bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Immigration Status and Acute Stroke Care
Authors: Vyas Manav V. , Laupacis Andreas , Austin Peter C. , Fang Jiming , Silver Frank L. , Kapral Moira K. 
Published: April 2020

Background and Purpose—
Immigrants to high-income countries have a lower incidence of stroke compared with long-term residents; however, little is known about the care and outcomes of stroke in immigrants.

Methods—
We used linked clinical and administrative data to conduct a retrospective cohort study of adults seen in the emergency department or hospitalized with ischemic stroke or transient ischemic attack between July 1, 2003, and April 1, 2013, and included in the provincial stroke registry. We ascertained immigration status using immigration records and compared processes of stroke care delivery between immigrants (defined as those immigrating after 1985) and long-term residents. In the subgroup with ischemic stroke, we calculated inverse probability treatment weight (IPTW)–adjusted risk ratios for disability on discharge (modified Rankin Scale score of 3 to 5), accounting for demographic characteristics and comorbid conditions to compare outcomes between immigrants and long-term residents.

Results—

We included 34 987 patients with ischemic stroke or transient ischemic attack, of whom 2649 (7.6%) were immigrants. Immigrants were younger than long-term residents at the time of stroke/transient ischemic attack (median age 67 years versus 76 years;
P
<0.001). In the subgroup with ischemic stroke, there were no differences in stroke care delivery, except that a higher proportion of immigrants received thrombolysis than long-term residents (21.2% versus 15.5%;
P
<0.001). Immigrants with ischemic stroke had a higher adjusted risk of being disabled on discharge (adjusted risk ratio, 1.18; 95% CI, 1.13–1.22) compared to long-term residents.

Conclusions—
Stroke care is similar in Canadian immigrants and long-term residents. Future research is needed to confirm the observed association between immigration status and disability after stroke and to identify factors underlying the association.
MJO Teleconnections over the PNA Region in Climate Models. Part II: Impacts of the MJO and Basic State
Authors: Wang Jiabao , Kim Hyemi , Kim Daehyun , Henderson Stephanie A. , Stan Cristiana , Maloney Eric D. 
Published: April 2020

AbstractIn an assessment of 29 global climate models (GCMs), Part I of this study identified biases in boreal winter MJO teleconnections in anomalous 500-hPa geopotential height over the Pacific–North America (PNA) region that are common to many models: an eastward shift, a longer persistence, and a larger amplitude. In Part II, we explore the relationships of the teleconnection metrics developed in Part I with several existing and newly developed MJO and basic state (the mean subtropical westerly jet) metrics. The MJO and basic state diagnostics indicate that the MJO is generally weaker and less coherent and propagates faster in models compared to observations. The mean subtropical jet also exhibits notable biases such as too strong amplitude, excessive eastward extension, or southward shift. The following relationships are found to be robust among the models: 1) models with a faster MJO propagation tend to produce weaker teleconnections; 2) models with a less coherent eastward MJO propagation tend to simulate more persistent MJO teleconnections; 3) models with a stronger westerly jet produce stronger and eastward shifted MJO teleconnections; 4) models with an eastward extended jet produce an eastward shift in MJO teleconnections; and 5) models with a southward shifted jet produce stronger MJO teleconnections. The results are supported by linear baroclinic model experiments. Our results suggest that the larger amplitude and eastward shift biases in GCM MJO teleconnections can be attributed to the biases in the westerly jet, and that the longer persistence bias is likely due to the lack of coherent eastward MJO propagation.
To be able, or disable, that is the question: A critical discussion on how language affects the stigma and self-determination in people with parability
Authors: Mousavi S. Bentolhoda , Lecic-Tosevski Dusica , Khalili Hassan , Mousavi S. Zeinab 
Published: April 2020

Background: Despite several fruitful attempts in destigmatization, disability is still associated with stigma. The role of language, especially when addressing a disabling condition and people, has been the matter of social as well as scientific debates. This article poses an intriguing question about the language we apply when addressing people and disability. Method: A narrative review of different models of disability with the emphasis on how labels and more generally language affect identity formation, and the extendibility of positive psychology concepts on the field of disability studies. Results: In this theoretical paper, the authors suggest that the term disability per se is contributing to increasing the stigma and has disempowering effect. Considering previous evidence from different lines of literature, the authors suggest a new approach of destigmatization, namely changing the term disability to a less stigmatizing one. Moreover, the authors discuss some theories to support this perspective. Conclusion: Replacing ‘dis’ in ‘disability’ with the prefix ‘para’ in the term ‘Para-ability’ is suggested.
Smoke and Mirrors: The Recreational Marijuana Debate
Authors: Millea Timothy P. 
Published: April 2020

The increasingly widespread legalization of recreational marijuana should raise concerns regarding the societal and medical impact of its use. The relative cultural acceptance for its use should be counterbalanced with an honest and scientific review of the adverse impacts. This article provides a synopsis of recent studies that point to significant concerns from medical and psychiatric viewpoints. Summary: With the increasing number of states that have legalized the use of recreational marijuana, concerns regarding its negative effects are necessary. There is growing scientific evidence that the use of marijuana for recreational purposes has a wide variety of negative health effects, both physical and psychiatric.
Identification of genes associated with clinicopathological features of colorectal cancer
Authors: Wang Xiaoting , Hu Shouzi , Ji Wenbin , Tang Yan , Zhang Shulong 
Published: April 2020

Objective To identify genes associated with the clinicopathological features of colorectal cancer (CRC). Methods Gene expression profiles were downloaded and preprocessed by GEOquery and affy R packages, respectively. The limma package was applied to identify the differentially expressed genes (DEGs) in CRC. Gene Ontology and Kyoto Gene and Genome Encyclopedia (KEGG) pathway enrichment analyses for the DEGs were carried out using the clusterProfiler package. Protein–protein interaction (PPI) and weighted gene co-expression (WGC) networks were constructed using the STRING database and WGCNA package, respectively. Results A total of 523 DEGs (283 downregulated and 240 upregulated genes) in CRC tissues were identified. These DEGs were mainly enriched in 111 biological processes, 16 cellular components and 40 molecular functions, such as proteinaceous extracellular matrix, extracellular structure organization and chemokine-mediated signalling pathway. PPI and WGC networks showed that four upregulated genes ( KIF2C, CDC45, CEP55 and DTL) were key genes. Subgroup analysis based on individual cancer stages and histological subtypes indicated that the expression of these key genes was upregulated in CRC stages I–IV, adenocarcinoma and mucinous adenocarcinoma. Conclusions The study provides new insights into understanding the pathogenesis of CRC. These identified genes may act as potential targets for CRC diagnosis and treatment.
Spirituality in nursing: A concept analysis
Authors: Murgia Carla , Notarnicola Ippolito , Rocco Gennaro , Stievano Alessandro 
Published: April 2020

Background: Spirituality has always been present in the history of nursing and continues to be a topic of nursing interest. Spirituality has ancient roots. The term ‘spirituality’ is interpreted as spirit and is translated as breath and soul, whereas spirituality (immateriality) is spiritual nature. Historically, the term spirituality is associated with the term religiosity, a definition that persists today, and often the two terms are used interchangeably. In the healthcare context, the construct is still. Objective To clarify the concept of spirituality in nursing. Research design In this article spirituality was explored using Rodgers' evolutionary and inductive method of concept analysis. Participants and research context For this analysis, a sample of 71 articles published in English, from 2008 to 2018 from PubMed/Medline, CINAHL Plus with full text, PsycINFO, SciELO databases were retrieved. It was also accomplished an empirical search of dictionaries and e-books. Ethical considerations This study was conducted according to good scientific practice. Findings It emerged that “spirituality” is a dynamic process and has a range of attributes. The cultural dimensions, the religious and spiritual traditions, the ethnic diversity and the influence of the historical and social contexts represent the societal and historical conditions ingrained in the Western thought that influence the emergence of spirituality as a concept. Antecedents, attributes and onsequences appeared to inform and strengthen one another over time. Spirituality is a significant concept for the discipline of nursing with profound consequences for caring patients and for work organizations.
Generalist Palliative Care in the California Safety Net: A Structured Assessment to Design Interventions for a Range of Care Settings
Authors: Anderson Wendy G. , Parrish Monique , Kerr Kathleen , Kinderman Anne , Rabow Michael , Schoen Melissa , Meyers Kate 
Published: April 2020

Background: To provide high quality care to all patients who have serious illness, health-care systems must develop effective generalist palliative care strategies. Objective: To identify palliative care quality gaps within a range of settings in the California safety net and to develop theory-based interventions to address them. Design: Structured assessment using the National Consensus Project for Quality Palliative Care Clinical Practice Guidelines and a Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation intervention planning model-based worksheet, which integrates behavior theories to identify factors that predispose, enable, and reinforce clinicians to perform recommended behaviors. Setting and Participants: Adviser pairs—one from palliative care and one from a partner service line—from 10 California public health-care systems conducted assessments at their sites. A steering committee provided educational webinars, best practices, and assessment tools. Measurements: Adviser pairs interviewed at least 6 partner service line stakeholders to identify palliative care quality gaps, behaviors clinicians should perform to close gaps, and factors that predispose, enable, and reinforce those behaviors. Results: Partner service lines were primary care (n = 4), surgery (n = 3), emergency department (n = 2), and radiation oncology (n = 1). Selected gaps were advance care planning and goals of care communication (n = 6), identifying patients with serious illness (n = 3), and pain management (n = 1). All sites designed multiple interventions to address gaps, based on factors that predispose, enable, and reinforce a target audience to perform a target behavior. Advisers reported that the program strengthened relationships between palliative care and the partner service line Conclusion: This structured assessment helped busy clinicians develop theory-based generalist palliative care interventions.
Evaluating Emergency Department Utilization for Mobile Mental Health Patients: A Correlational Retrospective Analysis
Authors: Weissinger Alyssa C. , Burns Rachel , Campbell Nancy J. 
Published: April 2020

Background: Patients who have barriers to attending traditional mental health clinics are at risk for psychiatric decompensation, which can lead to inappropriate utilization of emergency departments (EDs). Mobile health clinics have the potential to reduce avoidable ED visits by providing easily accessible care. Aims: To determine whether psychiatric patients have a significant reduction in ED visits after admission to the mobile mental health clinic (MMHC). Method: This study is a replication of a pilot study on the first 43 patients admitted to the MMHC that was conducted soon after the opening. Results of that study were promising. In the current study, health records from a sample of 265 patients from the MMHC were reviewed retrospectively to determine the number of ED visits post admission to the MMHC. ED visits were examined 8 months prior to admission to the MMHC and 8 months after. Descriptive statistics and paired t-tests were used to analyze demographics and determine differences in ED visits pre- and post admission to the MMHC. Results: Findings demonstrated that patients admitted to the MMHC had a significant reduction ( p < .05) in ED utilization. There was also a decrease in mean ED visits in patients who received combined treatment, which included medication management and counseling. Conclusion: The MMHC is an effective initiative to reduce ED overutilization, thereby decreasing Medicaid costs. Psychiatric care provided directly in the home can promote health and prevent destabilization.
Spontaneous unilateral exophthalmos after a vaginal delivery
Authors: Różańska-Walędziak Anna , Szewczuk Oksana , Walędziak Maciej , Czajkowski Krzysztof 
Published: April 2020

Introduction: Spontaneous orbital exophthalmos is an extremely rare incident during a vaginal delivery. In most cases, it is associated with venous malformations and presents spontaneous resolution. Case description: We report a case of orbital hematoma after vaginal delivery due to a superior ophthalmic vein rupture. The patient presented proptosis of the right eye and diplopia immediately after the delivery and was diagnosed with unilateral orbital hematoma. The patient was given conservative treatment with complete resolution of clinical symptoms 4 weeks after the delivery. Conclusion: Increased abdominal pressure during a vaginal delivery may lead to a spontaneous orbital hemorrhage.
Opioid maintenance treatment of pregnant women in the Scandinavian countries
Authors: Handal Marte , Skurtveit Svetlana , Mahic Milada , Øhman Inger , Wikner Birgitta Norstedt , Tjagvad Christian , Kieler Helle , Halmesmäki Erja , Lund Ingunn Olea 
Published: April 2020

Background: WHO guidelines emphasise the need for descriptions of clinical practice and observational studies on risk and benefits of pharmacotherapies in pregnancy. The aims of the present study were to: (1) Describe opioid maintenance treatment (OMT) in the Scandinavian countries in general, and specifically for pregnant women, (2) Describe a project which utilises a new approach using registry-linkage data to examine associations between prenatal exposure to OMT and child outcomes: a Scandinavian cohort study of pregnant women in OMT during pregnancy (ScopeOMT). Data: Guidelines describing the treatment of persons with opioid use disorders in general, and specifically for pregnant women. Scandinavian registry-linkage data from ScopeOMT. Results: Registry data show that approximately 800 pregnant women received OMT during pregnancy in the period of the ScopeOMT study. Similarities across the Scandinavian countries include access to free healthcare and treatment; multidisciplinary teams trained to support pregnant women in OMT; buprenorphine as the recommended drug when initiating therapy; and a holistic focus on the patients’ lives. An important difference is that Norwegian women who use illegal substances that may harm the foetus may be admitted – voluntarily, or against their will – for parts of, or the remainder of the pregnancy to inpatient treatment at specialised clinics. Conclusion: Many similarities in the treatment provided to opioid-dependent persons in the Scandinavian countries place this area in an excellent position to combine the efforts and carry out observational studies concerning the safety of OMT during pregnancy.
Translumbar Embolization of Type II Endoleaks: 12 Years of Experience at a Regional Vascular Centre
Authors: Thomas Wiliam Rhodri , Karkhanis Salil , Hopkins Jonathan , Duddy Martin 
Published: April 2020

Background and Aims: The management of persistent type II endoleaks (T2E) is often problematic for the endovascular specialist, with a lack of clear evidence for the best approach for embolization. The aim of this study was to evaluate the safety and efficacy of translumbar embolization (TLE) for T2E following endovascular aneurysm repair (EVAR). Methods: This retrospective review included 27 embolizations performed on 23 patients with a median age of 78 (range 67-94 years; male: female 15:9), during the period September 2006 to July 2018. Primary outcome was freedom from aneurysm sac growth defined as <2 mm sac diameter increase on subsequent computed tomography. Results: The initial technical success rate was 100%, with complete “on table” embolization of the T2E on fluoroscopy; however, 4 (15%) patients needed repeat TLE due to persistent endoleak identified on follow-up computed tomography or because of further sac expansion. Satisfactory stasis was achieved in these 4 cases following a second embolization. The mean volume of embolic injected was 7.4 mL per case. Feeding vessels were identified on angiography in all cases; the nidus was supplied by lumbar branches in 21 cases, by the inferior mesenteric artery in 1 case and by both in a further 5 cases. Freedom from aneurysm sac growth (defined as < 2 mm) following 1 or 2 separate TLE was achieved in 18 (78%) and 20 (86%) patients, respectively. The major complication rate was <5% with one case of psoas abscess presenting 7 months following embolization; there were 2 minor complications in the form of intraprocedural transient abdominal pain. Conclusion: The translumbar approach is a safe and effective technique to treat T2E, as evidenced by the low complication and reintervention rate.
Association Between Acid-Suppressive Agents’ Use and Risk of Hepatocellular Carcinoma
Authors: Lin Hsiu C. , Hsu Huan Y. , Lin Hsiu L. , Uang Yow S. , Ho Yi , Wang Li H. 
Published: April 2020

Background:Acid-suppressive agents (ASAs), which are mostly used in patients with upper gastrointestinal diseases (UGIDs), may influence the risk of hepatocellular carcinoma (HCC).Methods:A population-based retrospective cohort study was conducted. Patients with UGID who used ASAs and those who did not receive ASAs were identified. Patients without UGIDs were randomly selected and matched (comparison group). All groups were followed up for 6 years. A Cox proportional hazard model was used to estimate the risk of HCC among the different groups.Results:Patients with UGID who used ASAs had a significantly elevated HCC risk (adjusted hazard ratio [HR] 1.53; 95% confidence interval [CI], 1.32-1.76] compared to those who did not use ASAs. Patients with UGID who used more than 540 defined daily doses of ASAs had a significantly higher risk of HCC (adjusted HR 2.04; 95% CI, 1.62-2.58). Moreover, the dose effect on HCC risk exhibited a significant increasing trend ( P < .01). Furthermore, patients with UGID who did not use ASAs had a significantly elevated HCC risk (adjusted HR 1.94; 95% CI, 1.59-2.36) compared to the comparison group.Conclusion:The use of ASAs increased the risk of HCC in patients with UGIDs, and the effect of ASAs was dose dependent. In addition, UGIDs alone increased the risk of HCC.
Effect of Repaglinide on Blood Glucose, Endothelial Function, Lipid Metabolism, and Inflammatory Reaction in a Rat Model of Atherosclerosis
Authors: Chang Jie , Liu Bing , Cheng Yan-xia , Zhang Jin-guang , Tao Shuo , Yan Hong-ling 
Published: April 2020

Objective: To investigate the protective effect of repaglinide on rat with atherosclerosis. Methods: Sprague Dawley (SD) rats were divided into control, model, repaglinide, and metformin groups. In addition to the normal group, rats were given intraperitoneal injection of streptozotocin and high-fat diet (HFD). Meanwhile, repaglinide or metformin was administrated to the treatment rats, respectively, for 4 weeks. Serum, plasma, liver, epididymal fat, and aorta thoracica were obtained to observe the protective effect of repaglinide on rat with atherosclerosis. Results: Compared to the control group, blood glucose was increased in the model group ( P < .05), while it was decreased in the drug-administered groups. In addition, the levels of endothelin 1, TG, TC, low-density lipoprotein cholesterol, atherogenic index, liver index, and epididymal fat index were significantly increased, but the levels of high-density lipoprotein cholesterol, plasminogen activator inhibitor 1, and antiatherogenic index were decreased significantly in the model group compared to the control group ( P < .05, respectively). And these effects were reversed by treatment with repaglinide ( P < .05, respectively). Conclusion: Our results suggested that repaglinide may regulate the formation of early atherosclerosis through the abovementioned mechanisms.
Quality Assurance of Commercial Insulin Formulations: Novel Assay Using Infrared Spectroscopy
Authors: Delbeck Sven , Heise H. Michael 
Published: April 2020

Background: For insulins in commercial formulations, degradation can be observed within the certified shelf life when not stored at recommended conditions. Elevated temperatures and exposure to shear forces can cause changes in the secondary structure of the hormone, leading to a decrease in pharmaceutical potency. International pharmacopoeia recommendations for insulin quality monitoring assays mainly rely on liquid chromatography methods. These methods are unable to distinguish between active and inactive forms, both of which may exist in pharmaceutical insulins exposed to stress conditions. Method: Infrared attenuated total reflection spectroscopy has been used for the analysis of insulin dry film preparations using affordable instrumentation. This method can be applied to either formulated insulin specimens or pure insulins obtained by ultrafiltration. Such samples have been stored under different temperatures (0°C, 20°C, and 37°C), and degradation processes have been monitored up to a period of a few months. Results: By analyzing specific shifts of absorption bands in the infrared spectra, which are sensitive to the protein secondary structure, even small structural changes in the hormone become evident. Another option is amide I band deconvolution into individual bands, which can be attributed to secondary structure subunits that are part of the insulin tertiary structure. Conclusion: A novel and innovative method based on infrared attenuated total reflection spectroscopy of insulin dry films is a promising analytical tool for quantifying the degree of insulin degradation, as it provides information on indicating a decrease in biological potency. The established methods for insulin potency assays require animal testing or clamp experiments on people with diabetes.