bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluative Discourse and Affective States of Mind
Authors: Franzén Nils 
Published: December 2019

AbstractIt is widely held within contemporary metaethics that there is a lack of linguistic support for evaluative expressivism. On the contrary, it seems that the predictions that expressivists make about evaluative discourse are not borne out. An instance of this is the so-called problem of missing Moorean infelicity. Expressivists maintain that evaluative statements express non-cognitive states of mind in a similar manner to how ordinary descriptive language expresses beliefs. Conjoining an ordinary assertion that p with the denial of being in the corresponding belief state famously gives rise to Moorean infelicity:(i) ?? It’s raining but I don’t believe that it’s raining.If expressivists are right, then conjoining evaluative statements with the denial of being in the relevant non-cognitive state of mind should give rise to similar infelicity. However, as several theorists have pointed out, this does not seem to be the case. Statements like the following are not infelicitous:(ii) Murder is wrong but I don’t disapprove of it.In this paper, I argue that evaluative statements express the kind of states that are attributed by ‘find’-constructions in English and that these states are non-cognitive in nature. This addresses the problem of missing Moorean infelicity and, more generally, goes to show that there are linguistic facts which support expressivism about evaluative discourse.
Loneliness among veterans in the Netherlands
Authors: Reijnen A , Duel J 
Published: December 2019

Abstract

Background
Loneliness among military veterans may have unique features because of deployment-related experiences. Consequently, loneliness is increasingly recognized as an issue that may affect the health of veterans, even years after military deployment.

Aims
To examine the prevalence of loneliness in Dutch veterans and to assess the extent to which their loneliness is associated with deployment-related factors.

Methods
We invited 6000 veterans who have left the Armed Forces to fill out a questionnaire. Hierarchical regression analysis was used to assess the association between loneliness and deployment-related factors in addition to demographic information, social support and needs of care.

Results
We received the responses of 2643 veterans (44%). Of them, 27% experienced at least some loneliness and 13% experienced severe loneliness. Social support, perceived comradeship during deployment and a perceived positive effect of one’s deployment on life at present are negatively related to loneliness. Younger age, living alone (with or without children), unemployment or work disability, needs of care in general or deployment-related, perceived frustration related to the deployment and longing back to the time of the deployment were positively associated with loneliness.

Conclusions
Feelings of loneliness are prevalent among Dutch veterans who have left the Armed Forces. Veterans’ loneliness is associated with several deployment-related factors. To reduce veterans’ loneliness, attention for deployment-related experiences and its consequences is recommended.
One dose of immunotherapy leading to an exceptional and durable response in a patient with metastatic renal cell carcinoma
Authors: Wade Louise , Hilman Serena 
Published: December 2019

ABSTRACT
A 72-year-old man with metastatic clear cell renal carcinoma, who had progressed after previous treatment with Sunitinib and Axitinib, was given one dose of immunotherapy. He was initially unwell after treatment with fever, shortness of breath, chest pain and raised inflammatory markers. Following this he elected not to have any further immunotherapy. Before the treatment he had multiple pulmonary metastases and hilar and mediastinal lymph nodes on chest X-ray and suffered with a persistent cough. Chest X-ray 10 months after treatment showed normal appearances and his cough had largely resolved. The patient initially declined repeat computed tomography imaging but agreed to it 2 years after the immunotherapy, the results showed a maintained response. Some patients with renal cell carcinoma show a durable response to immunotherapy but we are not aware of other published cases where a patient has shown such a dramatic and sustained response to one dose.
Smart watch-detected tachycardia: a case of atrial flutter
Authors: Goldstein Lara N , Wells Mike 
Published: December 2019

Abstract
The use of smart watches like the Apple watch and other wearable electronic devices by the general public has been increasing dramatically. Until their accuracy for detecting dysrhythmias has been well-established, however, it would not be appropriate to rely on them solely to rule-in or rule-out pathology. Nonetheless, unusual findings from these devices should be followed up with more conventional investigations, and this approach may prove highly beneficial to patients and treating clinicians alike. This case demonstrates a diagnosis of atrial flutter that was suspected based on the Apple watch and iPhone Health app findings.
A blend of essential oils improved feed efficiency and affected ruminal and systemic variables of dairy cows
Authors: Silva Rayana Brito da , Pereira Marcos Neves , Araujo Rafael Canonenco de , Silva Wesley de Rezende , Pereira Renata Apocalypse Nogueira 
Published: December 2019

Abstract
This experiment evaluated the effect of a blend of essential oils (BEO) on intake, lactation performance, diet digestibility, ruminal fermentation profile, eating behavior, body thermoregulation, blood acid–base balance, and milk fatty acid profile of lactating cows. Twenty-eight Holstein cows were individually fed a standard diet for 14 d and treatments control or BEO (a microencapsulated blend of pepper extract containing capsaicin and pure forms of carvacrol, cinnamaldehyde, and eugenol; 150 mg/kg of diet dry matter) for 56 d. Significance was declared at P ≤ 0.05 and trends at 0.05 &lt; P ≤ 0.10. Dry matter intake (DMI) was reduced (19.5 vs. 20.1 kg/d) and milk yield was increased (30.1 vs. 30.8 kg/d) by BEO, inducing improved milk to DMI ratio (1.53 vs. 1.62). Milk fat concentration tended to be increased by BEO, but total solids yield did not differ. There was a trend for increased total tract non-neutral detergent fiber organic matter digestibility with BEO. The molar proportion of acetate in ruminal fluid was reduced (51.4 vs. 57.8%) and that of propionate was increased (26.1 vs. 31.3%) by BEO. Ruminal microbial yield and total protozoa count in ruminal fluid did not differ. Cows fed BEO ingested a greater proportion of the daily intake in the morning (30.6 vs. 36.6%) and tended to ingest a lower proportion at night, tended to have longer meals, and had fewer meals per day (11.9 vs. 13.7) and larger meal size (1.5 vs. 1.7 kg of dry matter per meal). Blood urea-N and glucose concentrations did not differ. The BEO increased jugular blood oxygenation. The sweating rate on a hot and dry day was increased (160 vs. 221 g/m2/h) by BEO. The mean rectal and skin temperatures and respiration rate did not differ, but the proportion of rectal temperature measurements ≥39.2 °C was reduced by BEO at 1400 h (17.8 vs. 28.5%) and 2000 h (23.2 vs. 34.8%). The BEO increased the secretion (g/d) of 18:2 trans-10, cis-12 and the concentration of 18:0 iso fatty acids in milk fat. When one sample of milk from BEO cows was offered with two samples of milk from control, 59% of regular consumers of milk (n = 63) identified the odd sample correctly. The gain in feed efficiency induced by BEO was associated with reduced acetate-to-propionate ratio in ruminal fluid, altered eating behavior, lower frequency of high rectal temperature, and increased blood oxygenation. Essential oils had positive effects on ruminal fermentation and systemic variables of dairy cows.
Vitamin D: can the sun stop the atopic epidemic?
Authors: Hawrylowicz Catherine M. , Santos Alexandra F. 
Published: December 2019

Purpose of review
To review recent evidence on the capacity of vitamin D to prevent atopic disease, focussing on food allergy and asthma, and potential underlying mechanisms.

Recent findings
The incidence of allergic disease continues to increase worldwide. Vitamin D status is influenced by sun exposure and dietary intake. Vitamin D deficiency is linked to an increased incidence of allergic disease and asthma. These associations are generally strongest in early life. The capacity of vitamin D to enhance antimicrobial pathways, promote peripheral immunological tolerance and maintain mucosal barrier integrity may underlie these associations. Interventional studies have addressed the capacity of vitamin D supplementation in utero and early life to reduce the incidence of disease. Ancillary studies have provided insights into potential biological mechanisms linked to these effects.

Summary
Observational studies show an inverse association between vitamin D levels and development of food allergy and asthma. Secondary analyses of two recent interventional studies suggest that achieving vitamin D sufficiency throughout pregnancy reduces the incidence of asthma/recurrent wheeze at 3 years. Longitudinal studies of vitamin D requirements in utero and postnatally, better understanding of factors that influence bioavailability of vitamin D and mechanistic insights into vitamin D effects on neonatal-specific immune pathways are awaited.
Organ donation: from diagnosis to transplant
Authors: Robba Chiara , Fossi Francesca , Citerio Giuseppe 
Published: December 2019

Purpose of review
Organ transplantation has largely expanded over the last decades and despite several improvements have been made in the complex process occurring between the identification of organ donors and organ transplant, there is still a chronic inability to meet the needs of patients. Consequently, the optimization of the transplant process through its different steps is crucial, and the role of the intensivists is fundamental as it requires clinical, managerial and communication skills to avoid the loss of potential donors. The purpose of this review is to provide an update on the transplant process from the early identification of the donor, to transplant. The two main pathways of organ donation will be discussed: donation after death by neurologic criteria and the donation after cardiac death (DCD).

Recent findings
Recent evidence demonstrates that appropriate intensive care management is fundamental to increase organ availability for transplantation. The expansion of pool donation requires a strong legal framework supporting ethical and organizational considerations in each country, together with the implementation of physicians’ technical expertise and communication skills for family involvement and satisfaction. New evidence is available regarding organ donor's management and pathway. The importance of checklists is gaining particular interest according to recent literature. Recent clinical trials including the use of naloxone, simvastatin and goal directed hemodynamic therapies were not able to demonstrate a clear benefit in improving quality and number of transplanted organs. Ethical concerns about DCD are recently being raised, and these will be discussed focusing on the differences of outcome between controlled and uncontrolled procedure.

Summary
The major change in the process of organ donation has been to implement parallel DCD and donation after brain death pathways. However, more research is needed for improving quality and number of transplanted organs.
Rhombic Flap: A Useful Flap for Small-to-Medium Defects of the Medial Canthus
Authors: Cressey Brienne D. , Jellinek Nathaniel J. 
Published: December 2019

BACKGROUND
Medial canthal defects are frequently encountered yet present specific challenges for the reconstructive surgeon. Surgical repair in this area may inadvertently lead to canthal webbing, ectropion, and/or epiphora. The rhombic flap is a versatile workhorse in the reconstructive armamentarium for canthal defects.

OBJECTIVE
To describe the use of the inferiorly based rhombic flap for reconstructing defects on the medial canthus.

METHODS
A retrospective analysis of the Mohs micrographic surgery cases was performed. All cases in which an inferiorly based rhombic flap was used for canthal reconstruction between 2012 and 2017 were identified. Defect size, location, and any postoperative complications were noted. Surgical scars were scored using the Vancouver Scar Scale.

RESULTS
There were 34 cases (17 men and 17 women). Age ranged from 38 to 86 (mean 69). Defect size varied from 0.6 to 2.1 cm in diameter. Postoperative complications were uncommon and minor.

CONCLUSION
The rhombic flap is a versatile and useful option for reconstructing surgical defects of the medial canthus.
Quality over quantity: skeletal loading intensity plays a key role in understanding the relationship between physical activity and bone density in postmenopausal women
Authors: Madansingh Stefan I. , Ngufor Che G. , Fortune Emma 
Published: December 2019

Abstract

Objective:
Increasing physical activity (PA) is regularly cited as a modifiable target to improve health outcomes and quality of life in the aging population, especially postmenopausal women who exhibit low bone mineral density (BMD) and high fracture risk. In this cross-sectional study, we aimed to quantify real-world PA and its association with BMD in postmenopausal women.

Methods:
Seventy postmenopausal women, aged 46 to 79 years, received a dual-energy X-ray absorptiometry scan measuring total hip BMD and wore bilateral triaxial accelerometers on the ankles for 7 days to measure PA in their free-living environment. Custom step detection and peak vertical ground reaction force estimation algorithms, sensitive to both quantity and intensity of PA, were used to calculate a daily bone density index (BDI) for each participant. Multiple regression was used to quantify the relationship between total hip BMD, age, step counts, and mean BDI over the span of 7 days of data collection.

Results:
All participants completed the full 7 days of PA monitoring, totaling more than 7 million detected steps. Participants averaged 14,485 ± 4,334 steps daily with mean peak vertical ground reaction force stepping loads of 675 ± 121 N during daily living. Across the population, total hip BMD was found to be significantly correlated with objective estimates of mean BDI (r = 0.44), as well as participant age (r = 0.285).

Conclusion:
Despite having higher-than-expected PA, the low stepping loads observed in this cohort, along with half of the participants having low BMD measures, underscores the need for PA intensity to be considered in the management of postmenopausal bone health.
Variability in Transitional Care Outcomes Across Hospitals Discharging Veterans to Skilled Nursing Facilities
Authors: Burke Robert E. , Canamucio Anne , Glorioso Thomas J. , Barón Anna E. , Ryskina Kira L. 
Published: December 2019

Background:
The period after transition from hospital to skilled nursing facility (SNF) is high-risk, but variability in outcomes related to transitions across hospitals is not well-known.

Objectives:
Evaluate variability in transitional care outcomes across Veterans Health Administration (VHA) and non-VHA hospitals for Veterans, and identify characteristics of high-performing and low-performing hospitals.

Research Design:
Retrospective observational study using the 2012–2014 Residential History File, which concatenates VHA, Medicare, and Medicaid data into longitudinal episodes of care for Veterans.

Subjects:
Veterans aged 65 or older who were acutely hospitalized in a VHA or non-VHA hospital and discharged to SNF; 1 transition was randomly selected per patient.

Measures:
Adverse “transitional care” outcomes were a composite of hospital readmission, emergency department visit, or mortality within 7 days of hospital discharge.

Results:
Among the 365,942 Veteran transitions from hospital to SNF across 1310 hospitals, the composite outcome rate ranged from 3.3% to 23.2%. In multivariable analysis adjusting for patient characteristics, hospital discharge diagnosis and SNF category, no single hospital characteristic was significantly associated with the 7-day adverse outcomes in either VHA or non-VHA hospitals. Very few high or low-performing hospitals remained in this category across all 3 years. The increased odds of having a 7-day event due to being treated in a low versus high-performing hospital was similar to the odds carried by having an intensive care unit stay during the index admission.

Conclusions:
While variability in hospital outcomes is significant, unmeasured care processes may play a larger role than currently measured hospital characteristics in explaining outcomes.
Review on the role of socioeconomic status in child health and development
Authors: Poulain Tanja , Vogel Mandy , Kiess Wieland 
Published: December 2019

Purpose of review
This review presents findings from recent studies investigating the role of socioeconomic status (SES) in child development. Studies on associations between SES and different parameters of physical and psychological health, on interventions and possible resilience factors are reviewed.

Recent findings
Several cross-sectional and longitudinal studies demonstrate social disparities in child behavior and health. They underline the detrimental effects of low SES on child development. Some studies also highlight the potentially adverse effects of early diseases or vulnerabilities on later career and social position. Whereas most studies applied parent-based measures of SES, some studies emphasize the significance of child-based (e.g. perceived social position) and area-level indicators of SES (e.g. area deprivation). With respect to intervention, study findings suggest positive effects of programs aiming to improve specific neighborhood characteristics and psychosocial functioning of individuals.

Summary
The relation between SES and health is bidirectional and stable, and the effects of interventions aiming at changing behaviors of children and families with low SES are small. There is a need for further center-based and area-level interventions and studies evaluating the effects of these interventions.
Performance of an Alternative Laboratory-Based HIV Diagnostic Testing Algorithm Using HIV-1 RNA Viral Load
Authors: Pitasi Marc A. , Patel Shilpa N. , Wesolowski Laura G. , Masciotra Silvina , Luo Wei , Owen S. Michele , Delaney Kevin P. 
Published: December 2019

Background
Since 2014, the recommended algorithm for laboratory diagnosis of HIV infection in the United States has consisted of an HIV-1/2 antigen/antibody (Ag/Ab) test followed by an HIV-1/2 antibody (Ab) differentiation test and, if necessary, a diagnostic HIV-1 nucleic acid test to resolve discordant or indeterminate results.

Methods
Using stored specimens from persons seeking HIV testing who had not received a previous diagnosis or treatment, we compared the performance of a 3-step alternative algorithm consisting of an Ag/Ab test followed by a quantitative HIV-1 RNA viral load assay and, if viral load is not detected, an Ab differentiation test, to that of the recommended algorithm. We calculated the sensitivity and specificity of 5 Ag/Ab tests and the proportion of specimens correctly classified by the alternative algorithm compared with the recommended algorithm. Results were examined separately for specimens classified as early infection, established infection, and false-reactive screening.

Results
Sensitivity and specificity were similar among all Ag/Ab tests. Viral load quantification correctly classified all specimens from early infection, all false-reactive screening specimens, and the majority of specimens from established infection.

Conclusions
Although cost, regulatory barriers, test availability, and the ability to differentiate early from established infection must be considered, this alternative algorithm can potentially decrease the total number of tests performed and reduce turnaround time, thereby streamlining HIV diagnosis and initiation of treatment.
Parental Knowledge of Appropriate Placement of Child Restraint Systems Before and After Educational Intervention in a Pediatric Emergency Department
Authors: Perez Vanessa , Zidan Marwan A. , Sethuraman Usha 
Published: December 2019

Objective
This study aimed to determine caregiver's knowledge of appropriate car restraint systems (CRSs) use and compare this with the actual use among children presenting to the pediatric emergency department (PED), and to determine the efficacy of PED-based intervention on improving knowledge.

Methods
We conducted a prospective, intervention study of children (<8 years old) during a 12-month period in the PED. Based on their height and weight, children were assigned to group 1 (rear facing), group 2 (forward facing), or group 3 (booster). Caregivers were surveyed in their baseline CRS knowledge. Certified child passenger safety technicians evaluated each CRS and gave caregivers one-on-one education. Participants were called back to answer a posttest to determine if the information given was retained.

Results
Of the 170 children enrolled, 64 (37.6%) were assigned to group 1, 68 (40%) to group 2, and 38 (22.3%) to group 3. Of these, 63% were not aware of the state law regarding CRS use. Among those without a CRS, 18% belonged to group 1, 36% to group 2, and 46% to group 3. Even among those who reportedly had CRS, 13% of children did not have one-on-on inspection. After inspection, 84% of group 1, 71% of group 2, and 70% of group 3 were in the appropriate one. Nearly 45% were not compliant with American Academy of Pediatrics guidelines of children riding in rear-facing CRS until 2 years of age.

Conclusions
A significant proportion of children visiting the PED are not in appropriate CRS, and caretaker knowledge about correct CRS types and installation is poor. Future educational efforts should focus on rear-facing and booster seat age-group children.
Discrepant Perception of Lupus Disease Activity
Authors: Elera-Fitzcarrald Claudia , Vega Karen , Gamboa-Cárdenas Rocío V. , Zúñiga Katiuska , Medina Mariela , Pimentel-Quiroz Victor , Pastor-Asurza César , Perich-Campos Risto , Rodríguez Bellido Zoila , Griffin Russell , Aranow Cynthia , Alarcón Graciela S. , Calvo Armando , Ugarte-Gil Manuel F. 
Published: December 2019

Objective
The aim of this study was to compare patient and physician (MD) assessment of disease activity in systemic lupus erythematosus patients.

Methods
This cross-sectional study was conducted between August 2016 and December 2017 at 2 Peruvian hospitals. One group assessed disease activity using a visual analog scale (VAS, 0–100 mm) and the other one using a numerical rating scale (NRS, 0–4), before and after their MD's visit. MDs assessed it with the Mexican Systemic Lupus Erythematosus Disease Activity (Mex-SLEDAI) (0–32) and with the SLICC/ACR Damage Index (SDI) for damage. Health-related quality of life was ascertained with the LupusQoL. Visual analog scale and NRS were compared using the Wilcoxon signed-rank test and the correlation between disease activity as assessed by the patient and the Mex-SLEDAI, SDI, and LupusQoL with the Spearman rank correlation.

Results
Two hundred forty patients were included; mean (SD) age at diagnosis was 34.9 (12.9) years; most patients were Mestizo. Disease duration was 10.1 (7.0) years. The Mex-SLEDAI was 1.9 (2.7) and the SDI 1.2 (1.5). Disease activity as assessed by the patient, either by VAS or NRS, did not correlate with the Mex-SLEDAI or the SDI. In contrast, patient assessment of disease activity, by VAS or NRS, significantly correlated with several components of the LupusQoL (physical health, pain, planning, emotional health, and fatigue).

Conclusions
Physician's and patient's assessments of disease activity are discrepant; overall, patients score higher than their MDs. Patients score how they perceive the disease is affecting them, rather than disease activity per se. The VAS could be more useful than the NRS as a measurement of disease activity.