bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chemistry of the Karst Sarabkalan Spring, Iran, and Controls of PDO and ENSO Climate Indices on It
Authors: Rezaei Abolfazl 
Published: July 2020

AbstractThe Sarabkalan Spring serves as a primary water supply to irrigation and domestic use in the Sirvan Region, Iran. As it has a highly variable discharge, understanding its teleconnections with large‐scale climate variability is crucial. In this study, we first characterize the springshed and its corresponding karst aquifer system using genetic algorithm analysis on the spring discharge, water balance calculations, temporal variations of physicochemical parameters, and stable isotopes along with considering its geological settings. Then, the large‐scale climate indices teleconnections with precipitation and spring discharge are studied using wavelet analysis. Results reveal that the springshed contains two karst subaquifers resulting from geological and morphological settings. Unlike most developed karst systems in Zagros, which show one peak, the spring has two principal flow peaks over most hydrological years where the second peak occurs over the dry season. It takes ∼99 d (from lag correlation over 2008‐2019) and ∼145 d (from δ18O measurements over 2018‐2019) for rain water to reach the Sarabkalan Spring. Moreover, intense precipitations would result in an increase in discharge and a decrease in electrical conductivity, Ca + Mg, HCO3, SO4, Cl, ionic strength, and δ18O of the spring because of the developed karst conduit(s). It is further found that a positive Pacific Decadal Oscillation phase coupled with El Niño causes an increase in both the precipitation and spring discharge, signifying the influence of the atmospheric circulations of the Pacific Ocean on the spring behavior.
Reflectance confocal microscopy and its role in the follow‐up of a topical treatment for lentigo maligna
Authors: Coco Valeria , Perino Francesca , Di Stefani Alessandro , Cappilli Simone , Peris Ketty 
Published: July 2020

AbstractBackgroundIn recent years, there has been an ongoing interest in topical treatment for lentigo maligna (LM) as imiquimod 5% cream owing to the localization of this tumor and the advanced age of patients; however, the efficacy of imiquimod 5% cream is controversial, and the rate of local relapses is about 25–53%. Reflectance confocal microscopy (RCM) is a noninvasive diagnostic tool useful not only for diagnostic purpose but also for monitoring the response to the local treatment of LM. Our aim was to demonstrate the role of RCM in the follow‐up of a topical treatment with imiquimod 5% cream in clinical practice.MethodsWe report three patients with histopathologically confirmed LM who were not candidates for surgery and were successfully treated with imiquimod 5% cream. In such patients, dermatoscopic images and reflectance confocal microscopy were useful to evaluate treatment response and to verify long‐term clinical benefits during the follow‐up visits.ResultsNo relapses were observed in our patients 18 months after the end of treatment; although, continuous follow‐up visits are needed in these patients.ConclusionsIn the case series presented herein, we highlight the importance of RCM as a noninvasive tool to monitor the efficacy of imiquimod to treat LM during and after treatment. Detailed confocal images of two of our patients allowed us to establish the persistence of atypical cells and to continue treatment, although clinical and dermatoscopic examinations showed “apparent complete remission” after the first cycle of therapy.
Identifying and characterizing basal cell carcinomas in persons with albinism
Authors: Juhasz Margit L. W. , Levin Melissa K. , Sharp Andrew 
Published: July 2020

AbstractBackgroundHistorically, persons with albinism (PWA) were thought to develop squamous cell carcinoma (SCC) more frequently than basal cell carcinoma (BCC). Recent evidence suggests BCCs in PWA are more common than initially hypothesized.ObjectiveTo characterize the presentation of BCC in PWA.MethodsFifty‐four PWA with lesions suspicious for non‐melanoma skin cancer sought care at Tanzanian dermatologic clinics from 2017 to 2019. Demographic and clinical presentation data were recorded. Histologic analysis of each sample was completed.ResultsThe majority of PWA were female (53.7%), with a mean age of 34.6 ± 14.9 years and a mean duration of disease of 0.70 ± 0.73 years. Physician description of histologically proven BCC included ulceration (41.7%), erythema (16.7%), and scale (16.7%). Lesions were most commonly located on the trunk (47.1%) and face (41.2%). Histologic analysis demonstrated 30.2% of lesions were BCC, 26.4% SCC, and 17% Bowen's disease.LimitationsPatient population was limited to those visiting clinics, and data were limited by accuracy of the medical record.ConclusionsBasal cell carcinoma occurs at a higher rate than SCC in our population, suggesting BCC in PWA is underdiagnosed. It is important to recognize BCC early in PWA to avoid large disease burden and high rates of morbidity and mortality.
Duration of smoking cessation is negatively associated with the magnitude of chronic prostatic inflammation and storage dysfunction in patients with benign prostatic hyperplasia
Authors: Inamura So , Ito Hideaki , Oe Hideki , Seki Masaya , Taga Minekatsu , Kobayashi Motohiro , Yokoyama Osamu 
Published: July 2020

ObjectivesTo evaluate the impact of smoking and the benefit of smoking cessation on lower urinary tract function and prostatic inflammation in patients with benign prostatic hyperplasia.MethodsThe medical records of 118 benign prostatic hyperplasia patients who underwent transurethral prostatic surgery between 2006 and 2016 were analyzed. Their smoking history was confirmed. The relationship between smoking and main clinical parameters, International Prostate Symptom Scores, uroflowmetry, pressure flow study, magnitude of prostatic inflammation and the level of serum C‐reactive protein was investigated. Furthermore, the relationships between smoking cessation and these clinical parameters were assessed.ResultsThe International Prostate Symptom Scores for straining among the non‐smokers were significantly lower than those of the smokers (1.71 vs 2.60, P = 0.029). In the pressure flow study, there were negative correlations between the duration of smoking and strong desire to void (correlation coefficient −0.314, P = 0.013), urgency (correlation coefficient −0.349, P = 0.008) and bladder volume at initial detrusor overactivity (correlation coefficient −0.417, P = 0.021). The duration of smoking cessation was negatively correlated with the magnitude of chronic prostatic inflammation (correlation coefficient −0.253, P = 0.027). In the pressure flow study, the duration of smoking cessation was positively correlated with urgency (correlation coefficient 0.286, P = 0.030) and maximum cystometric capacity (correlation coefficient 0.241, P = 0.050).ConclusionsSmoking could be a risk factor for the exacerbation of storage dysfunction in benign prostatic hyperplasia patients. Smoking cessation is effective in improving chronic prostatic inflammation and storage dysfunction.
Is the membranous urethral length related to postoperative urinary incontinence after holmium laser enucleation of the prostate?
Authors: Ueki Hideto , Takahashi Kosuke , Yasufuku Tomihiko , Yuen Keiji , Yamashita Masuo 
Published: July 2020

ObjectivesTo investigate the findings of preoperative magnetic resonance imaging associated with the occurrence of transient urinary incontinence after holmium laser enucleation of the prostate.MethodsAt a single institution, 360 patients underwent holmium laser enucleation of the prostate between January 2014 and December 2018. Of those, we retrospectively evaluated 237 who underwent preoperative magnetic resonance imaging and for whom postoperative evaluations were available for >3 months after holmium laser enucleation of the prostate. We carried out preoperative magnetic resonance imaging, and measured the periurethral sphincter complex, levator ani thickness, membranous urethral length and minimal residual membranous urethral length. Logistic regression analysis was carried out to assess the variables associated with incontinence.ResultsTransient urinary incontinence occurred after holmium laser enucleation of the prostate in 68 patients (28.7%); 46 (67.6%) of whom recovered within 3 months. Multivariate analysis showed that the membranous urethral length was independently associated with postoperative urinary incontinence at 1 and 3 months after surgery. The operative time was also independently associated with postoperative transient urinary incontinence at 1 month after surgery.ConclusionPreoperative membranous urethral length and operative time are independent predictors of transient urinary incontinence after holmium laser enucleation of the prostate. These findings should be considered by surgeons before surgery.
The use of acellular porcine dermis, hyaluronic acid and polynucleotides in the treatment of cutaneous ulcers: Single blind randomised clinical trial
Authors: Segreto Francesco , Carotti Simone , Marangi Giovanni Francesco , Francesconi Maria , Scaramuzzino Luca , Gratteri Marco , Caldaria Erika , Morini Sergio , Persichetti Paolo 
Published: July 2020

AbstractReconstruction of chronic ulcers is often hampered by lack of local tissues and poor general conditions. Conservative approaches with debridement and advanced medications, such as polyurethane foam, stand as mainstays. However, the healing process is often slow, thus increasing the risk for infection or other complications. In such cases, porcine dermis (PD) and polynucleotides‐added hyaluronic acid (PAHA) were previously reported to accelerate healing. The aim of the study was to compare the efficacy of PD, PAHA and polyurethane foam in chronic ulcers. Thirty patients were randomly divided into 3 groups: group 1 was treated with advanced medications, group 2 with PD, group 3 with PAHA. Standardised photographs and biopsies were taken before treatment and at 30‐day follow‐up. Photographs were processed to calculate the wound area. Specimens were stained with Haematoxylin/Eosin, Masson trichrome, and immunohistochemically for CD34, alpha‐Smooth Muscle Actin (α‐SMA), Collagen types I and III, Ki67. The re‐epithelialized area was larger in patients treated with PD and PAHA compared with those treated with polyurethane foam (P < .05 and P < .01, respectively). Specimens from patients treated with PD and PAHA showed a higher number of myofibroblasts (α‐SMA+, P < .01), neo‐angiogenesis (CD34+, P < .01), proliferating dermal cells (Ki67+, P < .01), proliferating keratinocytes (Ki67+, P < .01) and collagen type 1 deposition (P < .05). No difference was found between PD and PAHA. PD and PAHA proved to be more effective than polyurethane foam in the treatment of chronic ulcers. These approaches are a versatile and reliable option to address such cases.
Alcohol consumption does not increase the risk of surgical wound complications in breast cancer patients
Authors: de Menezes Raquel Ferreira , Bergmann Anke , Thuler Luiz Claudio Santos 
Published: July 2020

AbstractAlcohol consumption, despite influencing several organic processes, has been scarcely studied regarding the risk of developing surgical wound complications after surgical breast cancer treatment. The aim of this study was to analyse the association between alcohol consumption and the development of surgical wound complications in women undergoing surgical treatment for breast cancer. A prospective cohort study was conducted, comprising 486 women between 40 and 69 years old, interviewed during the preoperative period and followed up for 30 days. The occurrence of seroma, necrosis, surgical site infection (SSI), dehiscence, ecchymosis, and hematoma were considered as outcomes. Alcohol consumption during the 30 days prior to surgery was reported by 20.8% of the patients, with 8.4% being occasional consumers and 12.4% regular consumers. Binge drinking was reported by 10.2% of the women. The presence of surgical wound complications was observed in 65.2%. The most frequent complications were seroma (54.3%), necrosis (17.7%), and SSI (7.8%). No statistically significant association between alcohol consumption and the development of cicatricial complications was observed.
Family network typologies of adults with intellectual disability: Associations with psychological outcomes
Authors: Tournier Tess , Hendriks Alexander H. C. , Jahoda Andrew , Hastings Richard P. , Giesbers Sanne A. H. , Vermulst Ad A. , Embregts Petri J. C. M. 
Published: July 2020

AbstractBackgroundBased on self‐reported social capital, different typologies of family networks of people with intellectual disabilities were examined. Associations between behavioural and emotional problems or well‐being and typologies were investigated.Method137 participants with mild intellectual disability were interviewed using the Family Network Method‐Intellectual Disability to assess their emotionally supportive family relationships. Data on participants’ well‐being and behavioural and emotional problems were also gathered. Latent class analysis was used to identify family typologies based on social network measures.ResultsFour distinguishable typologies were identified, two supportive and two less supportive. A small association was found with behavioural and emotional problems and one of the supportive typologies. Associations with constructs of well‐being were found for both supportive and less supportive typologies.ConclusionsA variety of family types were found, with implications for sensitive professional support.
Rationale, design, and baseline characteristics of the Salt Substitute in India Study (SSiIS): The protocol for a double‐blinded, randomized‐controlled trial
Authors: Thout Sudhir Raj , Yu Jie , Tian Maoyi , Huffman Mark D. , Arnott Clare , Li Qiang , Devarsetty Praveen , Johnson Claire , Pettigrew Simone , Neal Bruce , Wu Jason H. Y. 
Published: July 2020

AbstractReduced‐sodium, added‐potassium salt substitutes have favorable effects on blood pressure, but have not been tested in India. The Salt Substitute in India Study (SSiIS) is a double‐blinded, randomized‐controlled trial designed to investigate the effects of reduced‐sodium, added‐potassium salt substitution to replace usual cooking salt use and blood pressure (BP) among hypertensive patients in rural India. The primary objective is to assess effects on systolic blood pressure at 3 months. The secondary objectives are to determine effects on diastolic blood pressure, urinary sodium, and potassium levels, and to determine acceptability of the intervention. Eligible individuals received usual salt (100% sodium chloride) or salt substitute (70% sodium chloride and 30% potassium chloride) to replace all salt required for cooking and seasoning in the household. A total of 502 participants aged ≥18 years with a history of hypertension were successfully recruited and randomized in a 1:1 ratio to intervention or control, between November 2019 and January 2020. Mean blood pressure at baseline was 133.5/83.6 mm Hg and 96% were using one or more blood pressure‐lowering medications. The overall mean average 24‐hour urinary sodium excretion was 2825 (SD, 1166) mg/L, which corresponds to a urinary salt excretion of 10.4 g/d. Baseline findings suggest sodium intake in this population significantly exceeds World Health Organization recommendations. The SSiIS trial has successfully recruited participants and is well placed to determine whether salt substitution is an effective means of lowering blood pressure for rural Indian patients with hypertension.
Mental health of healthcare workers during the COVID‐19 pandemic in Italy
Authors: Di Tella Marialaura , Romeo Annunziata , Benfante Agata , Castelli Lorys 
Published: July 2020

AbstractBackgroundThe COVID‐19 pandemic represents one of the most stressful events of recent times. Among the population, healthcare professionals who treat COVID‐19 patients are most likely to develop psychological distress and posttraumatic stress symptoms (PTSS). The present study thus aimed to investigate the psychological impact of the COVID‐19 outbreak on Italian healthcare workers.MethodsThe responses of 145 healthcare workers (72 medical doctors and 73 nurses) were included in the final dataset. Participants were asked to provide sociodemographic and clinical information, and to complete: (a) quality of life and health‐related Visual Analogue Scales, (b) State‐Trait Anxiety Inventory‐Form Y1, (c) Beck Depression Inventory, and (d) PTSD Checklist for DSM‐5.ResultsA comparison between healthcare professionals working in COVID‐19 wards and other units revealed that the former reported higher levels of both depressive symptoms and PTSS. Moreover, the results of regression analyses showed that in healthcare professionals working with COVID‐19 patients, gender and marital status, and gender and age significantly predicted depressive symptoms and PTSS, respectively. Particularly, being female and not in a relationship were found to be associated with higher levels of depressive symptoms, whereas being female and older were found to be related to higher levels of PTSS.ConclusionsThe current findings suggest that specific predisposing factors could identify healthcare workers who are at high risk of developing mental health symptoms when faced with COVID‐19 patients.
First estimates of metabolic rate in Atlantic bluefin tuna larvae
Authors: Blanco Edurne , Reglero Patricia , Ortega Aurelio , Folkvord Arild , de la Gándara Fernando , Hernández de Rojas Alma , Moyano Marta 
Published: July 2020

AbstractAtlantic bluefin tuna is an iconic scombrid species with a high commercial and ecological value. Despite their importance, many physiological aspects, especially during the larval stages, are still unknown. Metabolic rates are one of the understudied aspects in scombrid larvae, likely due to challenges associated to larval handling before and during respirometry trials. Gaining reliable estimates of metabolic rates is essential to understand how larvae balance their high growth needs and activity and other physiological functions, which can be very useful for fisheries ecology and aquaculture. This is the first study to (a) estimate the relationship between routine metabolic rate (RMR) and larval dry weight (DW) (mass scaling exponent) at a constant temperature of 26°C, (b) measure the RMR under light and darkness and (c) test whether the interindividual differences in the RMR are related to larval nutritional status (RNA/DNA and DNA/DW). The RMR scaled nearly isometrically with body size (b = 0.99, 0.60–31.56 mg DW) in contrast to the allometric relationship observed in most fish larvae (average b = 0.87). The results show no significant differences in larval RMR under light and darkness, suggesting similar larval activity levels in both conditions. The size explained most of the variability in RMR (97%), and nutritional condition was unrelated to the interindividual differences in routine metabolism. This is the first study to report the metabolic rates of Atlantic bluefin tuna larvae and discuss the challenges of performing bioenergetic studies with early life stages of scombrids.
The Black and White of Invasive Mechanical Ventilation in Advanced Dementia
Authors: Sharma Rashmi K. , Kim Hyosin , Gozalo Pedro L. , Sullivan Donald R. , Bunker Jennifer , Teno Joan M. 
Published: July 2020

BACKGROUND/OBJECTIVESOver the past decade, feeding tube use in nursing home residents with advanced dementia has declined by 50% among white and black patients. Little is known about whether a similar reduction has occurred in other invasive interventions, such as mechanical ventilation.DESIGNRetrospective cohort study.SETTINGAcute‐care hospitals in the United States.PARTICIPANTSMedicare beneficiaries with advanced dementia who previously resided in a nursing home and were hospitalized between 2001 and 2014 with pneumonia and/or septicemia and of either black or white race.MEASUREMENTInvasive mechanical ventilation (IMV), as identified by International Classification of Diseases (ICD) procedure codes. Two multivariable logistic regression models examined the association between race and the likelihood of receiving IMV, adjusting for patients' demographics, physical function, and comorbidities. A hospital fixed‐effects model examined the association of race within a hospital, whereas a random‐effects logistic model was used to estimate the between‐hospital variation in the probability of receiving IMV and examine the overall association of race and use of IMV.RESULTSBetween 2001 and 2014, 289,017 patients with advanced dementia were hospitalized for pneumonia or septicemia. Use of IMV increased from 3.7% to 12.1% in white patients and from 8.6% to 21.8% in blacks. Among those ventilated, 1‐year mortality rates remained high, at 82.7% for whites and 84.2% for blacks dying in 2013. Compared with whites, blacks had a higher odds of receiving IMV in the fixed‐effects (within‐hospital) model (adjusted odds ratio (AOR) = 1.34; 95% confidence interval (CI) = 1.29–1.39) and in the random‐effects (between‐hospital) model (AOR = 1.46; 95% CI = 1.40–1.51).CONCLUSIONIMV use in patients with advanced dementia has increased substantially, with black patients having a larger increase than whites, based, in part, on the hospitals where black patients receive care.
Hospital Elder Life Program in Long‐Term Care (HELP‐LTC): A Cluster Randomized Controlled Trial
Authors: Boockvar Kenneth S. , Judon Kimberly M. , Eimicke Joseph P. , Teresi Jeanne A. , Inouye Sharon K. 
Published: July 2020

BACKGROUND/OBJECTIVESThe Hospital Elder Life Program (HELP) has been shown to prevent delirium in hospitalized older adults. The objective of this study was to test the efficacy of HELP adapted to long‐term care (HELP‐LTC).DESIGNCluster randomized controlled trial.SETTINGA 514‐bed academic urban nursing home.PARTICIPANTSA total of 219 long‐term nursing home residents who developed an acute illness or change in condition were randomly assigned to HELP‐LTC (n = 105) or usual care (n = 114) by unit.INTERVENTIONHELP‐LTC is a multicomponent intervention targeting delirium risk factors of cognitive impairment, immobility, dehydration, and malnutrition. Two certified nursing assistants (CNAs) delivered HELP‐LTC components twice daily 7 days per week. In addition, recommendations were given to primary providers to reduce medications associated with delirium.MEASUREMENTSDelirium (primary outcome) and delirium severity were ascertained each weekday by a research assistant blinded to group assignment, using the Confusion Assessment Method (CAM) and CAM severity score (CAM‐S), respectively. Cognitive function was determined using the Cognitive Performance Scale (CPS). Hospitalization was ascertained by chart review.RESULTSParticipants were 81.7 years of age on average and 65.3% female. At baseline, usual care group participants had better cognitive function than intervention group participants (CPS = 1.33 vs 2.25; P = .004). Delirium symptoms declined over the course of the episode (mean CAM‐S = 3.63 at start vs 3.27 at end). Overall, 33.8% of the total sample experienced incident delirium. After adjusting for baseline cognitive function, no significant differences were found in delirium or delirium severity between intervention and usual care groups. Hospitalization was not significantly different between groups.CONCLUSIONAn intervention targeting delirium risk in long‐term nursing home residents did not prevent delirium or reduce delirium symptoms. Baseline differences in cognitive function between groups, greater than expected improvements in both groups, quality‐enhancing practices such as consistent assignments delivered to both groups, and adaptations of the intervention may have biased results toward null. J Am Geriatr Soc 68:2329–2335, 2020.