bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical gait features are associated with MRI findings in patients with haemophilic ankle arthropathy
Authors: Eerdekens Maarten , Peerlinck Kathelijne , Staes Filip , Pialat Jean‐Baptiste , Hermans Cédric , Lobet Sébastien , Deschamps Kevin 
Published: January 2020

AbstractIntroductionHaemophilic ankle arthropathy due to repeated joint bleeds often leads to altered gait in adult patients with haemophilia.AimTo investigate the association between clinical gait features and blood‐induced ankle joint damage scored using MRI findings in patients with haemophilic ankle arthropathy.MethodsThis observational study investigated 48 ankles of 24 patients with severe haemophilia (median age of 33 years). Blood‐induced ankle joint damage was scored by an experienced radiologist using the International Prophylaxis Study Group (IPSG‐)MRI score which evaluates the presence or absence of effusion, synovial hypertrophy, haemosiderin, surface erosions, subchondral cysts and cartilage degeneration. Using 3D gait analysis, peak ankle joint power generation and absorption (W/kg) were measured for each ankle since these are surrogate measures for joint loading during walking. Associations between MRI findings and these two clinical gait features were calculated using Spearman's ρ correlation with an α‐level correction (α = 0.01) for multiple tests.ResultsWe found large negative associations between ankle joint peak power generation and IPSG‐MRI score (ρ = −0.631; P = <.001), IPSG‐MRI osteochondral subscore (ρ = −0.701; P = <.001), severity of synovial hypertrophy (ρ = −0.507; P = <.001) and haemosiderin (ρ = −0.400; P = .005). Associations were also found for ankle joint peak power absorption and IPSG‐MRI score (ρ = −0.425; P = .003) and IPSG‐MRI osteochondral subscore (ρ = −0.556; P = <.001).ConclusionSevere blood‐induced ankle joint damage relates to a lowered tolerance towards ankle joint mechanical loading during walking in patients with haemophilia.
Does glyceryl trinitrate cause central sympatholytic effects? Insights from a case of baroreflex failure
Authors: Tan Sarah , Xie Lin , Anderson Robert , Hammond Andrew , Fong Angelina Y. , Lim Seok , Allen Andrew M. , Harrap Stephen B. 
Published: January 2020

AbstractWhether part of the blood pressure lowering effects of glyceryl trinitrate (GTN) is the result of centrally mediated reduction in sympathetic activity is debated. In humans, baroreflex activity potentially obscures the central sympatholytic effects of GTN. We examined this in a routine clinical tilt test in a patient with baroreflex failure secondary to previous neck radiotherapy. With reduced baroreflex function we observed an exaggerated fall in blood pressure and reduced sympathetic activity with GTN, supporting a peripheral vasodilation and central sympatholytic effect.
Asymmetric impact of earnings news on investor uncertainty
Authors: Peng Zihang , Johnstone David , Christodoulou Demetris 
Published: January 2020

AbstractWe describe a model that predicts an asymmetric impact of disclosure on investor uncertainty. We show that good news tends to resolve more uncertainty than bad news, and that uncertainty can be revised upwards if the investors' prior belief is sufficiently strong and the signal is sufficiently bad. This result is in contrast to classical disclosure models, where new information always resolves uncertainty and the change in uncertainty depends only on the relative precision of the news. Using option‐implied volatility as a proxy for uncertainty, we find strong support for our predictions. We also show that our results are robust to competing explanations, notably to the leverage effect and volatility feedback, as well as to the jump risk induced in anticipation of the earnings announcements.
Blood pressure and glucose control and the prevalence of albuminuria and left ventricular hypertrophy in patients with hypertension and diabetes
Authors: Zhang Wei , Liu Chang‐Yuan , Ji Li‐Nong , Wang Ji‐Guang ,   For the ATTEND investigators
Published: January 2020

AbstractWe investigated association between blood pressure and glucose control and the prevalence of albuminuria and left ventricular hypertrophy (LVH) in patients with hypertension and diabetes. Our study participants were treated patients with both diseases, enrolled in a China nationwide registry. The 773 patients were classified into four groups according to the control status of hypertension (systolic/diastolic blood pressure [BP] ≤140/90 mm Hg) and diabetes (HbA1c <7.0%): both uncontrolled (n = 208), only diabetes (n = 175) or hypertension controlled (n = 172), and both controlled (n = 218). Albuminuria was defined as a urinary albumin‐to‐creatinine ratio of ≥30 mg/g. LVH was assessed by the electrocardiogram Cornell product method. Antihypertensive therapy was not different between the four groups (P ≥ .48). The use of insulin alone or insulin plus oral antidiabetic agents was significantly higher than those with both diseases controlled (P ≤ .02). Patients with controlled hypertension and diabetes had a significantly (P < .0001) lower prevalence of albuminuria (odds ratio 0.22, 95% confidence interval 0.11‐0.43) than those with both diseases uncontrolled. Intensive BP control to <130/80 mm Hg was associated with lower risks of albuminuria in all patients (P = .001) and patients with HbA1c <7.0% (P = .048). Intensive glycemic control to HbA1c <6.5% was also associated with a significantly lower risk of albuminuria in all patients (P = .01), but not those with controlled BP (P = .43). Similar trends were observed for LVH, but statistical significance was not achieved on either intensive control condition (P ≥ .07). In patients with hypertension and diabetes, blood pressure and glucose control were associated with a lower prevalence of albuminuria and LVH, especially when achieving a more stringent target.
Water dynamics and microbial communities of bigeye tuna (Thunnus obesus) during simulated cold chain logistics
Authors: Wang Xin‐Yun , Xie Jing 
Published: January 2020

AbstractThis study investigated changes in the physicochemical indexes, water dynamics, and microbial communities of bigeye tuna (Thunnus obesus) during simulated cold chain logistics. With increasing storage time, the color and water activity decreased gradually, while drip loss gradually increased, and pH increased with a fluctuating pattern. The trend of bound water content was not obvious, trapped water declined, and free water increased with fluctuations over time, according to low‐field nuclear magnetic resonance (LF‐1H NMR). High‐throughput sequencing results indicated that fluctuating temperatures inhibited Acinetobacter and Pseudomonas and promoted Pelomonas, Psychrobacter, and Shewanella. Principal component analysis and redundancy analysis revealed significantly different microbial community interactions among the four groups, and environmental factors had distinct effects on bacterial community assemblages. LF‐NMR and high‐throughput sequencing can be used to monitor dynamic quality changes in bigeye tuna during simulated cold chain logistics with fluctuating temperatures.
Extension of shelf life of pasteurized trim milk using ultraviolet treatment
Authors: Ansari Jawaad Ahmed , Ismail Marliya , Farid Mohammed 
Published: January 2020

AbstractThe demand for minimally processed foods has increased in the last few years and gains high acceptability among consumers as it has better nutritional value than highly processed foods. Pasteurized milk is minimally processed and consumed largely for its fresh taste and higher nutritional value compared to ultrahigh temperature (UHT) and powdered milk. However, one of the constraints is its limited shelf life under refrigeration, as it cannot retain quality and safety for more than 14 days. Nonthermal technologies can extend the shelf life of milk while using low energy. Ultraviolet (UV‐C) is well known to inactivate spores as well as vegetative cells. In this study, it was shown that 2.64 J/ml of UV‐C treatment applied on pasteurized trim milk can extend shelf life up to 53 days under refrigeration. This finding was also supported by the inactivation of 3.40 ± 0.14 log of thermoresistant Geobacillus stearothermophilus spores (ATCC 7953) in UHT (or sterilized) trim milk with similar UV‐C operating conditions. Therefore, microbial study together with physicochemical properties demonstrated that pasteurization followed by UV‐C can enhance the shelf life of trim milk considerably.
Musical adaptation as phonological evidence: Case studies from textsetting, rhyme, and musical surrogates
Authors: McPherson Laura 
Published: January 2020

AbstractMusic and language are both inherently human, rule‐governed systems. Language‐based music, including vocal music and musical surrogate languages, offers the opportunity to look at how musical and linguistic grammars interact and how linguistic structure is adapted to another modality. This article focuses on how this musical adaptation of language can provide valuable evidence for phonological structure and theory, drawing on case studies from textsetting (tonal and non‐tonal), rhyme, and musical surrogate languages.
Probabilistic Assessment of the Failure Risk of the Europa Clipper Spacecraft due to Radiations
Authors: Ding Yiqing , Duggan Sean , Ferranti Matthew , Jagadpramana Michael , Rege Rushal , Zhovtobryukh Yuriy , Paté‐Cornell M.‐Elisabeth 
Published: January 2020

AbstractThe Europa mission approved in 2019 is still in the development phase. It is designed to conduct a detailed reconnaissance of that moon of Jupiter as it could possibly support life as we know it. This article is based on a top‐down approach (mission → system → subsystems → components) to model the probability of mission failure. The focus here is on the case where the (uncertain) radiation load exceeds the (uncertain) capacity of critical subsystems of the spacecraft. The model is an illustrative quantification of the uncertainties about (1) the complex external radiation environment in repeated exposures, (2) the effectiveness of the shielding in different zones of the spacecraft, and (3) the components’ capacities, by modeling all three as dynamic random variables. A simulation including a sensitivity analysis is used to obtain the failure probability of the whole mission in forty‐five revolutions around Jupiter. This article illustrates how probabilistic risk analysis based on engineering models, test results and expert opinions can be used in the early stages of the design of space missions when uncertainties are large. It also describes the optimization of the spacecraft design, taking into account the decisionmakers’ risk attitude and the mission resource constraints.
Long term exposure to ambient fine particulate matter and incidence of stroke: prospective cohort study from the China-PAR project
Authors: Huang Keyong , Liang Fengchao , Yang Xueli , Liu Fangchao , Li Jianxin , Xiao Qingyang , Chen Jichun , Liu Xiaoqing , Cao Jie , Shen Chong , Yu Ling , Lu Fanghong , Wu Xianping , Zhao Liancheng , Wu Xigui , Li Ying , Hu Dongsheng , Huang Jianfeng , Liu Yang , Lu Xiangfeng , Gu Dongfeng 
Published: January 2020

AbstractObjectiveTo study the effect of long term exposure to ambient fine particulate matter of diameter ≤2.5 μm (PM2.5) on the incidence of total, ischemic, and hemorrhagic stroke among Chinese adults.DesignPopulation based prospective cohort study.SettingPrediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project carried out in 15 provinces across China.Participants117 575 Chinese men and women without stroke at baseline in the China-PAR project.Main outcome measuresIncidence of total, ischemic, and hemorrhagic stroke.ResultsThe long term average PM2.5 level from 2000 to 2015 at participants’ residential addresses was 64.9 μg/m3, ranging from 31.2 μg/m3 to 97.0 μg/m3. During 900 214 person years of follow-up, 3540 cases of incident stroke were identified, of which 63.0% (n=2230) were ischemic and 27.5% (n=973) were hemorrhagic. Compared with the first quarter of exposure to PM2.5 (<54.5 μg/m3), participants in the highest quarter (>78.2 μg/m3) had an increased risk of incident stroke (hazard ratio 1.53, 95% confidence interval 1.34 to 1.74), ischemic stroke (1.82, 1.55 to 2.14), and hemorrhagic stroke (1.50, 1.16 to 1.93). For each increase of 10 μg/m3 in PM2.5 concentration, the increased risks of incident stroke, ischemic stroke, and hemorrhagic stroke were 13% (1.13, 1.09 to 1.17), 20% (1.20, 1.15 to 1.25), and 12% (1.12, 1.05 to 1.20), respectively. Almost linear exposure-response relations between long term exposure to PM2.5 and incident stroke, overall and by its subtypes, were observed.ConclusionsThis study provides evidence from China that long term exposure to ambient PM2.5 at relatively high concentrations is positively associated with incident stroke and its major subtypes. These findings are meaningful for both environmental and health policy development related to air pollution and stroke prevention, not only in China, but also in other low and middle income countries.
Bend it like Beckham or fix them like Florence—proportional representation of healthcare in New Year honours: an observational study
Authors: Emelifeonwu John A , Hazelwood James E , Nolan Oscar , Sharland Emma , O’Donald Anna , Peet Alison , Frazer Ricky 
Published: January 2020

AbstractObjectivesTo compare the proportional representation of healthcare workers in receipt of New Year honours (NYHs) with workers in other industries and to determine whether the NYH system has gender or geographical biases.DesignObservational study of the UK honours system with a comparative analysis of proportional representation of the UK workforce and subgroup analyses of gender and geographical representations.ParticipantsRecipients of NYHs from 2009 to 2018.Main outcome measuresAbsolute risk of receiving an NYH based on industry, gender, or region of the UK. Relative risk of receiving an NYH for services to healthcare compared with other industries.Results10 989 NYHs were bestowed from 2009 to 2018, 47% of which were awarded to women. 832 awards (7.6%) were for services to healthcare. People working in sport and in the arts and media were more likely to receive NYHs than those working in healthcare (relative risks of 22.01 (95% confidence interval 19.91 to 24.34) and 5.84 (5.31 to 6.44), respectively). There was no significant difference between the rate of receiving honours for healthcare and for science and technology (P=0.22). 34% (3741) of awards were issued to people living in London and in the southeast of England, and only 496 of 1447 (34%) higher order awards (knighthoods, damehoods, companions of honour, and commanders of the order of the British empire) were received by women.ConclusionsIn relation to the size of its workforce, a career in healthcare is not as “honourable” as careers in certain other industries. Geographical and gender biases might exist in the honours system.
Potential impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease in England: a modelling study
Authors: Seferidi Paraskevi , Laverty Anthony A , Collins Brendan , Bandosz Piotr , Capewell Simon , O’Flaherty Martin , Millett Christopher , Pearson-Stuttard Jonathan 
Published: January 2020

BackgroundCurrent proposals for post-Brexit agricultural policy do not explicitly incorporate public health goals. The revised agricultural policy may be an opportunity to improve population health by supporting domestic production and consumption of fruits and vegetables (F&V). This study aims to quantify the potential impacts of a post-Brexit agricultural policy that increases land allocated to F&V on cardiovascular disease (CVD) mortality and inequalities in England, between 2021 to 2030.MethodsWe used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to translate changes in land allocated to F&V into changes in F&V intake and associated CVD deaths, stratified by age, sex and Index of Multiple Deprivation. The model combined data on F&V agriculture, waste, purchases and intake, CVD mortality projections and appropriate relative risks. We modelled two scenarios, assuming that land allocated to F&V would gradually increase to 10% and 20% of land suitable for F&V production.ResultsWe found that increasing land use for F&V production to 10% and 20% of suitable land would increase fruit intake by approximately 3.7% (95% uncertainty interval: 1.6% to 8.6%) and 17.4% (9.1% to 36.9%), and vegetable intake by approximately 7.8% (4.2% to 13.7%) and 37% (24.3% to 55.7%), respectively, in 2030. This would prevent or postpone approximately 3890 (1950 to 7080) and 18 010 (9840 to 28 870) CVD deaths between 2021 and 2030, under the first and second scenario, respectively. Both scenarios would reduce inequalities, with 16% of prevented or postponed deaths occurring among the least deprived compared with 22% among the most deprived.ConclusionPost-Brexit agricultural policy presents an important opportunity to improve dietary intake and associated cardiovascular mortality by supporting domestic production of F&V as part of a comprehensive strategy that intervenes across the supply chain.
Cholinesterase alterations in delirium after cardiosurgery: a German monocentric prospective study
Authors: Adam Elisabeth Hannah , Haas Victoria , Lindau Simone , Zacharowski Kai , Scheller Bertram 
Published: January 2020

ObjectivesPostoperative delirium (POD) is a common complication after elective cardiac surgery. Recent evidence indicates that a disruption in the normal activity of the cholinergic system may be associated with delirium.DesignProspective observational study.SettingSingle-centre at a European academic hospital.Primary and secondary outcome measuresIn our study the enzyme activities of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) were determined preoperatively as well as on the first and second postoperative day. The confusion assessment method for the intensive care unit was used to screen patients for the presence of POD.ResultsA total of 114 patients were included in the study. POD was associated with a decrease in BChE activity on postoperative day 1 (p=0.03). In addition, patients who developed POD, had significantly lower preoperative AChE activity than patients without POD (p<0.01). Multivariate analysis identified a preoperatively decreased AChE activity (OR 3.1; 95% CI 1.14 to 8.46), anticholinergic treatment (OR 5.09; 95% CI 1.51 to 17.23), elevated European System for Cardiac Operative Risk Evaluation (OR 3.68; 95% CI 1.04 to 12.99) and age (OR 3.02; 95% CI 1.06 to 8.62) to be independently associated with the development of POD.ConclusionsWe conclude that a reduction in the acetylcholine hydrolysing enzyme activity in patients undergoing cardiac surgery may correlate with the development of POD.
Development of a Cannabis Assessment Tool (CAT-1) to measure current and lifetime marijuana use among older Veterans
Authors: Keyhani Salomeh , Abraham Ann , Cohen Beth , Vali Marzieh , Yoo Sodahm Robin , Dollinger Camille , Steigerwald Stacey 
Published: January 2020

ObjectiveTo develop a tool to assess current (past 30 days) and lifetime marijuana use in older Veterans.SettingUS Veteran’s Affairs Healthcare System.Participants704 older Veterans were screened, 339 completed the initial survey, 100 completed the follow-up.Primary outcome measurePearson’s correlation coefficient to assess strength of association between initial and follow-up survey on measures of current and lifetime marijuana use.ResultsBoth a ‘gram-month’ measure of marijuana smoked in the past 30 days (r=0.83) and a frequency-based measure assessing total number of times smoked in the past 30 days were reliable (r=0.89). Both a simple categorical measure of lifetime use (agreement=85%) and a continuous measure of lifetime use (r=0.82) were reliable.ConclusionsThe Cannabis Assessment Tool offers a reliable assessment of past 30 days and lifetime assessments of smoking cannabis in older adults.
What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care
Authors: Isbell Linda M , Boudreaux Edwin D , Chimowitz Hannah , Liu Guanyu , Cyr Emma , Kimball Ezekiel 
Published: January 2020

BackgroundDespite calls to study how healthcare providers’ emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers’ emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.MethodsEmploying grounded theory, we conducted 86 semi-structured qualitative interviews with experienced ED providers (45 physicians and 41 nurses) from four academic medical centres and four community hospitals in the Northeastern USA. Constant comparative analysis was used to develop a grounded model of provider emotions and patient safety in the ED.ResultsED providers reported experiencing a wide range of emotions in response to patient, hospital, and system-level factors. Patients triggered both positive and negative emotions; hospital and system-level factors largely triggered negative emotions. Providers expressed awareness of possible adverse effects of negative emotions on clinical decision making, highlighting concerns about patient safety. Providers described strategies they employ to regulate their emotions, including emotional suppression, distraction, and cognitive reappraisal. Many providers believed that these strategies effectively guarded against the risk of emotions negatively influencing their clinical decision making.ConclusionThe role of emotions in patient safety is in its early stages and many opportunities exist for researchers, educators, and clinicians to further address this important issue. Our findings highlight the need for future work to (1) determine whether providers’ emotion regulation strategies are effective at mitigating patient safety risk, (2) incorporate emotional intelligence training into healthcare education, and (3) shift the cultural norms in medicine to support meaningful discourse around emotions.
Young women’s fertility knowledge: partial knowledge and implications for contraceptive risk-taking
Authors: Newton Victoria Louise , Dickson Jane , Hoggart Lesley 
Published: January 2020

BackgroundThere is a lack of research on young women’s fertility knowledge and awareness. This has implications for contraceptive risk-taking, including the use of emergency hormonal contraception (EHC). By drawing on two research studies, this article shows how greater fertility knowledge could benefit young women in terms of pregnancy prevention.MethodsWe draw on two qualitative research studies (‘fertility study’ and ‘abortion study’) resulting in a composite sample of 46 interviews with women aged 16–24 years. Focused secondary analysis was undertaken looking specifically at fertility knowledge in relation to contraceptive behaviour.FindingsA lack of accurate knowledge about the menstrual cycle was evident in two ways. Young women drew conclusions about their invulnerability to pregnancy if previous unprotected sexual intercourse (UPSI) had not resulted in pregnancy. Additionally, although participants were aware of EHC, there was no awareness of when it might fail other than after a certain time limit.ConclusionsYoung women would benefit from a more nuanced understanding of fertility. Episodes of UPSI that do not result in pregnancy can encourage a belief that ‘it won’t happen to me’, and this has implications for taking chances with contraception. Partial knowledge about the effectiveness of EHC may also lead to unintended pregnancy. Calculating the number of hours following UPSI generates overreliance on what is only one of the factors determining the effectiveness of EHC. Information regarding the link between EHC and failure rates near the day of ovulation needs to be more widely publicised.