bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caregiving for ageing parents: A literature review on the experience of adult children
Authors: Luichies Ina , Goossensen Anne , der Meide Hanneke van 
Published: November 2019

Background: More and more adults in their fifties and sixties are confronted with the need to support their ageing parents. Although many aspects of filial caregiving have been researched, a well-documented and comprehensive overview of the caregiving experience is lacking. Aim: This study aims for a better understanding of the caregiving experience of adult children by generating an overview of main themes in international research. Method: A literature review of qualitative studies, focusing on the experiences of adult children caring for their ageing parents, was performed. The electronic EBSCO databases Academic Search Premier, CINAHL and PsycINFO, and Google Scholar were searched to identify relevant qualitative studies published between 2000 and 2017. The ‘SPIDER’ eligibility criteria directed the approach. The quality of studies included was screened with the assessment sheet designed by Hawker and colleagues. The experiences reported were analysed and themes were synthesized. Ethical consideration: Ethical requirements were respected in every phase of the research process. Findings: Nineteen qualitative studies met the inclusion criteria. The quality of the relationship with the parent appears to be an important determinant of the children’s caregiving experience. Within this context, three themes were found: caregiving as an emotional rollercoaster, a normatively demanding experience and an opportunity for personal development. Discussion: Children caring for their ageing parents have to deal with a wide range of contradicting and conflicting norms and values. Implications for healthcare professionals and future research have been discussed. Conclusion: Caring for ageing parents is a continuous quest for giving the best possible care and living up to one’s personal values, within the context of the parent’s declining health. Professionals who support filial caregivers should address not only practical responsibilities but also the normative questions and moral considerations caregivers are dealing with.
Ocular biometric changes after Ahmed glaucoma valve implantation
Authors: Miraftabi Arezoo , Lotfi Mahboubeh , Nilforushan Naveed , Abdolalizadeh Parya , Jafari Samira 
Published: November 2019

Purpose: To investigate the ocular biometric changes after uneventful Ahmed glaucoma valve implantation. Methods: Patients with refractory glaucoma who were candidate for Ahmed valve surgery were prospectively included in this study. Patients with a history of any kinds of corneal surgery were excluded. Refractive status, intraocular pressure, axial length, anterior chamber parameters including anterior and posterior mean keratometry, central corneal thicknesses, and anterior chamber depth, anterior chamber volume, and anterior chamber angle were evaluated at baseline and 1 and 3 months after surgery. Results: A total of 20 eyes from 20 patients were included. Mean intraocular pressure at baseline was 33.4 ± 12.3 mm Hg that significantly decreased to 14.6 ± 6.2 mm Hg at 1 month and 13.5 ± 4.3 mm Hg at 3 months after Ahmed glaucoma valve implantation ( p < 0.001). Mean number of medications was 3.6 ± 1.3 at baseline which significantly decreased to 1.0 ± 1.3 at 3 months after Ahmed glaucoma valve implantation ( p < 0.001). Axial length decreased significantly from 23.69 ± 1.95 to 23.47 ± 1.91 mm ( p < 0.001) at month 3. There were no significant changes in other parameters such as mean spherical equivalent, anterior chamber volume, anterior chamber angle, anterior chamber depth, and keratometry at the end of month 3 after surgery ( p > 0.05 in all). Conclusion: Ahmed glaucoma valve implantation had a significant effect on axial length at 3 months after surgery but its effect on keratometry and other anterior chamber parameters was not significant.
Clinical Validation of a Ray-Casting Analytical Dose Engine for Spot Scanning Proton Delivery Systems
Authors: Younkin James E. , Morales Danairis Hernandez , Shen Jiajian , Shan Jie , Bues Martin , Lentz Jarrod M. , Schild Steven E. , Stoker Joshua B. , Ding Xiaoning , Liu Wei 
Published: November 2019

Purpose: To describe and validate the dose calculation algorithm of an independent second-dose check software for spot scanning proton delivery systems with full width at half maximum between 5 and 14 mm and with a negligible spray component. Methods: The analytical dose engine of our independent second-dose check software employs an altered pencil beam algorithm with 3 lateral Gaussian components. It was commissioned using Geant4 and validated by comparison to point dose measurements at several depths within spread-out Bragg peaks of varying ranges, modulations, and field sizes. Water equivalent distance was used to compensate for inhomogeneous geometry. Twelve patients representing different disease sites were selected for validation. Dose calculation results in water were compared to a fast Monte Carlo code and ionization chamber array measurements using dose planes and dose profiles as well as 2-dimensional–3-dimensional and 3-dimensional–3-dimensional γ-index analysis. Results in patient geometry were compared to Monte Carlo simulation using dose–volume histogram indices, 3-dimensional–3-dimensional γ-index analysis, and inpatient dose profiles. Results: Dose engine model parameters were tuned to achieve 1.5% agreement with measured point doses. The in-water γ-index passing rates for the 12 patients using 3%/2 mm criteria were 99.5% ± 0.5% compared to Monte Carlo. The average inpatient γ-index analysis passing rate compared to Monte Carlo was 95.8% ± 2.9%. The average difference in mean dose to the clinical target volume between the dose engine and Monte Carlo was −0.4% ± 1.0%. For a typical plan, dose calculation time was 2 minutes on an inexpensive workstation. Conclusions: Following our commissioning process, the analytical dose engine was validated for all treatment sites except for the lung or for calculating dose–volume histogram indices involving point doses or critical structures immediately distal to target volumes. Monte Carlo simulations are recommended for these scenarios.
Evaluation of Precision and Bias Specifications Required to Achieve the 2018 FDA Guidance Criteria for Glucose Meter Performance Using Simulation Models
Authors: Lyon Andrew W. , Lyon Martha E. 
Published: November 2019

Background: The objective of this study was to estimate the combinations of total bias and total imprecision required for devices to meet the Food and Drug Administration (FDA) specifications using Monte Carlo simulation rather than collection and analysis of experimental data. Methods: A model Gaussian distribution of true-glucose values was altered by adding bias and imprecision to create measured-glucose values affected by analytic error. The fraction of measured-glucose values that met the 2018 FDA criteria for blood glucose monitoring system (BGMS) or self-monitoring blood glucose (SMBG) devices was determined as a function of bias and imprecision. Results: The BGMS model determined that a maximum total imprecision of 6% was required with no bias, and with a total bias of +10 mg/dL the total imprecision allowed was reduced to 5% to achieve the 95% FDA performance expectation: 95% of results ≥75 mg/dL within ±12% and 95% of results <75 mg/dL within ±12 mg/dL. The SMBG model determined that a maximum total imprecision of 6% was required at no bias, and with a total bias of +10 mg/dL the total imprecision allowed was reduced to 4% to achieve the 98% FDA expectation: 98% of results ±75 mg/dL within ±15% and 98% of results <75 mg/dL within ±15 mg/dL. Conclusions: The 2018 FDA guidance criteria require strict conditions for glucose meter clinical trials to achieve <10 mg/dL total bias and total imprecision of <5%. Total imprecision and bias values assessed in models in this study represent the cumulative imprecision and bias errors for the glucose meters, the reference method, and preanalytic processes.
The Demographics of Fractures and Dislocations Across the Entire United States due to Common Sports and Recreational Activities
Authors: Meixner Cory , Loder Randall T. 
Published: November 2019

Background: There exists little nationwide data regarding fracture and dislocation patterns across a wide variety of sporting activities for all ages and sexes. Hypothesis: Participant demographics (age and sex) will vary with regard to fracture and joint dislocation sustained during sport-related activities. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: The National Electronic Injury Surveillance System All Injury Program data 2005 through 2013 were accessed; 18 common sports and recreational activities in the United States were selected. Statistical software was used to calculate the numbers of fractures and dislocations, and incidence was calculated using US Census Bureau data. Multivariate logistic regression analysis determined the odds ratios (ORs) for the occurrence of a fracture or dislocation. Results: A fracture occurred in 20.6% and a joint dislocation in 3.6% of the emergency department visits for sports-related injuries; annual emergency department visit incidence was 1.51 for fractures and 0.27 for dislocations (per 1000 people). Most of the fractures occurred in football (22.5%). The OR for fracture was highest for inline skating (OR, 6.03), males (OR, 1.21), Asians, whites, and Amerindians compared with blacks (OR, 1.46, 1.25, and 1.18, respectively), and those older than 84 years (OR, 4.77). Most of the dislocations occurred in basketball (25.7%). The OR for dislocation was highest in gymnastics (OR, 4.08), males (OR, 1.50), Asians (OR, 1.75), and in those aged 20 to 24 years (OR, 9.04). The most common fracture involved the finger, and the most common dislocation involved the shoulder. Conclusion: Inline skating had the greatest risk for fracture, and gymnastics had the greatest risk for joint dislocation. Clinical Relevance: This comprehensive study of the risks of sustaining a fracture or dislocation from common sports activities across all age groups can aid sports health providers in a better understanding of those sports at high risk and be proactive in prevention mechanisms (protective gear, body training).
Sildenafil improves exercise capacity in patients with cystic fibrosis: a proof-of-concept clinical trial
Authors: Rodriguez-Miguelez Paula , Ishii Haruki , Seigler Nichole , Crandall Reva , Thomas Jeffrey , Forseen Caralee , McKie Kathleen T. , Harris Ryan A. 
Published: November 2019

Background: Exercise intolerance is a common phenotype observed in patients with cystic fibrosis (CF). Treatment with sildenafil, a phosphodiesterase type 5 (PDE5) inhibitor, has previously been shown to improve exercise capacity (VO2 peak) in other patient populations. Thus, the present study sought to determine the acute and subacute effects of sildenafil on exercise capacity in patients with CF. Methods: The present investigation utilized a randomized, double-blind, placebo-controlled, crossover study with an acute dose of either sildenafil (50 mg) or placebo ( n = 13, age 25 ± 10), followed by a 4 week open-label extension with sildenafil (20 mg, TID; n = 15, age 23 ± 11). A comprehensive evaluation of pulmonary function and a maximal exercise test were each performed at every visit. Results: A significant increase in VO2 peak was observed after the acute sildenafil dose with no changes following placebo (77 ± 13 versus 72 ± 13% predicted; p = 0.033). In addition, after 4 weeks of treatment, patients showed a significant increase in exercise capacity (72 ± 12 versus 75 ± 12% predicted; p = 0.028) and exercise duration (409 ± 98 versus 427 ± 101 s; p = 0.014). A robust correlation ( r = 0.656; p = 0.008) between baseline FEV1 (% predicted) and the change in exercise capacity following 4 weeks of treatment was identified. Conclusions: This proof-of-concept clinical trial demonstrates that sildenafil treatment can improve exercise capacity in patients with CF and that pulmonary function may play an important role in the effectiveness of treatment. Future investigations of sildenafil treatment in patients with CF are certainly warranted.
Development of the mHealth App Trustworthiness checklist
Authors: van Haasteren Afua , Gille Felix , Fadda Marta , Vayena Effy 
Published: November 2019

Background Mobile health applications (mHealth apps) currently lack a consensus on substantial quality and safety standards. As such, the number of individuals engaging with untrustworthy mHealth apps continues to grow at a steady pace. Objective The purpose of this study was to investigate end-users’ opinions on the features or actions necessary for trustworthy mHealth apps; and to convey this information to app developers via a succinct but informative checklist: the mHealth app trustworthiness checklist. Methods The checklist was formulated in three stages: (a) a literature review of studies identified the desirable features of the most prolific mHealth apps (health and fitness apps); (b) four focus group sessions with past or current users of these apps ( n = 20); and (c) expert feedback on whether the checklist items are conceivable in a real-life setting ( n = 6). Results Five major themes emerged from the focus group discussions: informational content, organizational attributes, societal influence, technology-related features, and user control factors. The mHealth app trustworthiness checklist was developed to incorporate these five themes and subsequently modified following expert consultation. In addition to the trustworthiness themes, we identified features that lie between trust and mistrust (limited digital literacy and indifference) as well as 10 features and actions that cause end-users to mistrust mHealth apps. Conclusion This study contributes to the evidence base on the attributes of trustworthy mHealth apps. The mHealth app trustworthiness checklist is a useful tool in advancing continued efforts to ensure that health technologies are trustworthy.
Impact of Hybrid Rice Cultivation on Farmers’ Livelihood in Tamil Nadu
Authors: Sivagnanam K. Jothi , Murugan K. 
Published: November 2019

This study explores new varieties of Hybrid rice and its impact on overall production and productivity in Tamil Nadu. The data for this study have been collected from two districts, namely Nagapattinam and Tiruvarur of Tamil Nadu. These districts are harvesting relatively higher concentration of hybrid rice within the group of National Food Security Mission districts in Tamil Nadu. In each of the districts of Nagapattinam and Tiruvarur, two representative blocks, namely, Kuttalam and Mayiladuthurai and Needamangalam and Valangaiman were taken, respectively, and within each block two villages were selected. After introduction of hybrid rice technology since 1994, there has been slow development in that technology in Tamil Nadu, mainly because of the unawareness of the benefits of the hybrid rice, and the farmers mainly use the high yielding variety (HYVs) because of cost-effectiveness. Even after two decades, the hybrid rice technology did not spread all over Tamil Nadu due to lukewarm policies of the government, unfamiliarity with the technology and high cost of cultivation and shortage of labour force. Therefore, the farmers did not shift their cropping pattern from HYVs into hybrid rice technology.
Impact of Patient Demographic Factors on Preoperative Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function, Pain Interference, and Depression Computer Adaptive Testing Scores in Patients Undergoing Shoulder and Elbow Surgery
Authors: Meldau Jason E. , Borowsky Peter , Blanchett Jacob , Stephens Jeffrey , Muh Stephanie , Moutzouros Vasilios , Makhni Eric C. 
Published: November 2019

Background: There has been a growing emphasis in orthopaedics on providing patient-centered care. The US National Institutes of Health launched the Patient-Reported Outcomes Measurement Information System (PROMIS) initiative that incorporates patient-reported outcome measures across a number of medical domains. The relationship between PROMIS domains and the impact of patient demographic factors in those undergoing upper extremity surgery remains unclear. Purpose/Hypothesis: The goal of this study was to investigate the correlation between physical function, pain interference, and depression in patients undergoing shoulder and elbow surgery as measured by PROMIS computer adaptive testing (CAT) forms and to determine the impact of patient demographic factors. We hypothesized that there would be a significant negative correlation between physical function and both pain interference and depression in this patient population. Study Design: Cross-sectional study; Level of evidence, 3. Methods: All patients who underwent elective shoulder or elbow surgery by 3 shoulder, elbow, and/or sports medicine fellowship–trained orthopaedic surgeons were included in the study. Preoperative PROMIS–Upper Extremity (PROMIS-UE), PROMIS–Pain Interference (PROMIS-PI), and PROMIS-Depression (PROMIS-D) CAT scores were analyzed. Pearson correlations were calculated between PROMIS domains as well as between PROMIS outcomes with patient demographic factors. Results: Preoperative PROMIS CAT scores for all 3 domains were collected and analyzed from 172 unique patients (516 individual CAT forms) with shoulder and elbow injuries. A negative correlation of moderate strength was found between the PROMIS-UE and PROMIS-PI ( R = –0.61; P < .001), and a negligible correlation was found between the PROMIS-UE and PROMIS-D ( R = –0.28; P < .001). When stratified by patient demographic factors, the correlation between the PROMIS-UE and PROMIS-PI was stronger in female patients compared with male patients ( R = –0.77 vs –0.46, respectively; P < .001 for both), stronger in black patients compared with white patients ( R = –0.72 vs –0.56, respectively; P < .001 for both), and highest in current tobacco users ( R = –0.80; P < .001). Conclusion: Before shoulder and elbow surgery, patients demonstrated impairments in physical function and pain interference as measured by CAT forms, with a moderate negative correlation between baseline upper extremity physical function and pain interference scores. In certain subpopulations, such as female patients, black patients, and current tobacco users, the correlations between these tested domains were stronger than in other groups.
Monitoring Ischemic Changes in Retinal Vasculitis With Optical Coherence Tomography Angiography
Authors: Dillon Alexander B. , Kovacs Kyle , Orlin Anton 
Published: November 2019

Purpose: This article illustrates the ability of optical coherence tomography angiography (OCTA) to aid in the diagnostic workup and management of occlusive retinal vasculitis over time. Methods: A case presentation is discussed. Results: In this case, OCTA helped define the extent and evolution of superficial and deep retinal capillary plexus occlusion and reperfusion over the treatment course. Conclusions: OCTA detects blood flow and maps retinal vasculature at the capillary level without the use of intravenous dye. Serial image acquisition can reveal patterns of ischemia and reperfusion in retinal vascular conditions as they evolve and respond to therapy, providing more granular information regarding the status of the retinal microvasculature that may guide treatment.
Enzyme-catalyzed C–F bond formation and cleavage
Authors: Tong Wei , Huang Qun , Li Min , Wang Jian-bo 
Published: November 2019

AbstractOrganofluorines are widely used in a variety of applications, ranging from pharmaceuticals to pesticides and advanced materials. The widespread use of organofluorines also leads to its accumulation in the environment, and two major questions arise: how to synthesize and how to degrade this type of compound effectively? In contrast to a considerable number of easy-access chemical methods, milder and more effective enzymatic methods remain to be developed. In this review, we present recent progress on enzyme-catalyzed C–F bond formation and cleavage, focused on describing C–F bond formation enabled by fluorinase and C–F bond cleavage catalyzed by oxidase, reductase, deaminase, and dehalogenase.
Anesthetic management of modified electroconvulsive therapy for a patient with coronary aneurysms: a case report
Authors: Nakayama Riho , Yoshida Takuya , Obata Norihiko , Mizobuchi Satoshi 
Published: November 2019

Abstract
Background
Modified electroconvulsive therapy (m-ECT) is utilized worldwide as an effective treatment for drug-resistant psychiatric disorders. However, during m-ECT, treatment of hypotension and hypertension in response to rapid hemodynamic changes is required. We used noninvasive continuous blood pressure monitoring system for continuous hemodynamic measurement during m-ECT.

Case presentation
The patient was a 77-year-old man with depression complicated by coronary artery aneurysms (CAAs). We managed general anesthesia during m-ECT by using the ClearSight™ system (Edwards Lifesciences Corp, Irvine, CA, USA) for hemodynamic measurement. As a result, we performed a total of 10 m-ECTs. No rupture of CAAs or myocardial ischemia occurred and depressive symptoms improved.

Conclusion
We successfully managed the anesthesia in m-ECT for a depressed patient with CAAs without complications by using the ClearSight™ system, which was used for the effective management of circulatory fluctuations.
Load shedding strategy coordinated with storage device and D-STATCOM to enhance the microgrid stability
Authors: Chandak Sheetal , Bhowmik Pritam , Rout Pravat Kumar 
Published: November 2019

AbstractRecently microgrids have drawn a potential attraction by fulfilling the environmental demands and the increasing energy demands of the end-users. It is necessary to focus on various protection and control aspects of a microgrid. During the transition between the grid-following and grid-forming modes, the voltage and the frequency instability due to the power mismatch condition becomes the major point of concern. Therefore, the paper executes a frequency-active power and voltage-reactive power drooping control strategy for the precise power-sharing among the distributed power generators. Furthermore, to handle the power deficit scenarios and to maintain the system stability, a system independent and priority-based adaptive three-stage load shedding strategy is proposed. The sensitivity of the strategy depends on the system inertia and is computed according to the varying absolute rate-of-change-of-frequency. The strategy incorporates the operation of battery storage system and distributed static compensator (D-STATCOM) in the microgrid, to provide a reliable power supply to the customers for a considerable time instead of a sudden load shedding. The effectiveness of the proposed strategies is investigated on a scaled-down modified IEEE 13-bus microgrid system on the podium of MATLAB 2015b through the time-domain simulation.