bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of combined physical training on cognitive function in people with epilepsy: Results from a randomized controlled trial
Authors: Feter Natan , Alt Ricardo , Häfele César A. , da Silva Marcelo C. , Rombaldi Airton J. 
Published: June 2020

AbstractObjectiveTo examine the effect of 12‐week exercise program on cognitive function in people with epilepsy.MethodsTwenty‐one physically inactive subjects were randomized into two groups: the exercise group (EG) or the control group (CG). EG performed 12 weeks of combined physical training. CG was advised to maintain usual daily activities. EG received a structured, individually supervised exercise program with two 60‐minute sessions per week. Each session included warmup (5‐minutes), aerobic (15‐20 minutes at 14‐17 on Borg scale), strength (2‐3 sets, 10‐15 repetitions), and 5‐minute active stretches. Sociodemographic characteristics, clinical information, memory (Digit Span Test [DST]), executive function (Trail Making Test [TMT] A and B), Stroop Color and Word Test, a verbal fluency task, global cognitive function (Montreal Cognitive Assessment [MoCA]), anthropometric measurements (weight, height, and hip and waist circumferences), cardiorespiratory fitness (maximal oxygen consumption [VO2max]), and strength (dynamometer) were measured at baseline and after the 12‐week intervention.ResultsExercise decreased time spent on TMT‐A from baseline to postintervention (difference = −7.9 seconds, 95% confidence interval [CI] = −14.5 to −1.3,P = .023). EG improved total number of words on the verbal fluency task after intervention (difference = 8.1 words, 95% CI = 3.0 to 13.2,P = .002). EG also improved the score on MoCA at 1.7 (95% CI = 0.1 to 3.3,P = .043) points. We observed a 22.4% (95% CI = 13.1 to 31.6,P = .021) improvement in executive function in EG. No effect of group, time, or group × time was observed on any other cognitive test. Changes in VO2max were negatively associated with changes in performance on DST (r = −.445,P = .049) and overall memory score (r = −.544,P = .042).SignificanceThis randomized controlled trial provided the first evidence that combined physical training improves executive function in adults with epilepsy, showing main improvements in attention and language tasks. Physical exercise should be encouraged for people with epilepsy to reduce the burden on cognitive function associated with this disease.
Evaluation of the Healthcare Cost Offsets of Mend: A Family Systems Mental Health Integration Approach
Authors: Distelberg Brian , Castronova Marjorie , Tapanes Daniel , Allen Jesse , Puder David 
Published: June 2020

Behavioral and physical health integration has been shown to be beneficial for overall health outcomes, as well as financial benefits. The current research clearly shows benefits, but lacks evidence specific to couples and family therapy (CFT) as a medium or profession within mental health integrated sites. This study tests the cost offsets of Mastering Each New Directions (MEND), a family system psychosocial approach to chronic illness (CI). Using retrospective charges from 107 CI adult patients, MEND (with an average of 25 sessions) was estimated to produce a 12‐month cost savings of $16,684 or a 34.3% reduction in healthcare costs. This reduction significantly outweighed the cost of the intervention for a total net savings of $9,251 per participant in 12 months. Variations in cost reductions by demographic and treatment dosage are explored, and results suggest that a family systems psychosocial intervention can offer a health system an overall cost savings.
Using a think‐aloud methodology to understand online physical activity information search experiences and preferences of parents of children and youth with disabilities
Authors: Natkunam Tharsheka , Tristani Lauren , Peers Danielle , Fraser‐Thomas Jessica , Latimer‐Cheung Amy E. , Bassett‐Gunter Rebecca 
Published: June 2020

AbstractBackgroundThe Internet is a preferred source of physical activity (PA) information. However, limited research exists regarding the experiences of parents of children and youth with disabilities (CYWD) in searching for PA programme information online. This research examined the experiences and preferences of parents of CYWD in searching for PA programme information online.MethodParents of CYWD (n = 10) participated in a think‐aloud exercise while searching for PA programme information online. Following the think‐aloud exercise, semi‐structured interviews were used to further understand parents’ experiences and preferences in searching for PA programme information online.ResultsParents identified key features that contributed to a positive online search experience. Additionally, parents noted challenges and resulting negative affect that was experienced.ConclusionsThis research can inform the development and dissemination of online PA programme information that is accessible and relevant to the preferences of parents of CYWD and can facilitate positive search experiences.
IsCutibacterium(previouslyPropionibacterium)acnesa potential pathogenic factor in the aetiology of the skin disease progressive macular hypomelanosis?
Authors: McDowell A. , McLaughlin J. , Layton A.M. 
Published: June 2020

AbstractProgressive macular hypomelanosis (PMH) is a skin condition that normally causes symmetrically distributed hypopigmented macules on the front and back of the trunk, but rarely the face. To date, the pathophysiology of the condition is not well understood, but a role for the anaerobic skin bacteriumCutibacterium(previouslyPropionibacterium)acnesin the development of the disease has been proposed due to its sole presence within lesional, but not normal peri‐lesional, skin. The success of antimicrobials in the treatment of PMH also provides circumstantial evidence that this association may be causal, although this is still to be proven. More recent culture and metagenomic typing studies indicate that strains ofC. acnessubsp.elongatum(type III) may be important in the aetiology of the condition, which would help to explain why PMH does not normally affect the face since such strains are rarely present there, and why no association between this condition and acne vulgaris is found; acne appears to primarily involve type IA1strains fromC. acnessubsp.acnes(type I). In this review, we summarize current knowledge on the relationship betweenC. acnesand PMH, and re‐examine previous challenges to the view that the bacterium plays a role in the condition against the backdrop of newly emerged data.
Contracting under unverifiable monetary costs
Authors: Quérou Nicolas , Soubeyran Antoine , Soubeyran Raphael 
Published: June 2020

AbstractWe consider a contracting relationship where the agent's effort induces monetary costs, and limits on the agent's resource restrict his capability to exert effort. We show that the principal finds it best to offer a sharing contract while providing the agent with an up‐front financial transfer only when the monetary cost is neither too low nor too high. Thus, unlike in the limited liability literature, the principal might find it optimal to fund the agent. Moreover, both incentives and the amount of funding are nonmonotonic functions of the monetary cost. These results suggest that an increase in the interest rate may affect the form of contracts differently, depending on the initial level of the former. Using the analysis, we provide and discuss several predictions and policy implications.
Subsecond spontaneous catecholamine release in mesenteric lymph node ex vivo
Authors: Lim Gary N. , Regan Samantha L. , Ross Ashley E. 
Published: June 2020

AbstractMeasuring the dynamics of neurochemical‐regulated immunity, particularly in the gut, has been a growing interest over the last several years because of its important implications in gastrointestinal inflammation, neurodegeneration, and even depression. Sympathetic noradrenergic nerves innervate the gastrointestinal tract and resident immune organs, including the mesenteric lymph nodes (MLN) and Peyer's patches. Previous research has suggested that neuronal inputs in the MLN release norepinephrine (NE) at neural‐immune synapses to regulate immune function. The current immunological techniques do not have the appropriate temporal or spatial resolution to monitor this dynamic process in real‐time, within specific regions of intact lymphoid organs. Monitoring dynamic neural signaling within intact immune organs, in real‐time, would facilitate a deeper understanding of neuroimmune communication and would allow the mechanism of rapid immunomodulation to be elucidated. Here, we overcome this technological barrier by coupling real‐time neurochemical detection using fast‐scan cyclic voltammetry (FSCV) in live MLN slices from C57BL/6 mice. We have discovered rapid, spontaneous catecholamine transients in the T‐cell zone of the MLN which are on the order of a few hundred nanomolar, rapid (a few seconds), and frequent (every 20‐s). We demonstrate that the β2‐adrenergic receptor and the classic catecholamine transporters (DAT and NET) play a minor role in transient regulation in the MLN suggesting that regulation at the neural‐immune synapse is quite complicated and further mechanistic studies are needed. Overall, these findings provide direct evidence for rapid neurochemical events in the MLN which could have a major impact on our understanding of neurochemical‐regulated immunomodulation in the gut.
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Oral anticoagulants for nonvalvular atrial fibrillation in frail elderly patients: insights from the ARISTOPHANES study
Authors: Lip G. Y. H. , Keshishian A. V. , Kang A. L. , Dhamane A. D. , Luo X. , Li X. , Balachander N. , Rosenblatt L. , Mardekian J. , Pan X. , Di Fusco M. , Garcia Reeves A. B. , Yuce H. , Deitelzweig S. 
Published: June 2020

AbstractBackgroundPatient frailty amongst patients with nonvalvular atrial fibrillation (NVAF) is associated with adverse health outcomes and increased risk of mortality. Additional evidence is needed to evaluate effective and safe NVAF treatment in this patient population.ObjectivesThis subgroup analysis of the ARISTOPHANES study compared the risk of stroke/systemic embolism (S/SE) and major bleeding (MB) amongst frail NVAF patients prescribed nonvitamin K antagonist oral anticoagulants (NOACs) or warfarin.MethodsThis comparative retrospective observational study of frail, older NVAF patients who initiated apixaban, dabigatran, rivaroxaban or warfarin from 01JAN2013‐30SEP2015 was conducted using Medicare and 3 US commercial claims databases. To compare each drug, 6 propensity score‐matched (PSM) cohorts were created. Patient cohorts were pooled from 4 databases after PSM. Cox models were used to estimate hazard ratios (HR) of S/SE and MB.ResultsAmongst NVAF patients, 34% (N = 150 487) met frailty criteria. Apixaban and rivaroxaban were associated with a lower risk of S/SE vs warfarin (apixaban: HR: 0.61, 95% CI: 0.55–0.69; rivaroxaban: HR: 0.79, 95% CI: 0.72–0.87). For MB, apixaban (HR: 0.62, 95% CI: 0.57–0.66) and dabigatran (HR: 0.79, 95% CI: 0.70–0.89) were associated with a lower risk and rivaroxaban (HR: 1.14, 95% CI: 1.08–1.21) was associated with a higher risk vs warfarin.ConclusionAmongst this cohort of frail NVAF patients, NOACs were associated with varying rates of stroke/SE and MB compared with warfarin. Due to the lack of real‐world data regarding OAC treatment in frail patients, these results may inform clinical practice in the treatment of this patient population.
Obstetrical Care in Rural Minnesota: Family Physician Perspectives on Factors Affecting the Ability to Provide Prenatal, Labor, and Delivery Care
Authors: Pearson Jennifer , Anderholm Kaitlyn , Bettermann Maren , Friedrichsen Samantha , Mateo Carolina De La Rosa , Richter Sara , Onello Emily 
Published: June 2020

AbstractPurposeWith decreasing access to rural obstetrical care, this study aimed to identify factors that contribute to the ability of Minnesota's rural communities to continue to offer obstetrical services locally. The study also sought to characterize attributes that differentiate rural communities that continue to offer obstetrical care from those that do not.MethodsFamily medicine physicians practicing in communities of fewer than 20,000 people were interviewed through a phone survey that included multiple choice and open‐ended questions. Quantitative and qualitative analyses were performed on data collected from the responses.FindingsWithin the Minnesota communities represented (N = 25), prenatal care was provided broadly, regardless of whether labor and delivery services were available. For the communities providing local labor and delivery (N = 17), several factors seemed to be key to sustaining these services: having a sufficient cohort of delivering providers, having surgical backup, having accessible confident nurses and nurse anesthetists, sustaining a sufficient annual birth volume at the hospital, and having organizational and administrative support. In addition, supporting anesthesia and analgesic services, access to specialist consultation, having resources for managing and referring both newborn and maternal complications, and sustaining proper equipment were also requisite.ConclusionsRural Minnesota family medicine physicians practicing in communities providing local labor and delivery care emphasized several essential components for sustainable provision of these services. With awareness of these essential components, rural health care providers, administrators, and policy makers can focus resources and initiatives on efforts that are most likely to support a sustainable and coordinated rural labor and delivery program.
Overcoming Barriers to Health Care Access in Rural Latino Communities: An Innovative Model in the Eastern Coachella Valley
Authors: Tulimiero Monica , Garcia Michael , Rodriguez Maria , Cheney Ann M. 
Published: June 2020

AbstractIntroductionLatino farmworkers lack access to basic needs, including health care services. These farmworkers face barriers common to rural areas (eg, limited health services and public transportation), as well as language barriers, an unfamiliar medical system, no health insurance, and income‐based financial challenges exacerbated by a lack of workers’ rights.MethodsThis study involved focus group discussions to elicit community health priorities and barriers to health care service use among Latinos in rural farm working communities, as well as participants’ ideal model for health care services delivery. Free mobile clinics were subsequently implemented at locations and times the community identified as ideal, and pre‐ and postinterviews of patients’ experiences utilizing clinic services, and perceptions of access barriers, were conducted.ResultsResults from focus group discussions (n = 82) and one‐on‐one interviews (n = 15) to evaluate mobile clinic health care services use confirmed documented barriers to health care for this population, shed light on structural and cultural barriers to service access, and suggested innovative models for service delivery to Spanish‐speaking Latino farmworkers in rural communities. These models should (1) provide care within farm working communities, (2) offer services at times outside of business hours, and (3) encourage provider immersion in patient communities to better understand their health care needs.DiscussionTraditional models of care that expect patients to access health care services at brick and mortar structures are impractical for Latino farmworkers in rural communities. Innovative models bringing health care services to community spaces can reduce access barriers and emergency department utilization and improve health outcomes for this structurally vulnerable population.
Risk factors modifying the double burden of malnutrition of young children in Thailand
Authors: Okubo Tomoo , Janmohamed Amynah , Topothai Chompoonut , Blankenship Jessica L. 
Published: June 2020

AbstractThailand is now faced with a double burden of malnutrition. Using nationally representative data from the 2015–2016 Multiple Indicator Cluster Survey, we utilized multinomial logistic regression models to examine factors associated with stunting only, wasting only, overweight only, concurrent stunting and overweight, and concurrent stunting and wasting among children 0–59 months of age (n = 11,068). The prevalences of <5 stunting only (height‐for‐age Z score < −2 SD) and wasting only (WHZ < −2 SD) were 8.5% and 4.7%, respectively. The prevalence of <5 overweight only (WHZ > +2 SD) was 7.8%. Children 12–23 months (risk ratio [RR], 95% confidence interval [CI]: 1.47 [1.18, 1.83]; p < .01) and 24–35 months (RR, 95% CI: 1.56 [1.26, 1.94]; p < .001) were at increased risk for stunting only, compared with children 48–59 months. The strongest risk factor for stunting only was low birth weight (RR, 95% CI: 3.42 [2.86, 4.10]; p < .001). Children 0–5 months were at highest risk for wasting only, compared with children 48–59 months (RR, 95% CI: 2.91 [2.16, 3.92]; p < .001). Children 48–59 months and male children were more likely to be overweight only. Higher household wealth and smaller household size were also significant predictors of overweight only. A small proportion of children were concurrently stunted and overweight (1.3%) and concurrently stunted and wasted (0.6%). A multipronged approach focused on adequate prenatal care, improving breastfeeding and complementary feeding practices, and mitigating the growing burden of overweight is needed to address the double burden of malnutrition in Thailand.
Pure Means vs. Supernatural Means? On the Solidarity and Differences between Jacques Maritain and Dorothy Day
Authors: Stout Huili 
Published: June 2020

AbstractThis paper clarifies the full extent of the differences between Jacques Maritain and Dorothy Day on pacifism and anarchism in the light of their solidarity. I argue that their differences were primarily due to the particular challenges they faced in their specific vocation arising from the World War II context, and secondarily due to their different understandings of the relationship between nature and grace. While Day became drawn to a concrete heroic life of the supernatural virtues under the guidance of her spiritual director John Hugo, Maritain aimed to philosophically elucidate all the possible means available to modern Christians which may contribute to a historical realization of the Christian ideal. Their theological difference on nature and grace did not constitute a fundamental rift if taking into account the role of conscience as the essential element of a person's dignity, where the spiritual life takes shape and discernments are made. The pure means of the philosopher and the supernatural means of the saint are united in the Christian who is willing to give all for the object of their love.
Criteria for interpretation of the athlete's ECG: A critical appraisal
Authors: Zorzi Alessandro , Vio Riccardo , Bettella Natascia , Corrado Domenico 
Published: June 2020

AbstractThe electrocardiogram (ECG) is cheap and widely available but its use as a screening tool for early identification of athletes with a cardiac disease at risk of sudden cardiac death is controversial because of presumed low specificity. In the last decade, several efforts have been made to improve the distinction between physiological and pathological ECG findings in the athlete, leading to continuous evolution of the interpretation criteria. The most recent 2017 International criteria grouped ECG changes into three categories: normal, borderline, and abnormal. Borderline findings warrant further investigations only when two or more are present while abnormal changes should always be considered as the sign of a possible underlying disease. This review encompasses the evolution of the athlete's ECG interpretation criteria and highlights areas of uncertainty that will need to be addressed by further studies.
Potential evolutionary trade‐off between feeding and stability in Cambrian cinctan echinoderms
Authors: Rahman Imran A. , O'Shea James , Lautenschlager Stephan , Zamora Samuel 
Published: June 2020

AbstractReconstructing the function and behaviour of extinct groups of echinoderms is problematic because there are no modern analogues for their aberrant body plans. Cinctans, an enigmatic group of Cambrian echinoderms, exemplify this problem: their asymmetrical body plan differentiates them from all living species. Here, we used computational fluid dynamics to analyse the functional performance of cinctans without assuming an extant comparative model. Three‐dimensional models of six species from across cinctan phylogeny were used in computer simulations of water flow. The results demonstrate that cinctans with strongly flattened bodies produced much less drag than species characterized by dorsal protuberances or swellings, suggesting the former were more stable on the seafloor. However, unlike the flattened forms, cinctans with high‐relief bodies were able to passively direct flow towards the mouth and associated food grooves, indicating that they were capable of more efficient feeding on particles suspended in the water. This study provides evidence of a previously unknown evolutionary trade‐off between feeding and stability in Cambrian cinctan echinoderms.
All The Same? On a Certain Pattern in Cross‐National Death Risk
Authors: Barnett Arnold 
Published: June 2020

AbstractThis article considers whether a nation that fares relatively well (or badly) on a particular dimension of mortality risk tends also to do so on others. Working with 2016 data from the Global Burden of Disease (GBD) Study, we focus on six causes of premature death: transport accidents, other accidents, homicide, early‐childhood diseases, and both communicable and noncommunicable diseases beyond early childhood. We consider data from all 26 nations that had populations of at least 50 million in 2016, as well as 15 clusters of smaller nations that are similar in longevity (e.g., Scandinavia). We use an analytic method that facilitates useful comparisons across nations, for it recognizes that some potential death risks can be underestimated because citizens die sooner from other causes. We estimate reductions in lifespan from each of the six causes relative to natural lifespan as defined by GBD. It emerges that, for all 15 pairings among the six causes, these reductions are positively correlated. We introduce metrics to summarize a nation's overall “safety status,” and find that losses of longevity because of premature deaths are nearly three decades fewer in the safest countries than in the least safe ones. Turning to possible explanations for the cross‐national differences, we find a strong association between a nation's safety status and both its economic wherewithal as indicated by the 2016 GDP per capita (adjusted for purchasing power parity) and its income inequality as reflected by its Gini coefficient.