical in clinical settings signify a major shift in diagnosing dementia pathology. Continued research and studies must be conducted to improve current findings and streamline methods to further subcategorise neurodegenerative disorders and diagnosis.
Managing hypertension in 2018: which guideline to follow?
Authors: Angeli Fabio , Reboldi Gianpaolo , Trapasso Monica , Aita Adolfo , Verdecchia Paolo
Published: February 2019

Hypertension is a global public health issue and a major cause of morbidity and mortality. Its prevalence is increasing in many Asian countries, with a number of countries with blood pressure above the global average. Although the average systolic blood pressure is decreasing worldwide since the 1980s at the rate of about 1 mm Hg systolic blood pressure per decade, it is increasing in low-income and middle-income countries, especially in the East and South Asian population. Of note, the much larger base Asian population results in a considerably larger absolute number of individuals affected. When compared with Western countries, hypertension among Asian populations has unique features in terms of its onset, clustering of associated cardiovascular risk factors, complications and outcomes. Moreover, only a minority of hypertensive individuals are receiving treatment and achieving control. Projected number of deaths related to hypertension dramatically increased in the last 25 years in some Asian regions with a disproportionately high mortality and morbidity from stroke compared with Western countries. The relation between blood pressure and the risk of stroke is stronger in Asia than in Western regions. Although new Guidelines for hypertension diagnosis and management have been recently released from Europe and North America, the unique features of Asian hypertensive patients raise concerns on the clinical applicability of Western Guidelines to Asian populations. To this purpose, we critically reviewed key elements from the most updated Guidelines. We also discussed their core concepts to verify the impact on hypertension prevention and management in Asian countries.
Knowledge of risk factors for hypertension in a rural Indian population
Authors: Busingye Doreen , Arabshahi Simin , Evans Roger G , Riddell Michaela A , Srikanth Velandai K , Kartik Kamakshi , Kalyanram Kartik , Zhu Xuan , Suresh Oduru , Howard George , Thrift Amanda G
Published: February 2019

Objective

To study knowledge of risk factors and consequences of hypertension in a rural population in South India.

Methods

This is a community-based study conducted among adults of a rural population in the Rishi Valley, India. Residents of randomised rural villages were invited to participate in a study of hypertension. We obtained measures of blood pressure, height, weight, waist and hip circumferences and questionnaire-based information on knowledge about hypertension, sociodemographic characteristics and health behaviours. Multivariable logistic regression analyses were conducted to determine the factors associated with knowledge of risk factors for hypertension (knowledge of ≥2 risk factors).

Results

The study comprised 641 adults; 132 aware and 218 unaware of their hypertension, and 291 with normal blood pressure. Only 31% of participants knew that hypertension adversely affects an individual’s health and 7% knew the benefits of treating hypertension. Almost a third (30%) of those aware of their hypertensive status, and 48% overall, did not know any of the risk factors for hypertension. Being aware of one’s hypertensive status (OR 2.51, 95% CI 1.44 to 4.39), being treated for hypertension, male sex, younger age, having some schooling, abdominal obesity and physical inactivity were associated with better knowledge of risk factors for hypertension.

Conclusion 

Knowledge of risk factors and consequences of hypertension in this disadvantaged population was poor. There was better knowledge of risk factors in some, but not all, people who were aware of having hypertension. Screening and targeted educational programmes are warranted in this population to improve health behaviours and reduce the consequences of hypertension.
Twenty-five-year-old woman with palpitations and hypertrophic cardiomyopathy
Authors: Akrawinthawong Krittapoom , Kumar Vineet
Published: February 2019

Clinical introduction

A 25-year-old woman with a diagnosis of hypertrophic cardiomyopathy (HCM) and pre-excitation on ECG presented with unexplained syncope and daily palpitation. Genetic testing was positive for lysosome-associated membrane protein 2 (LAMP2) mutation which confirmed the diagnosis of Danon disease. Her younger sister was diagnosed with a similar condition and received a defibrillator implantation. Her 12-lead ECG (figure 1) and a long strip tracing (figure 2) are shown below.

Figure 1

12-lead ECG.

Question

Where is the location of the accessory pathway and what is the next appropriate management?

Anteroseptal pathway and catheter ablation

Mid-septal pathway and pacemaker/defibrillator implantation

Right lateral pathway and catheter ablation

Fasciculoventricular pathway and electrophysiological study

Left lateral pathway and electrophysiological study
Middle meningeal artery embolization for the management of chronic subdural hematoma
Authors: Fiorella David , Arthur Adam S
Published: February 2019

Chronic subdural hematoma (cSDH) is one of the most common neurosurgical diagnoses in adults. The disease is fundamentally a disorder of the meningeal blood vessels, and options exist for the minimally invasive neuroendovascular management. We review the potential role for the endovascular management of cSDH within the context of a discussion of the epidemiology, pathophysiology, and conventional management of this disease.
Treatment outcomes in patients with seropositive versus seronegative rheumatoid arthritis in Phase III randomised clinical trials of tofacitinib
Authors: Bird Paul , Hall Stephen , Nash Peter , Connell Carol A , Kwok Kenneth , Witcombe David , Thirunavukkarasu Krishan
Published: February 2019

Objectives

Tofacitinib is an oral JAK inhibitor for the treatment of rheumatoid arthritis (RA). We examined response to tofacitinib 5 or 10 mg two times a day in patients with seropositive vs seronegative RA.

Methods

Data were pooled from five Phase III studies of conventional synthetic disease-modifying antirheumatic drug (csDMARD)- or biological DMARD-inadequate responders (ORAL Step [NCT00960440]; ORAL Scan [NCT00847613]; ORAL Solo [NCT00814307]; ORAL Sync [NCT00856544]; ORAL Standard [NCT00853385]). ‘Serotype’ subgroups were: anticyclic citrullinated peptide (CCP) and rheumatoid factor (RF) positive (anti-CCP+/RF+); anti-CCP+/RF negative (-); anti-CCP-/RF+; anti-CCP-/RF-. At month 3, ACR20/50/70 response rates, Disease Activity Score (DAS28-4[ESR])-defined remission (DAS28-4[ESR]<2.6) and low disease activity (LDA; DAS28-4[ESR]≤3.2), changes from baseline (CFB) in Health Assessment Questionnaire-Disability Index (HAQ-DI), Short Form-36 Health Survey (SF-36) physical functioning and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) were evaluated. Safety endpoints were compared.

Results

Baseline demographics/characteristics were similar across subgroups. Tofacitinib significantly improved ACR20/50/70 response rates, DAS28-4(ESR) LDA rates and CFB in HAQ-DI and FACIT-F vs placebo across subgroups. More anti-CCP+/RF+ than anti-CCP-/RF- patients had ACR20/50/70 responses (ACR20/50: both tofacitinib doses; ACR70: 10 mg two times a day). SF-36 physical functioning improved in anti-CCP+/RF+, anti-CCP+/RF- and anti-CCP-/RF+ patients (both tofacitinib doses) and anti-CCP-/RF- patients (10 mg two times a day) vs placebo. More anti-CCP+/RF+ and anti-CCP+/RF- than anti-CCP-/RF- patients achieved DAS28-4(ESR) remission and LDA with tofacitinib 10 mg two times a day. Frequency of adverse events (AEs), serious AEs and discontinuations due to AEs were similar across subgroups.

Conclusion

Generally, tofacitinib efficacy (ACR20/50/70 responses) and safety were similar across subgroups. DAS28-4(ESR) remission rates and SF-36 physical functioning appeared lower in anti-CCP- patients.
Froude characterization for unsteady single-surge dry granular flows: impact pressure and runup height
Authors: Ng C.W.W. , Choi C.E. , Goodwin G.R.
Published: February 2019

The impact and pileup mechanisms of unsteady granular flows impacting a rigid barrier are governed by the Froude conditions (Fr). Velocity and depth vary along the length of the flow. There is currently no widely accepted approach for characterizing Fr for impact and runup problems. In this study, a discrete element method (DEM) model was calibrated against a physical flume test. Eighty-six simulations were performed using the DEM model to investigate the equivalent Fr governing pileup height and impact pressure for unsteady single-surge dry granular flows against a rigid barrier. Fr and the grain diameter were varied. Results reveal that Fr within the frontmost 5% of a flow governs both pileup height and impact pressure. Thus, taking frontal velocity and maximum flow depth within the frontmost region is crucial for properly characterizing the runup height and impact load. Consistent characterization of Fr is possible near the longitudinal centre of a flow; the frontmost Fr can then be extrapolated from calibration curves. Results imply that existing studies that predict impact pressure based on nonfrontal Fr values may underestimate impact pressure by a factor of up to 2.
Molecular Networks of Seed Size Control in Plants
Authors: Li Na , Xu Ran , Li Yunhai
Published: February 2019

The size of seeds affects not only evolutionary fitness but also grain yield of crops. Understanding the mechanisms controlling seed size has become an important research field in plant science. Seed size is determined by the integrated signals of maternal and zygotic tissues, which control the coordinated growth of the embryo, endosperm, and seed coat. Recent advances have identified several signaling pathways that control seed size through maternal tissues, including or involving the ubiquitin-proteasome pathway, G-protein signaling, mitogen-activated protein kinase (MAPK) signaling, phytohormone perception and homeostasis, and some transcriptional regulators. Meanwhile, growth of the zygotic tissues is regulated in part by the HAIKU (IKU) pathway and phytohormones. This review provides a general overview of current findings in seed size control and discusses the emerging molecular mechanisms and regulatory networks found to be involved.
Division Plane Establishment and Cytokinesis
Authors: Livanos Pantelis , Müller Sabine
Published: February 2019

Plant cells divide their cytoplasmic content by forming a new membrane compartment, the cell plate, via a rerouting of the secretory pathway toward the division plane aided by a dynamic cytoskeletal apparatus known as the phragmoplast. The phragmoplast expands centrifugally and directs the cell plate to the preselected division site at the plasma membrane to fuse with the parental wall. The division site is transiently decorated by the cytoskeletal preprophase band in preprophase and prophase, whereas a number of proteins discovered over the last decade reside continuously at the division site and provide a lasting spatial reference for phragmoplast guidance. Recent studies of membrane fusion at the cell plate have revealed the contribution of functionally conserved eukaryotic proteins to distinct stages of cell plate biogenesis and emphasize the coupling of cell plate formation with phragmoplast expansion. Together with novel findings concerning preprophase band function and the setup of the division site, cytokinesis and its spatial control remain an open-ended field with outstanding and challenging questions to resolve.
The Biocompatibility Challenges in the Total Artificial Heart Evolution
Authors: Dal Sasso Eleonora , Bagno Andrea , Scuri Silvia T.G. , Gerosa Gino , Iop Laura
Published: February 2019

There are limited therapeutic options for final treatment of end-stage heart failure. Among them, implantation of a total artificial heart (TAH) is an acceptable strategy when suitable donors are not available. TAH development began in the 1930s, followed by a dramatic evolution of the actuation mechanisms operating the mechanical pumps. Nevertheless, the performance of TAHs has not yet been optimized, mainly because of the low biocompatibility of the blood-contacting surfaces. Low hemocompatibility, calcification, and sensitivity to infections seriously affect the success of TAHs. These unsolved issues have led to the withdrawal of many prototypes during preclinical phases of testing. This review offers a comprehensive analysis of the pathophysiological events that may occur in the materials that compose TAHs developed to date. In addition, this review illustrates bioengineering strategies to prevent these events and describes the most significant steps toward the achievement of a fully biocompatible TAH.
Impaired Right Ventricular Mechanics at Rest and During Exercise Are Associated With Exercise Capacity in Patients With Hypertrophic Cardiomyopathy
Authors: Wu Xiao‐Peng , Li Yi‐Dan , Wang Yi‐Dan , Zhang Miao , Zhu Wei‐Wei , Cai Qi‐Zhe , Jiang Wei , Sun Lan‐Lan , Ding Xue‐Yan , Ye Xiao‐Guang , Qin Yun‐Yun , Lu Xiu‐Zhang
Published: February 2019

Background

Impaired right ventricular (
RV
) function indicates
RV
involvement in patients with hypertrophic cardiomyopathy (
HCM
). We aimed to assess
RV
function at rest and during exercise in
HCM
patients and to examine the association between impaired
RV
mechanics and exercise capacity.

Methods and Results

A total of 76
HCM
patients (48 without and 28 with
RV
hypertrophy) and 30 age‐ and sex‐matched controls were prospectively recruited.
RV
function was evaluated at rest and during semisupine bicycle exercise by conventional echocardiography and 2‐dimensional speckle‐tracking imaging. Exercise capacity was measured by metabolic equivalents.
RV
functional reserve was calculated as the difference of functional parameters between peak exercise and rest. Compared with controls,
HCM
patients had significantly higher
RV
free wall thickness, lower
RV
global longitudinal strain and
RV
free wall longitudinal strain at rest and during exercise, and reduced
RV
systolic functional reserve. Compared with those with
HCM
without
RV
hypertrophy, patients with
HCM
with
RV
hypertrophy had lower metabolic equivalents. Among
HCM
patients, an effective correlation was seen between exercise capacity and peak exercise
RV
global longitudinal strain and peak exercise
RV
free wall longitudinal strain. A binary logistic regression model revealed several independent predictors of exercise intolerance in
HCM
patients, but receiver operating characteristic curve analysis indicated exercise
RV
global longitudinal strain had the highest area under the curve for the prediction of exercise intolerance in
HCM
patients.

Conclusions

HCM
patients have
RV
dysfunction and reduced contractile reserve. Exercise
RV
global longitudinal strain correlates with exercise capacity and can independently predict exercise intolerance. In addition, patients with
HCM
with
RV
hypertrophy exhibit more reduced exercise capacity, suggesting more severe disease and poorer prognosis.
The Role of Early Immersive Culture Mixing in Cultural Identifications of Multiculturals
Authors: Martin Lee , Shao Bo , Thomas David C.
Published: February 2019

Becoming multicultural through early immersive culture mixing (EICM)—i.e., growing up with a mix of cultures that coexist and interact to form an emergent hybrid culture within one’s home—is a rapidly rising phenomenon in many parts of the world. This phenomenon calls for new research that recognizes the possibility of identification with a hybrid culture as well as the distinct cultures from which the hybrid culture derives. This article extends previous research into psychological variation among multiculturals based on the process of EICM, by investigating how EICM influences hybrid cultural identification and distinct cultural identification. In addition, we examine how EICM relates to the components of identity integration—blendedness and harmony. Across two studies of Chinese-Australian multiculturals, we found that whereas EICM was positively associated with multicultural participants’ identification with a hybrid culture and Australian culture, it was not related to their identification with Chinese culture. Findings also indicated that EICM positively predicted identity blendedness, but EICM did not show a clear link with identity harmony. We discuss the implications of our research for advancing EICM theory and helping to forge new research directions in cultural identification.