bluuebunny/crossref_metadata_2025_split huggingface dataset:
What influences adolescents to continuously use e‐cigarettes?
Authors: Han Gyumin , Son Hyunmi 
Published: May 2020

AbstractObjectiveThe use of e‐cigarettes is rapidly increasing in adolescents. Health care providers pay attention to e‐cigarette users because of the risk of developing addiction and problematic behavior. Based on ecological perspective, this study investigated factors influencing continued e‐cigarette use.MethodsWe classified 1556 current e‐cigarette users into experimental and continued users using the Korean national representative data. Data were analyzed using the chi‐square test and logistic regression based on a complex sample analysis.ResultsAmong current e‐cigarette users, 55.1% were continued users. Adolescents who use e‐cigarettes because of the belief that they are less harmful than cigarettes, concealment, easy purchase, and adding various flavors had a high risk of continued use. Continued users were more likely to have a higher weekly allowance, lower rate of living with family, and higher chance of smoking parents and exposure to passive smoking at home.ConclusionsContinued e‐cigarette use was influenced by interpersonal and environmental factors, such as ease of purchase and addition of flavoring substances. Improving the environment of adolescents can prevent continued use of e‐cigarettes.
Poverty, Policy, and Federal Administrative Discourse: Are Bureaucrats Speaking EquitableAntipovertyPolicy Designs into Existence?
Authors: Starke Anthony M. 
Published: May 2020

AbstractNon‐elected,non‐appointed federal employees,referred to as “bureaucrats,” are among the many policy actors that participate in policy discourse.This article investigates whether bureaucrats’ administrative discourse promotes economic equality,as Dr.Martin Luther King Jr.envisioned.Based on a qualitative analysis of data from congressional testimonies (n = 34) before and after the enactment of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, this study discusses the role of public administrators as contributors to welfare policy discourse and the resulting implications for the fight for equality and equal citizenship.It finds that bureaucrats’ welfare policy discourse marginalized vulnerable populations,particularly African American women.
Towards scheduled pre‐parturient caesarean sections in bitches
Authors: De Cramer Kurt G. M. , Nöthling Johan O. 
Published: May 2020

AbstractElective caesarean section (CS) is the safest means of delivering the litter in bitches in specific situations. Timeously performing elective pre‐parturient CSs at a fixed time would be convenient and prevent emergency CSs and foetal demise. This review proposes a method of performing elective pre‐parturient CSs which is safe for both the bitch and puppies. Brachycephaly, small litters and large litters, preceding litter delivered by CS and trial of labour after a preceding CS are identified as factors increasing the need for CS whereas emergency CS is identified as factor increasing foetal demise. The first day of cytological dioestrus more precisely predicts the day of onset of spontaneous parturition than the first day of the LH surge or the dates during oestrus on which progesterone (P4) first exceeds 6 nM or 16 nM. Foetal biparietal diameter at the time of onset of spontaneous parturition varies too much to accurately predict readiness for CS. During the last few days of gestation, P4 with cut‐off concentrations at 15.8, 8.7 and 3.18 nM, but not plasma cortisol concentrations, hold promise as predictors of onset of parturition and when to perform pre‐parturient CSs. A protocol associating medetomidine hydrochloride as premedicant with propofol as induction agent and sevoflurane as maintenance is safe for scheduled CS and yields good maternal and puppy survival rates at delivery, 2 hr and 7 days after CSs. Clinicians have to pay attention to the haematocrit of bitches at the time of cervical dilatation which is at the lower end of the normal reference ranges for non‐pregnant dogs and to the decline in haematocrit during CS (as a proxy for blood loss) which is approximately 7% for both parturient (open cervix) and pre‐parturient (closed cervix) CSs. Pre‐parturient CSs can be scheduled and performed 57 days after onset of cytological dioestrus with puppy survival rates of 99%. Collectively, these studies provide a protocol to safely perform elective CSs in a large proportion of the obstetric population at a convenient time of the day but more research is required with larger numbers to establish whether this practice is routinely safe and safe in all breeds.
Older patients’ perspectives on mealtimes in hospitals: a scoping review of qualitative studies
Authors: Jonsson Ann‐Sofie , Nyberg Maria , Jonsson Inger M. , Öström Åsa 
Published: May 2020

The increasing age of populations throughout the world means that healthcare services are faced with new challenges, not least regarding the provision of food during hospital stay. There is a lack of knowledge of how hospital mealtimes are experienced by older patients, and so the aim of this article was to review current knowledge regarding mealtimes in hospitals from the perspectives of older patients. A literature search was performed using seven databases: PubMed, Web of Science, Scopus, Sociological Abstracts, SweMed+, ASSIA and CINAHL with no limits regarding publication date. The inclusion criteria were peer‐reviewed articles in English or Swedish that used qualitative methods to examine older patients’ (>65 years) mealtime experiences. The Five Aspect Meal Model (FAMM) served as a framework for understanding the complexity behind a mealtime experience. Qualitative content analysis was used as a guide when analysing the material. The search produced 415 studies, 14 of which were included in the review. The findings generated three main themes for understanding how older patients experience mealtimes while in hospital: (1) the food and the food service, (2) mealtime assistance and commensality during mealtimes and (3) the importance of retaining one’s independence. The review also clearly indicated a shortage of studies that solely focus on older patients’ experiences of their mealtime. More research is therefore needed to be fully able to understand the complex task of providing meals in hospitals.
An Integrated Curriculum in Collegiate‐Level German Studies with Accompanying Proficiency Ratings
Authors: Bernhardt Elizabeth , Nissler Paul , Leffell Cici Malik 
Published: May 2020

AbstractThe contemporary watchword within curricular discussions in German is integration across multiple linguistic levels and literacy dimensions. This article contributes to the discussion by chronicling how one university responded and contributed to curricular currents in German, constructing concrete documents reflective of those currents. The article provides an explication of how an undergraduate German curriculum was developed horizontally (i.e., across courses) and vertically (i.e., within courses); it also discusses oral and writing proficiency ratings of 206 students completing the first‐year and second‐year sequence codified in these documents. This data set enables readers to judge the relationship between certain features of the curriculum and their influence on student performance and projects how this configuration can establish a foundation for the German major. Beyond vivifying student performance, the data provided enable direct comparison with other institutions, their student bodies, and with curricula developed in world languages other than German.
Living and Learning in a Foreign Language House: A Description of a Residential Language Learning Program
Authors: Kelling Hans‐Wilhelm , Bown Jennifer 
Published: May 2020

AbstractForeign language houses, on‐campus residences in which students pledge to speak in their target language, offer valuable opportunities for language and culture learning. Scores of such programs exist at universities across North America (Dewey, Baker, Bown, & Martinsen, 2011), yet little is written about them in the research literature. This article details a foreign language residence at a large private university in the Western United States, describing the history of the program as well as the design of the foreign language house – from the physical space to the curriculum and social programming. It is hoped that this article provides insights into how to initiate or improve existing programs.
Ketamine‐dexmedetomidine combination and controlled mild hypothermia for the treatment of long‐lasting and super‐refractory status epilepticus in 3 dogs suffering from idiopathic epilepsy
Authors: Gioeni Daniela , Di Cesare Federica , D'Urso Elisa Silvia , Rabbogliatti Vanessa , Ravasio Giuliano 
Published: May 2020

AbstractObjectiveTo describe the use of a ketamine‐dexmedetomidine combination and mild hypothermia for the treatment of status epilepticus in 3 dogs that did not respond to GABAergic medication.Case Series SummaryThree dogs, each with a diagnosis of idiopathic epilepsy, were presented to the emergency department in a state of status epilepticus. The dogs were treated unsuccessfully with benzodiazepine as a first‐line therapy that was followed by IV propofol anesthesia maintained for at least 12 hours. When general anesthesia was discontinued, seizures reoccurred. All 3 dogs then received a bolus of ketamine (1 mg/kg, IV) over a period of 5 minutes that was followed by a bolus of dexmedetomidine (3 μg/kg, IV) over the same time period and then followed by a continuous infusion for 12 hours of ketamine at a constant rate of 1 mg/kg/h and dexmedetomidine at a variable rate of 3–7 μg/kg/h. Body temperature was maintained between 36.7 and 37.7°C at a state of mild hypothermia throughout treatment. The dogs recovered uneventfully over 48 hours after treatment was discontinued with no evidence of seizures. No notable alterations in physiological parameters were observed during the drug infusions. All dogs were discharged following examinations that showed normal neurological function.New or Unique Information ProvidedThis case series highlights the potential benefits of a ketamine‐dexmedetomidine infusion combined with mild hypothermia for the treatment of status epilepticus refractory to GABAergic therapy in dogs suffering from idiopathic epilepsy. After the dogs were weaned from the ketamine‐dexmedetomidine infusion, all dogs experienced complete recovery. Thus, this case series introduces a novel approach to treat this intense condition.
Deep phenotyping of cardiac function in heart transplant patients using cardiovascular system models
Authors: Colunga Amanda L. , Kim Karam G. , Woodall N. Payton , Dardas Todd F. , Gennari John H. , Olufsen Mette S. , Carlson Brian E. 
Published: May 2020

Key points
Right heart catheterization data from clinical records of heart transplant patients are used to identify patient‐specific models of the cardiovascular system.
These patient‐specific cardiovascular models represent a snapshot of cardiovascular function at a given post‐transplant recovery time point.
This approach is used to describe cardiac function in 10 heart transplant patients, five of which had multiple right heart catheterizations allowing an assessment of cardiac function over time.
These patient‐specific models are used to predict cardiovascular function in the form of right and left ventricular pressure‐volume loops and ventricular power, an important metric in the clinical assessment of cardiac function.
Outcomes for the longitudinally tracked patients show that our approach was able to identify the one patient from the group of five that exhibited post‐transplant cardiovascular complications.

AbstractHeart transplant patients are followed with periodic right heart catheterizations (RHCs) to identify post‐transplant complications and guide treatment. Post‐transplant positive outcomes are associated with a steady reduction of right ventricular and pulmonary arterial pressures, toward normal levels of right‐side pressure (about 20 mmHg) measured by RHC. This study shows that more information about patient progression is obtained by combining standard RHC measures with mechanistic computational cardiovascular system models. The purpose of this study is twofold: to understand how cardiovascular system models can be used to represent a patient's cardiovascular state, and to use these models to track post‐transplant recovery and outcome. To obtain reliable parameter estimates comparable within and across datasets, we use sensitivity analysis, parameter subset selection, and optimization to determine patient‐specific mechanistic parameters that can be reliably extracted from the RHC data. Patient‐specific models are identified for 10 patients from their first post‐transplant RHC, and longitudinal analysis is carried out for five patients. Results of the sensitivity analysis and subset selection show that we can reliably estimate seven non‐measurable quantities; namely, ventricular diastolic relaxation, systemic resistance, pulmonary venous elastance, pulmonary resistance, pulmonary arterial elastance, pulmonary valve resistance and systemic arterial elastance. Changes in parameters and predicted cardiovascular function post‐transplant are used to evaluate the cardiovascular state during recovery of five patients. Of these five patients, only one showed inconsistent trends during recovery in ventricular pressure–volume relationships and power output. At the four‐year post‐transplant time point this patient exhibited biventricular failure along with graft dysfunction while the remaining four exhibited no cardiovascular complications.
Normal human and sheep fetal vessel oxygen saturations by T2 magnetic resonance imaging
Authors: Saini Brahmdeep S. , Darby Jack R. T. , Portnoy Sharon , Sun Liqun , van Amerom Joshua , Lock Mitchell C. , Soo Jia Yin , Holman Stacey L. , Perumal Sunthara R. , Kingdom John C. , Sled John G. , Macgowan Christopher K. , Morrison Janna L. , Seed Mike 
Published: May 2020

Key points
Human fetal Doppler ultrasound and invasive blood gas measurements obtained by cordocentesis or at the time of delivery reveal similarities with sheep (an extensively used model for human fetal cardiovascular physiology).
Oxygen saturation (SO2) measurements in human fetuses have been limited to the umbilical and scalp vessels, providing little information about normal regional SO2 differences in the fetus.
Blood T2 MRI relaxometry presents a non‐invasive measure of SO2 in the major fetal vessels.
This study presents the first in vivo validation of fetal vessel T2 oximetry against the in vitro T2–SO2 relationship using catheterized sheep fetuses and compares the normal SO2 in the major vessels between the human and sheep fetal circulations.
Human fetal vessel SO2 by T2 MRI confirms many similarities with the sheep fetal circulation and is able to demonstrate regional differences in SO2; in particular the significantly higher SO2 in the left versus right heart.
AbstractBlood T2 magnetic resonance imaging (MRI) relaxometry non‐invasively measures oxygen saturation (SO2) in major vessels but has not been validated in fetuses in vivo. We compared the blood T2–SO2 relationship in vitro (tubes) and in vivo (vessels) in sheep, and measured SO2 across the normal human and sheep fetal circulations by T2. Singleton pregnant ewes underwent surgery to implant vascular catheters. In vitro and in vivo sheep blood T2 measurements were related to corresponding SO2 measured using a blood gas analyser, as well as relating T2 and SO2 of human fetal blood in vitro. MRI oximetry was performed in the major vessels of 30 human fetuses at 36 weeks (term, 40 weeks) and 10 fetal sheep (125 days; term, 150 days). The fidelity of in vivo fetal T2 oximetry was confirmed through comparison of in vitro and in vivo sheep blood T2–SO2 relationships (P = 0.1). SO2 was similar between human and sheep fetuses, as was the fetal oxygen extraction fraction (human, 33 ± 11%; sheep, 34 ± 7%; P = 0.798). The presence of streaming in the human fetal circulation was demonstrated by the SO2 gradient between the ascending aorta (68 ± 10%) and the main pulmonary artery (49 ± 9%; P < 0.001). Human and sheep fetal vessel MRI oximetry based on T2 is a validated approach that confirms the presence of streaming of umbilical venous blood towards the heart and brain. Streaming is important in ensuring oxygen delivery to these organs and its disruption may have important implications for organ development, especially in conditions such as congenital heart disease and fetal growth restriction.
The Ability of Baseline and Normative Neurocognitive Testing to Identify Cognitive Impairments Following Concussion: A Critically Appraised Topic
Authors: Hattrup Nicholas M. , Gardiner Rebekah L. , Gray Hannah , Welch Bacon Cailee E. , Valovich McLeod Tamara C. 
Published: May 2020

Focused Clinical Question: In a high school, college, and professional athletic population, does individualized baseline tests increase the diagnostic accuracy (e.g., sensitivity and specificity) of identifying cognitive impairments when utilizing neurocognitive testing compared to normative data? Clinical Bottom Line: There was insufficient evidence to definitively suggest the use of individualized baseline data over the use of normative data during a postinjury assessment.
Cross-sectional centiles of blood pressure by age and sex: a four-hospital database retrospective observational analysis
Authors: Wong David , Gerry Stephen , Shamout Farah , Clifton David A , Pimentel Marco A F , Watkinson Peter J 
Published: May 2020

ObjectivesNational guidelines for identifying physiological deterioration and sepsis in hospitals depend on thresholds for blood pressure that do not account for age or sex. In populations outside hospital, differences in blood pressure are known to occur with both variables. Whether these differences remain in the hospitalised population is unknown. This database analysis study aims to generate representative centiles to quantify variations in blood pressure by age and sex in hospitalised patients.DesignRetrospective cross-sectional observational database analysis.SettingFour near-sea-level hospitals between April 2015 and April 2017Participants75 342 adult patients who were admitted to the hospitals and had at least one set of documented vital sign observations within 24 hours before discharge were eligible for inclusion. Patients were excluded if they died in hospital, had no vital signs 24 hours prior to discharge, were readmitted within 7 days of discharge, had missing age or sex or had no blood pressure recorded.ResultsSystolic blood pressure (SBP) for hospitalised patients increases with age for both sexes. Median SBP increases from 122 (CI: 121.1 to 122.1) mm Hg to 132 (CI: 130.9 to 132.2) mm Hg in men, and 114 (CI: 113.1 to 114.4) mm Hg to 135 (CI: 134.5 to 136.2) mm Hg in women, between the ages of 20 and 90 years. Diastolic blood pressure peaked around 50 years for men 76 (CI: 75.5 to 75.9) mm Hg and women 69 (CI: 69.0 to 69.4) mm Hg. The blood pressure criterion for sepsis, systolic <100 mm Hg, was met by 2.3% of younger (20–30 years) men and 3.5% of older men (81–90 years). In comparison, the criterion was met by 9.7% of younger women and 2.6% of older women.ConclusionWe have quantified variations in blood pressure by age and sex in hospitalised patients that have implications for recognition of deterioration. Nearly 10% of younger women met the blood pressure criterion for sepsis at hospital discharge.
Understanding decision making about major surgery: protocol for a qualitative study of shared decision making by high-risk patients and their clinical teams
Authors: Shaw Sara , Hughes Gemma , Stephens Tim , Pearse Rupert , Prowle John , Ashcroft Richard Edmund , Avagliano Ester , Day James , Edsell Mark , Edwards Jennifer , Everest Leslie 
Published: May 2020

IntroductionSurgical treatments are being offered to more patients than ever before, and increasingly to high-risk patients (typically multimorbid and over 75). Shared decision making is seen as essential practice. However, little is currently known about what ‘good’ shared decision making involves nor how it applies in the context of surgery for high-risk patients. This new study aims to identify how high-risk patients, their families and clinical teams negotiate decision making for major surgery.Methods and analysisFocusing on major joint replacement, colorectal and cardiac surgery, we use qualitative methods to explore how patients, their families and clinicians negotiate decision making (including interactional, communicative and informational aspects and the extent to which these are perceived as shared) and reflect back on the decisions they made. Phase 1 involves video recording 15 decision making encounters about major surgery between patients, their carers/families and clinicians; followed by up to 90 interviews (with the same patient, carer and clinician participants) immediately after a decision has been made and again 3–6 months later. Phase 2 involves focus groups with a wider group of (up to 90) patients and (up to 30) clinicians to test out emerging findings and inform development of shared decision making scenarios (3–5 summary descriptions of how decisions are made).Ethics and disseminationThe study forms the first part in a 6-year programme of research, Optimising Shared decision-makIng for high-RIsk major Surgery (OSIRIS). Ethical challenges around involving patients at a challenging time in their lives will be overseen by the programme steering committee, which includes strong patient representation and a lay chair. In addition to academic outputs, we will produce a typology of decision making scenarios for major surgery to feed back to patients, professionals and service providers and inform subsequent work in the OSIRIS programme.