bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the developmental tasks of emerging adults after paediatric heart transplantation: a cross-sectional case control study
Authors: Sepke Maria , Ferentzi Hannah , Disselhoff Vera Stephanie Umutoni , Albert Wolfgang 
Published: November 2018

ObjectivePaediatric heart transplantation (PHTX) comprises 12% of all cardiac transplants and many of the children now survive into adulthood. Only a few studies have investigated the long-term psychosocial well-being of young adult patients after PHTX; no studies have investigated developmental tasks of emerging adulthood in different domains (family, social environment, education and profession, partnership, social environment).SettingSpecialised heart centre in Germany.ParticipantsThirty-eight young adults aged 22.11 years (SD=4.7) who underwent PHTX and a control group of 46 participants with no known chronic diseases, aged 22.91 years (SD=1.8), participated in the study.Outcome measuresAll participants completed the following questionnaires: sociodemographic, the F-SozU, to measure perceived social support, the Gießener Beschwerde-Bogen to measure subjective complaints experienced by patients, the KIDSCREEN-27 to measure well-being and the SF-36 to measure health-related quality of life (QoL).Results‘Family’: the quality of the relationship with the parents was found to be equal in both groups, while PHTX patients stayed in closer spatial proximity to their parents. ‘Social environment’: PHTX patients reported lower social support by peers than the control group. ‘Education and profession’: PHTX patients most often worked full-time (23%), had no job and/or received a pension (21%). In comparison, most of the healthy controls did an apprenticeship (40%) and/or worked part time (32%). ‘Partnership’: fewer of the PHTX patients had a partner than the control group while relationship duration did not differ. In exploratory regression analyses, social support by peers predicted physical QoL, whereas physical complaints and the physical role predicted mental QoL in PHTX patients.ConclusionsOur exploratory findings highlight important similarities and differences in specific developmental tasks between PHTX patients and healthy controls. Future studies should focus on developmental tasks of PHTX patients in this age group more systematically, investigating their role in physical and mental well-being in a confirmatory manner.
Differences in infant and child mortality before and after the Great East Japan Earthquake and Tsunami: a large population-based ecological study
Authors: Tashiro Ai , Sakisaka Kayako , Okamoto Etsuji , Yoshida Honami 
Published: November 2018

ObjectivesTo examine associations between access to medical care, geological data, and infant and child mortality in the area of North-Eastern Japan that was impacted by the Great East Japan Earthquake and Tsunami (GEJET) in 2011.DesignA population-based ecological study using publicly available data.SettingTwenty secondary medical areas (SMAs) in the disaster-affected zones in the north-eastern prefectures of Japan (Iwate, Fukushima and Miyagi). Participants: Children younger than 10 years who died in the 20 SMAs between 2008 and 2014 (n=1 748). Primary and secondary outcome measures: Multiple regression analysis for infant and child mortality rate. The mean values were applied for infant and child mortality rates and other factors before GEJET (2008–2010) and after GEJET (2012–2014).ResultsBetween 2008 and 2014, the most common cause of death among children younger than 10 years was accidents. The mortality rate per 100 000 persons was 39.1±41.2 before 2011, 226.7±43.4 in 2011 and 31.4±39.1 after 2011. Regression analysis revealed that the mortality rate was positively associated with low age in each period, while the coastal zone was negatively associated with fewer disaster base hospitals in 2011. By contrast, the number of obstetrics and gynaecology centres (β=−189.9, p=0.02) and public health nurses (β=−1.7, p=0.01) was negatively associated with mortality rate per person in 2011.ConclusionsIn 2011, the mortality rate among children younger than 10 years was 6.4 times higher than that before and after 2011. Residence in a coastal zone was significantly associated with higher child mortality rates.
How does a new patient education programme for renal recipients become situated and adapted when implemented in the daily teaching practice in a university hospital? An ethnographic observation study
Authors: Lillehagen Ida , Andersen Marit Helen , Urstad Kristin Hjorthaug , Wahl Astrid , Engebretsen Eivind 
Published: November 2018

ObjectiveTo understand how a new patient education programme for renal recipients becomes situated and adapted when implemented in daily hospital teaching practice. The analysis focuses in particular on how principles of individual tailoring and patient involvement are adapted.DesignEthnographic observation study. 19 teaching sessions were observed, resulting in 35 pages of data written observation notes.SettingA Norwegian University hospital. The study included the transplantation (TX) post, the medical post and the outpatient clinic.Participants10 newly transplanted patients receiving the education programme, and 13 nurses trained in the new programme participated in the study.ResultsWe observed that the nurses attempted to implement the programme’s core principles of individual tailoring and patient involvement as intended, but that patients found it difficult to formulate their knowledge needs and interest. Patients and nurses developed an approach to individual tailoring and patient involvement, which used knowledge about the patients’ life and experiences as basis for translating generalised knowledge into knowledge that is individualised and meaningful for the patient. The individual tailoring was however also limited, as the nurses balanced between responsibilities for the programme’s principles of individual adaption and patient involvement at the one hand, and responsibilities of safety and economy from a health systems perspective on the other hand.ConclusionIndividual tailoring is observed to be a comprehensive practice which includes verbal, practical and emotional involvement with the patient’s life world. This extends the notion and practice of individual tailoring as selecting among predefined, generalised knowledge based on an initial mapping of the patients’ knowledge. While the adaptions to individual tailoring could have been seen as inaccurate implementation, in-depth analyses discloses that the extended approach to individual tailoring is in fact what retains the programme’s core principles in the implementation context.
Serum alkaline phosphatase and the risk of coronary heart disease, stroke and all-cause mortality: Tehran Lipid and Glucose Study
Authors: Kabootari Maryam , Raee Mohammad Reza , Akbarpour Samaneh , Asgari Samaneh , Azizi Fereidoun , Hadaegh Farzad 
Published: November 2018

ObjectivesTo investigate the association of alkaline phosphatase (ALP) levels with the risk of the composite end point of cardiovascular disease (CVD), and all-cause mortality as well as each of them separately.DesignProspective cohort study.SettingWithin the framework of the Tehran Lipid and Glucose Study (TLGS) cohort, participants were followed from baseline examination (1999–2001) until March 2014.ParticipantsA total of 2578 participants, aged ≥30 years free of prevalent CVD at baseline examination.Primary outcomeThe main outcome measures were composite end point of coronary heart disease (CHD), stroke, all-cause mortality and each per se.ResultsDuring a median follow-up of 11.3 years, 369, 68, 420, 170 and 495 participants experienced CHD, stroke, CVD, all-cause mortality and the composite outcome, respectively. In the multivariable Cox regression models, the adjusted HRs (95% CI) for mentioned events per one SD increase in ALP level after full adjustment were 1.11 (1.01 to 1.22), 1.20 (0.97 to 1.49, p=0.058), 1.10 (1.01 to 1.21), 1.16 (1.01 to 1.33) and 1.11 (1.02 to 1.21), respectively. Furthermore, participants with ALP levels in the highest tertile had significant adjusted HRs (95% CI) for stroke (1.88 (1.00 to 3.61)), CVD (1.30 (1.01 to 1.68)) and composite outcome (1.27 (1.00 to 1.61)). The cut-off value of ALP ≥199 IU/L for predicting composite outcome was derived using Youden’s index, based on which this cut-off point was associated with significant risk of 80%, 26%, 43% and 26% for incident stroke, CVD, all-cause mortality and composite outcome. Additionally, no improvement was seen in the predictive ability of traditional risk factors models after adding ALP values, considering the levels of Akaike information criterion, C-index and Net Reclassification Index.ConclusionIndependent associations between ALP levels and the risks of CVD and mortality events were shown, despite the fact that adding the data of ALP to known risk factors did not improve the prediction of these events.
Impact of telemedicine on neonatal resuscitation in the emergency department: a simulation-based randomised trial
Authors: Couturier Katherine , Whitfill Travis , Bhatnagar Ambika , Panchal Rajavee A , Parker John , Wong Ambrose H , Bruno Christie J , Auerbach Marc A , Gross Isabel T 
Published: November 2018

BackgroundThe delivery and initial resuscitation of a newborn infant are required but rarely practised skills in emergency medicine. Deliveries in the emergency department are high-risk events and deviations from best practices are associated with poor outcomes.IntroductionTelemedicine can provide emergency medicine providers real-time access to a Neonatal Resuscitation Program (NRP)-trained paediatric specialist. We hypothesised that adherence to NRP guidelines would be higher for participants with access to a remotely located NRP-trained paediatric specialist via telemedicine compared with participants without access.Materials and methodsProspective single-centre randomised trial. Emergency Medicine residents were randomised into a telemedicine or standard care group. The participants resuscitated a simulated, apnoeic and bradycardic neonate. In the telemedicine group a remote paediatric specialist participated in the resuscitation. Simulations were video recorded and assessed for adherence to guidelines using four critical actions. The secondary outcome of task load was measured through participants’ completion of the NASA Task Load Index (NASA-TLX) and reviewers completed a detailed NRP checklist.ResultsTwelve participants were included. The use of telemedicine was associated with significantly improved adherence to three of the four critical actions reflecting NRP guidelines as well as a significant improvement in the overall score (p<0.001). On the NASA-TLX, no significant difference was seen in overall subjective workload assessment, but of the subscore components, frustration was statistically significantly greater in the control group (p<0.001).ConclusionsIn this study, telemedicine improved adherence to NRP guidelines. Future work is needed to replicate these findings in the clinical environment.
Alcoholic and non-alcoholic fatty liver disease and associations with coronary artery calcification: evidence from the Kangbuk Samsung Health Study
Authors: Chang Yoosoo , Ryu Seungho , Sung Ki-Chul , Cho Yong Kyun , Sung Eunju , Kim Han-Na , Jung Hyun-Suk , Yun Kyung Eun , Ahn Jiin , Shin Hocheol , Wild Sarah Helen , Byrne Christopher D 
Published: November 2018

ObjectiveRecent evidence suggests that alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD) may differentially affect risk of cardiovascular mortality. To investigate whether early liver disease due to AFLD or NAFLD have similar or dissimilar effects on risk of early coronary artery atherosclerosis, we have investigated the associations between AFLD and NAFLD and coronary artery calcium (CAC).DesignA cross-sectional study was performed in 105 328 Korean adults who attended a health check-up programme. CAC score was assessed using CT, daily alcohol intake was recorded as grams/day and liver fat by ultrasound. Logistic regression model was used to calculate ORs with 95% CIs for prevalent CAC.ResultsBoth NAFLD and AFLD were positively associated with CAC score. After adjusting for potential confounders, multivariable-adjusted OR (95% CIs) for CAC >0 comparing NAFLD and AFLD to the reference (absence of both excessive alcohol use and fatty liver disease) were 1.10 (95% CI 1.05 to 1.16) and 1.20 (95% CI 1.11 to 1.30), respectively. In post hoc analysis, OR (95% CI) for detectable CAC comparing AFLD to NAFLD was 1.09 (95% CI 1.01 to 1.17). Associations of NAFLD and AFLD with CAC scores were similar in both non-obese and obese individuals without significant interaction by obesity (p for interaction=0.088). After adjusting for homeostasis model assessment of insulin resistance and high-sensitivity C reactive protein, the associations between fatty liver disease and CAC scores remained statistically significant.ConclusionIn this large sample of young and middle-aged individuals, early liver disease due to NAFLD and AFLD were both significantly associated with the presence of coronary artery calcification.
Influence of chronic diseases on societal participation in paid work, volunteering and informal caregiving in Europe: a 12-year follow-up study
Authors: Scharn Micky , Oude Hengel Karen , Boot Cécile R L , Burdorf Alex , Schuring Merel , van der Beek Allard J , Robroek Suzan J W 
Published: November 2018

BackgroundThis study aims to provide insight into (1) the associations between having a chronic disease and participation in paid work, volunteer activities or informal care, (2) the associations between the onset of a chronic disease and these forms of societal participation, and (3) whether these associations differ across educational level and gender.MethodsThe study population consisted of n=21 875 respondents of the Survey of Health, Ageing and Retirement in Europe aged between 50 years and the country-specific retirement age. The influence of having and the onset of a chronic disease on societal participation was analysed using a hybrid Poisson regression model, combining fixed and random effects, and presented by relative risks (RRs).ResultsIndividuals with a chronic disease were less likely to participate in paid work (RR: 0.69; 95% CI 0.67 to 0.71) and volunteer activities (RR: 0.92; 95% CI 0.88 to 0.97), but more likely to give informal care (RR: 1.05; 95% CI 1.01 to 1.08). Onset of a chronic disease was associated with a higher likelihood to quit paid work (RR: 0.91; 95% CI 0.86 to 0.97) and to give informal care (RR: 1.08; 95% CI 1.01 to 1.16). Lower educated individuals with a chronic disease or with the onset of a chronic disease were less likely to have paid work than higher educated individuals.ConclusionIndividuals with a chronic disease were less likely to participate in paid work and volunteer activities, and more likely to provide informal care. Educational inequalities were present for paid work. More insight into which factors hinder societal participation among individuals with a chronic disease is needed.
Reasons for failed endovascular recanalization attempts in stroke patients
Authors: Leischner Hannes , Flottmann Fabian , Hanning Uta , Broocks Gabriel , Faizy Tobias Djamsched , Deb-Chatterji Milani , Bernhardt Martina , Brekenfeld Caspar , Buhk Jan-Hendrik , Gellissen Susanne , Thomalla Götz , Gerloff Christian , Fiehler Jens 
Published: November 2018

PurposeMechanical thrombectomy (MT) is a highly effective therapy in patients with acute ischemic stroke due to large vessel occlusion (LVO). However, complete recanalization of the occluded vessel cannot be achieved in all patients, leading to poor clinical outcome. We analyzed the reasons for failed recanalization to help direct future improvements in therapy.Methods648 consecutive stroke patients with LVO and an MT attempt were retrospectively analyzed for none or minimal recanalization, assessed according to the Thrombolysis in Cerebral Infarction (TICI) score (0/1). Procedural parameters were evaluated in a standardized approach. Among other variables, number of retrieval attempts, devices, duration of the intervention, and rescue methods were analyzed.ResultsTICI 0/1 was observed in 72/648 patients (11%). In these patients, the thrombus could not be reached in 21% (n=15/72), was reached but not passed in 21% (n=15/72), and was reached and passed in 58% (n=42/72). Only a minor degree of initial recanalization was achieved in 19% (n=8/42) of patients with a reached occlusion during the course of the intervention. Furthermore, a higher number of passes with a single retriever device led to significant prolongation of the intervention. Therefore, major reasons for failed endovascular recanalization were difficult anatomical access and hard or resistant occlusions that might reflect hard thrombi or pre-existing atherosclerotic stenosis. Procedural complications such as dissection or perforation played a minor role.ConclusionIn stroke patients with failed MT attempts, approximately 60% of occlusions can be passed. In such cases, rescue therapy might be considered to improve recanalization and clinical outcome. Further development of access devices might help in the remaining cases where the microcatheter could not be manipulated to or through the occlusion.
Can early neurological improvement after mechanical thrombectomy be used as a surrogate for final stroke outcome?
Authors: Soize Sebastien , Fabre Guillaume , Gawlitza Matthias , Serre Isabelle , Bakchine Serge , Manceau Pierre-François , Pierot Laurent 
Published: November 2018

Background and purposeWe aimed to identify the best definition of early neurological improvement (ENI) at 2 and 24 hours after mechanical thrombectomy (MT) and determine its ability to predict a good functional outcome at 3 months.MethodsThis retrospective analysis was based on a prospectively collected registry of patients treated by MT for ischemic stroke from May 2010 to March 2017. We included patients treated with stent-retrievers with National Institute of Health Stroke Scale (NIHSS) score before treatment and at 2 and/or 24 hours after treatment and modified Rankin Score (mRS) at 3 months. Receiver operating characteristic curve analysis was performed to estimate optimal thresholds for ENI at 2 and 24 hours. The relationship between optimal ENI definitions and good outcome at 3 months (mRS 0–2) was assessed by logistic regression.ResultsThe analysis included 246 patients. At 2 hours, the optimal threshold to predict a good outcome at 3 months was improvementin the NIHSS score of >1 point (AUC 0.83,95% CI 0.77 to 0.87), with sensitivity and specificity 78.3% (62.2–85.7%) and 84.6% (77.2–90.3%), respectively, and OR 12.67 (95% CI 4.69 to 31.10, p<0.0001). At 24 hours, the optimal threshold was an improvementin the NIHSS score of >4 points (AUC 0.93, 95% CI 0.89 to 0.96), with sensitivity and specificity 93.8% (87.7–97.5%) and 83.2% (75.7–89.2%), respectively, and OR 391.32 (95% CI 44.43 to 3448.35, p<0.0001).ConclusionsENI 24 hours after thrombectomy appears to be a straightforward surrogate of long-term endpoints and may have value in future research.
Comparison of analogue and electronic stethoscopes for pulmonary auscultation by internal medicine residents
Authors: Gottlieb Eric R , Aliotta Jason M , Tammaro Dominick 
Published: November 2018

AbstractBackgroundElectronic stethoscopes are becoming more common in clinical practice. They may improve the accuracy and efficiency of pulmonary auscultation, but the data to support their benefit are limited.ObjectiveTo determine how auscultation with an electronic stethoscope may affect clinical decision making.MethodsAn online module consisting of six fictional ambulatory cases was developed. Each case included a brief history and lung sounds recorded with an analogue and electronic stethoscope. Internal medicine resident participants were randomly selected to hear either the analogue or electronic lung sounds. Numbers of correct answers, time spent on each case and numbers of times the recordings were played were compared between the groups who heard each mode of auscultation, with a p value of less than 0.05 indicating statistical significance.Results61 internal medicine residents completed at least one case, and 41 residents completed all six cases. There were no significant differences in overall scores between participants who heard analogue and electronic lung sounds (3.14±0.10 out of 6 correct for analogue, 3.20±0.10 out of 6 for electronic, p=0.74). There were no significant differences in performance for any of the six cases (p=0.78), time spent on the cases (p=0.67) or numbers of times the recordings were played (p=0.85).ConclusionWhen lung sounds were amplified with an electronic stethoscope, we did not detect an effect on performance, time spent on the cases or numbers of times participants listened to the recordings.
Parallel Metric Tree Embedding Based on an Algebraic View on Moore-Bellman-Ford
Authors: Friedrichs Stephan , Lenzen Christoph 
Published: November 2018

A
metric tree embedding
of expected
stretch α ≥ 1
maps a weighted
n
-node graph
G
= (
V
,
E
, ω) to a weighted tree
T
= (
V

T

,
E

T

, ω

T

) with
V
⊑
V

T

such that, for all
v
,
w
∈
V
, dist(
v
,
w
,
G
) ≤ dist(
v
,
w
,
T
), and E[dist(
v
,
w
,
T
)] ≤ α dist(
v
,
w
,
G
). Such embeddings are highly useful for designing fast approximation algorithms as many hard problems are easy to solve on tree instances. However, to date, the best parallel polylog
n
)-depth algorithm that achieves an asymptotically optimal expected stretch of α ∈ O(log
n
) requires Ω (
n
2
) work and a metric as input.

In this article, we show how to achieve the same guarantees using polylog
n
depth and Õ(
m
1+ε
) work, where
m
= |
E
| and ε > 0 is an arbitrarily small constant. Moreover, one may further reduce the work to Õ(
m
+
n
1+ε
) at the expense of increasing the expected stretch to O(ε
−1
log
n
).

Our main tool in deriving these parallel algorithms is an algebraic characterization of a generalization of the classic Moore-Bellman-Ford algorithm. We consider this framework, which subsumes a variety of previous “Moore-Bellman-Ford-like” algorithms, to be of independent interest and discuss it in depth. In our tree embedding algorithm, we leverage it to provide efficient query access to an approximate metric that allows sampling the tree using polylog
n
depth and Õ(
m
) work.

We illustrate the generality and versatility of our techniques by various examples and a number of additional results. Specifically, we (1) improve the state of the art for determining metric tree embeddings in the Congest model, (2) determine a (1 + εˆ)-approximate metric regarding the distances in a graph
G
in polylogarithmic depth and Õ(
n
(
m
+
n
1 + ε
)) work, and (3) improve upon the state of the art regarding the
k
-median and the buy-at-bulk network design problems.