bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nocturnal swallowing and arousal threshold in individuals with chronic spinal cord injury
Authors: Rizwan Aliza , Sankari Abdulghani , Bascom Amy T. , Vaughan Sarah , Badr M. Safwan 
Published: April 2018

Respiratory complications are potential causes of death in patients with spinal cord injury (SCI). Nocturnal swallowing could be related to transient arousals and could lead to fragmented sleep in SCI patients. However, the impact of nocturnal swallowing on breathing and sleep physiology in SCI is unknown. The objectives of this study were 1) to determine whether nocturnal swallowing is more common in SCI than in able-bodied (AB) subjects, 2) to determine the role of nocturnal swallowing on arousal threshold (ArTh) in SCI individuals with sleep-disordered breathing (SDB), and 3) to determine the effect of continuous positive airway pressure (CPAP) treatment on nocturnal swallowing. A total of 16 SCI and 13 AB subjects with SDB completed in-laboratory polysomnography with a pharyngeal catheter. A swallowing event (SW) was defined as a positive spike in pharyngeal pressure and was used to calculate the swallow index (SI) defined as a number of SW/total sleep time. Each SW was assessed for a relationship to the sleep stages and respiratory cycle phases, and associated arousals and ArTh were calculated. SI was higher in the SCI group compared with AB subjects during wake and different sleep stages ( P < 0.05). SWs were found to be significantly higher in the late expiratory phase in the group with SCI compared with the other respiratory phases and were eliminated by CPAP ( P < 0.05). ArTh for the subjects with SCI was significantly lower ( P < 0.05) compared with the AB subjects. Nocturnal swallowing is more common in SCI than in AB individuals who have SDB, particularly during the expiratory phase. The ArTh is significantly lower in SCI (indicating increased arousal propensity), which may contribute to the mechanism of sleep disturbances in SCI. NEW & NOTEWORTHY Nocturnal swallowing is common in patients with chronic spinal cord injury (SCI) and is associated with frequent arousals from sleep. The lower arousal threshold during sleep in SCI may contribute to the mechanism of sleep disturbances that are commonly found in cervical and high thoracic SCI. Continuous positive airway pressure may play a therapeutic role in alleviating nocturnal swallowing, which may contribute to reduced risk of aspiration.
Mucosal Two-Step Pathogenesis in Gastroesophageal Reflux Disease: Repeated Weakly Acidic Stimulation and Activation of Protease-Activated Receptor-2 on Mucosal Interleukin-8 Secretion
Authors: Winkelsett Lukas , Malfertheiner Peter , Wex Thomas , Kandulski Arne 
Published: April 2018

Background: Activation of protease-activated receptor-2 (PAR2) is involved in the mucosal immune pathogenesis of gastroesophageal reflux disease (GERD) that is characterized by proinflammatory cytokines such as interleukin-8 (IL-8). PAR2 activation on epithelial cells induces epithelial IL-8 secretion and initiates mucosal inflammation. Methods: A human primary esophageal epithelial cell model was established to investigate the effects of repeated stimulation with weakly acidic solutions and subsequent PAR2 activation. After creating a monolayer, cells were incubated under weakly acidic conditions for 7 h followed by 17 h at pH 7.4. This short-term exposure was repeated once. After weakly acidic stimulation, PAR2 activation was achieved by a synthetic agonist at pH 7.4. Results: After repeated weakly acidic incubation, PAR2 transcript levels were 3.6-fold upregulated (p = 0.001) and IL-8 transcripts were 2.4-fold enhanced (p = 0.034) compared to nonstimulated controls, while IL-8 protein in the cell pellet and supernatant was not increased. Only the additional PAR2 activation upon pH stimulation led to increased IL-8 secretion into the supernatant. Conclusions: We propose a 2-step mechanism in which repeated weakly acidic exposure leads to the upregulation of epithelial PAR2 expression. The subsequent activation of upregulated PAR2 contributes to the initiation of mucosal inflammation, which underlies the important role of esophageal epithelium in GERD pathogenesis.
A Web-Based Education Program for Colorectal Lesion Diagnosis with Narrow Band Imaging Classification
Authors: Aihara Hiroyuki , Kumar Nitin , Thompson Christopher C. 
Published: April 2018

<b><i>Background:</i></b> An<b><i></i></b> education system for narrow band imaging (NBI) interpretation requires sufficient exposure to key features. However, access to didactic lectures by experienced teachers is limited in the United States. <b><i>Aim:</i></b> To develop and assess the effectiveness of a colorectal lesion identification tutorial. <b><i>Methods:</i></b> In the image analysis pretest, subjects including 9 experts and 8 trainees interpreted 50 white light (WL) and 50 NBI images of colorectal lesions. Results were not reviewed with subjects. Trainees then participated in an online tutorial emphasizing NBI interpretation in colorectal lesion analysis. A post-test was administered and diagnostic yields were compared to pre-education diagnostic yields. <b><i>Results:</i></b> Under the NBI mode, experts showed higher diagnostic yields (sensitivity 91.5% [87.3–94.4], specificity 90.6% [85.1–94.2], and accuracy 91.1% [88.5–93.7] with substantial interobserver agreement [κ value 0.71]) compared to trainees (sensitivity 89.6% [84.8–93.0], specificity 80.6% [73.5–86.3], and accuracy 86.0% [82.6–89.2], with substantial interobserver agreement [κ value 0.69]). The online tutorial improved the diagnostic yields of trainees to the equivalent level of experts (sensitivity 94.1% [90.0–96.6], specificity 89.0% [83.0–93.2], and accuracy 92.0% [89.3–94.7], <i>p</i> &#x3c; 0.001 with substantial interobserver agreement [κ value 0.78]). <b><i>Conclusions:</i></b> This short, online tutorial improved diagnostic performance and interobserver agreement.
Early Flow Disturbances of Tunnelled Haemodialysis Catheters and Topographic Landmarks in Chest X-Ray
Authors: Fahnert Jeanette , Stumpp Patrick , Kahn Thomas , Keller Frieder , Schiekofer Stephan , Petros Sirak , Halbritter Jan , Lindner Tom H. , Rasche Franz Maximilian 
Published: April 2018

<b><i>Background/Aims:</i></b> The position of the tip of tunnelled haemodialysis (HD) catheters (THC) might influence flow characteristics during HD. In chest X-ray (CXR), carina-related landmarks may be practicable to verify the THC position, and tip-carina distance (TCD) might be useful to predict early-flow dysfunctions. <b><i>Methods:</i></b> In this single-centre, retrospective study, the TCD and the angle between the distal catheter and the body vertical axis (tip-body vertical-angle [TVA]) was measured in 115 THC by post-procedure CXR with 2 investigators. The parameters were proved to be feasible by interrater-reliability and correlated with the incidence of flow-dysfunction within 10 days after insertion. <b><i>Results:</i></b> Steep-aligned (TVA &#x3c;40°, <i>p</i> &#x3c; 0.01) and deep-ending catheters (TCD: right-sighted &#x3e;1.5 cm or left-sighted &#x3e;4.5 cm below the carina; <i>p</i> &#x3c; 0.01) showed a significantly less dysfunction with a good interrater-reliability (R[TVA] = 0.8, R[TCD] = 0.9). <b><i>Conclusions:</i></b> Carina-related landmarks in CXR might be helpful to predict early-flow dysfunctions. However, randomized studies will be necessary to confirm this in fluoroscopic-guided placement during the insertion of THC.
Hospitalidade e Intenção de Recompra na Economia Compartilhada: um estudo com equações estruturais em meios de hospedagem alternativos
Authors: Pinottti Rita De Cássia , Moretti Sérgio Luiz do Amaral 
Published: April 2018

O consumo colaborativo, também chamado de economia compartilhada, contribui para a ruptura das formas tradicionais de transação dos serviços, principalmente no caso dos meios de hospedagem. Essa nova perspectiva pode ser colocada sob a ótica dos estudos da hospitalidade pelo foco na relação entre anfitrião e hóspede. O objetivo desta pesquisa é responder à seguinte questão: qual o impacto entre meios de hospedagem alternativos, com base na pré-experiência com o site de serviços, hospitalidade, prazer e benefícios econômicos percebidos no contexto da economia compartilhada, na intenção de recompra? A metodologia foi quantitativa, por meio de questionário, com corte transversal, baseada em amostra de usuários de meios de hospedagem alternativos. O questionário ficou hospedado no Survey Monkey. A análise foi feita pela modelagem de equações estruturais (SEM, do inglês structural equation modeling), utilizando software SmartPLS. Todas as hipóteses propostas se confirmaram como influenciadoras na intenção de recompra e, portanto, capazes de gerar impacto entre os meios de hospedagem alternativos. O instrumento provou ser capaz de medir o que propôs e os resultados alcançados puderam responder ao problema da pesquisa. Entre eles, pode-se destacar que o consumo colaborativo é motivador de novas experiências. Parece correto afirmar que as empresas que exploram o setor de locação de propriedades privadas foram capazes de inovar e gerar valor em um setor até então dominado por grupos hoteleiros e incontáveis hotéis independentes em todo mundo.
P‐Wave Amplitude and PR Changes in Patients With Inappropriate Sinus Tachycardia: Findings Supportive of a Central Mechanism
Authors: Field Michael E. , Donateo Paolo , Bottoni Nicola , Iori Matteo , Brignole Michele , Kipp Ryan T. , Kopp Douglas E. , Leal Miguel A. , Eckhardt Lee L. , Wright Jennifer M. , Walsh Kathleen E. , Page Richard L. , Hamdan Mohamed H. 
Published: April 2018

Background

The mechanism of inappropriate sinus tachycardia (
IST
) remains incompletely understood.

Methods and Results

We prospectively compared 3 patient groups: 11 patients with
IST
(
IST
Group), 9 control patients administered isoproterenol (Isuprel Group), and 15 patients with cristae terminalis atrial tachycardia (AT Group). P‐wave amplitude in lead
II
and
PR
interval were measured at a lower and higher heart rate (
HR
1 and
HR
2, respectively). P‐wave amplitude increased significantly with the increase in
HR
in the
IST
Group (0.16±0.07 mV at
HR
1=97±12 beats per minute versus 0.21±0.08 mV at
HR
2=135±21 beats per minute,
P
=0.001). The average increase in P‐wave amplitude in the
IST
Group was similar to the Isuprel Group (
P
=0.26).
PR
interval significantly shortened with the increases in
HR
in the
IST
Group (146±15 ms at
HR
1 versus 128±16 ms at
HR
2,
P
<0.001). A similar decrease in the
PR
interval was noted in the Isuprel Group (
P
=0.6). In contrast, patients in the atrial tachycardia Group experienced
PR
lengthening during atrial tachycardia when compared with baseline normal sinus rhythm (153±25 ms at
HR
1=78±17 beats per minute versus 179±29 ms at
HR
2=140±28 beats per minute,
P
<0.01).

Conclusions

We have shown that
HR
increases in patients with
IST
were associated with an increase in P‐wave amplitude in lead
II
and
PR
shortening similar to what is seen in healthy controls following isoproterenol infusion. The increase in P‐wave amplitude and absence of
PR
lengthening in
IST
support an extrinsic mechanism consistent with a state of sympatho‐excitation with cephalic shift in sinus node activation and enhanced atrioventricular nodal conduction.
Smoking and Risk of Ischemic Stroke in Young Men
Authors: Markidan Janina , Cole John W. , Cronin Carolyn A. , Merino Jose G. , Phipps Michael S. , Wozniak Marcella A. , Kittner Steven J. 
Published: April 2018

Background and Purpose—
There is a strong dose–response relationship between smoking and risk of ischemic stroke in young women, but there are few data examining this association in young men. We examined the dose–response relationship between the quantity of cigarettes smoked and the odds of developing an ischemic stroke in men under age 50 years.

Methods—

The Stroke Prevention in Young Men Study is a population-based case–control study of risk factors for ischemic stroke in men ages 15 to 49 years. The χ
2
test was used to test categorical comparisons. Logistic regression models were used to calculate the odds ratio for ischemic stroke occurrence comparing current and former smokers to never smokers. In the first model, we adjusted solely for age. In the second model, we adjusted for potential confounding factors, including age, race, education, hypertension, myocardial infarction, angina, diabetes mellitus, and body mass index.

Results—
The study population consisted of 615 cases and 530 controls. The odds ratio for the current smoking group compared with never smokers was 1.88. Furthermore, when the current smoking group was stratified by number of cigarettes smoked, there was a dose–response relationship for the odds ratio, ranging from 1.46 for those smoking <11 cigarettes per day to 5.66 for those smoking 40+ cigarettes per day.

Conclusions—
We found a strong dose–response relationship between the number of cigarettes smoked daily and ischemic stroke among young men. Although complete smoking cessation is the goal, even smoking fewer cigarettes may reduce the risk of ischemic stroke in young men.
Synthesis of the Southeast Atmosphere Studies: Investigating Fundamental Atmospheric Chemistry Questions
Authors: Carlton Annmarie G. , de Gouw Joost , Jimenez Jose L. , Ambrose Jesse L. , Attwood Alexis R. , Brown Steven , Baker Kirk R. , Brock Charles , Cohen Ronald C. , Edgerton Sylvia , Farkas Caroline M. , Farmer Delphine , Goldstein Allen H. , Gratz Lynne , Guenther Alex , Hunt Sherri , Jaeglé Lyatt , Jaffe Daniel A. , Mak John , McClure Crystal , Nenes Athanasios , Nguyen Thien Khoi , Pierce Jeffrey R. , de Sa Suzane , Selin Noelle E. , Shah Viral , Shaw Stephanie , Shepson Paul B. , Song Shaojie , Stutz Jochen , Surratt Jason D. , Turpin Barbara J. , Warneke Carsten , Washenfelder Rebecca A. , Wennberg Paul O. , Zhou Xianling 
Published: April 2018

AbstractThe Southeast Atmosphere Studies (SAS), which included the Southern Oxidant and Aerosol Study (SOAS); the Southeast Nexus (SENEX) study; and the Nitrogen, Oxidants, Mercury and Aerosols: Distributions, Sources and Sinks (NOMADSS) study, was deployed in the field from 1 June to 15 July 2013 in the central and eastern United States, and it overlapped with and was complemented by the Studies of Emissions, Atmospheric Composition, Clouds and Climate Coupling by Regional Surveys (SEAC4RS) campaign. SAS investigated atmospheric chemistry and the associated air quality and climate-relevant particle properties. Coordinated measurements from six ground sites, four aircraft, tall towers, balloon-borne sondes, existing surface networks, and satellites provide in situ and remotely sensed data on trace-gas composition, aerosol physicochemical properties, and local and synoptic meteorology. Selected SAS findings indicate 1) dramatically reduced NOx concentrations have altered ozone production regimes; 2) indicators of “biogenic” secondary organic aerosol (SOA), once considered part of the natural background, were positively correlated with one or more indicators of anthropogenic pollution; and 3) liquid water dramatically impacted particle scattering while biogenic SOA did not. SAS findings suggest that atmosphere–biosphere interactions modulate ambient pollutant concentrations through complex mechanisms and feedbacks not yet adequately captured in atmospheric models. The SAS dataset, now publicly available, is a powerful constraint to develop predictive capability that enhances model representation of the response and subsequent impacts of changes in atmospheric composition to changes in emissions, chemistry, and meteorology.
Effects of empathic and positive communication in healthcare consultations: a systematic review and meta-analysis
Authors: Howick Jeremy , Moscrop Andrew , Mebius Alexander , Fanshawe Thomas R , Lewith George , Bishop Felicity L , Mistiaen Patriek , Roberts Nia W , Dieninytė Eglė , Hu Xiao-Yang , Aveyard Paul , Onakpoya Igho J 
Published: April 2018

Background Practitioners who enhance how they express empathy and create positive expectations of benefit could improve patient outcomes. However, the evidence in this area has not been recently synthesised. Objective To estimate the effects of empathy and expectations interventions for any clinical condition. Design Systematic review and meta-analysis of randomised trials. Data sources Six databases from inception to August 2017. Study selection Randomised trials of empathy or expectations interventions in any clinical setting with patients aged 12 years or older. Review methods Two reviewers independently screened citations, extracted data, assessed risk of bias and graded quality of evidence using GRADE. Random effects model was used for meta-analysis. Results We identified 28 eligible (n = 6017). In seven trials, empathic consultations improved pain, anxiety and satisfaction by a small amount (standardised mean difference −0.18 [95% confidence interval −0.32 to −0.03]). Twenty-two trials tested the effects of positive expectations. Eighteen of these (n = 2014) reported psychological outcomes (mostly pain) and showed a modest benefit (standardised mean difference −0.43 [95% confidence interval −0.65 to −0.21]); 11 (n = 1790) reported physical outcomes (including bronchial function/ length of hospital stay) and showed a small benefit (standardised mean difference −0.18 [95% confidence interval −0.32 to −0.05]). Within 11 trials (n = 2706) assessing harms, there was no evidence of adverse effects (odds ratio 1.04; 95% confidence interval 0.67 to 1.63). The risk of bias was low. The main limitations were difficulties in blinding and high heterogeneity for some comparisons. Conclusions Greater practitioner empathy or communication of positive messages can have small patient benefits for a range of clinical conditions, especially pain. Protocol registration Cochrane Database of Systematic Reviews (protocol) DOI: 10.1002/14651858.CD011934.pub2.
Do Coffee Farmers Benefit in Food Security from Participating in Coffee Cooperatives? Evidence from Southwest Ethiopia Coffee Cooperatives
Authors: Shumeta Zekarias , D’Haese Marijke 
Published: April 2018

Background: Most coffee in Ethiopia is produced by smallholder farmers who face a daily struggle to get sufficient income but also to feed their families. At the same time, many smallholder coffee producers are members of cooperatives. Yet, literature has paid little attention to the effect of cooperatives on combating food insecurity among cash crop producers including coffee farmers. Objective: The objective of the study was to investigate how coffee cooperative membership may affect food security among coffee farm households in Southwest Ethiopia. Methods: The study used cross-sectional household data on income, expenditure on food, staple food production (maize and teff), and utilization of improved inputs (fertilizer and improved seed) collected from 256 randomly selected farm households (132 cooperative members and 124 nonmembers) and applied an inverse probability weighting (IPW) estimation to assess the impact of cooperative membership on food security. Results: The result revealed that cooperative membership has a positive and significant effect on staple food production (maize and teff) and facilitated technological transformation via increased utilization of fertilizer and improved seeds. Nonetheless, the effect on food expenditure and income could not be confirmed. Conclusion: Findings suggest a trade-off between coffee marketing and input supply functions of the cooperatives, impairing their true food security impact from the pooled income and production effect.
Impact of Chronic Antiplatelet Therapy on Infarct Size and Bleeding in Patients With Acute Myocardial Infarction
Authors: Campodonico Jeness , Cosentino Nicola , Milazzo Valentina , Rubino Mara , De Metrio Monica , Marana Ivana , Moltrasio Marco , Grazi Marco , Lauri Gianfranco , Bonomi Alice , Veglia Fabrizio , Chiorino Elisa , Assanelli Emilio , Bartorelli Antonio L. , Marenzi Giancarlo 
Published: April 2018

Background: Patients hospitalized with acute myocardial infarction (AMI) are often on prior single antiplatelet therapy (SAPT) or a dual antiplatelet therapy (DAPT). Whether chronic SAPT or DAPT is beneficial or associated with an increased risk in AMI is still controversial. Methods and Results: We prospectively enrolled 1718 consecutive patients with AMI (798 ST-segment elevation myocardial infarction and 920 non-ST-segment elevation myocardial infarction) who were divided according to their chronic APT (no APT, SAPT, or DAPT). The study primary end point was the infarct size, as estimated by troponin I peak. Incidence of major bleeding was also evaluated. Five hundred thirty-six (31%) patients were on chronic SAPT and 215 (13%) on DAPT. A graded increase in Global Registry of Acute Coronary Events (GRACE) and Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) risk scores was found going from patients without APT to those with DAPT, while a progressive smaller troponin I peak was observed with the increasing number of chronic antiplatelet agents (11.2 [interquartile range: 2-45] ng/mL, 6.6 [1-33] ng/mL, and 4.1 [1-24] ng/mL; P < .001 for trend). This result was maintained after adjustment for baseline ischemic risk profile (GRACE score) and other major confounders ( P < .001). The incidence of bleeding was higher in patients on chronic APT than in those without APT (5.2% vs 2.4%; P = .002). However, when the bleeding risk was adjusted for the CRUSADE risk score, chronic SAPT (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 0.77-2.53) and DAPT (OR: 0.70, 95% CI: 0.29-1.70) were not associated with an increased bleeding risk. Conclusion: In patients with AMI, chronic APT is associated with higher baseline ischemic and bleeding risks. Despite this and unexpectedly, they have a smaller infarct size and similar adjusted bleeding risk.
Web-based rehabilitation interventions for people with rheumatoid arthritis: A systematic review
Authors: Srikesavan Cynthia , Bryer Catherine , Ali Usama , Williamson Esther 
Published: April 2018

Background Rehabilitation approaches for people with rheumatoid arthritis include joint protection, exercises and self-management strategies. Health interventions delivered via the web have the potential to improve access to health services overcoming time constraints, physical limitations, and socioeconomic and geographic barriers. The objective of this review is to determine the effects of web-based rehabilitation interventions in adults with rheumatoid arthritis. Methods Randomised controlled trials that compared web-based rehabilitation interventions with usual care, waiting list, no treatment or another web-based intervention in adults with rheumatoid arthritis were included. The outcomes were pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge, physical activity and adverse effects. Methodological quality was assessed using the Cochrane Risk of Bias tool and quality of evidence with the Grading of Recommendations Assessment, Development and Evaluation approach. Results Six source documents from four trials ( n = 567) focusing on self-management, health information or physical activity were identified. The effects of web-based rehabilitation interventions on pain, function, quality of life, self-efficacy, rheumatoid arthritis knowledge and physical activity are uncertain because of the very low quality of evidence mostly from small single trials. Adverse effects were not reported. Conclusion Large, well-designed trials are needed to evaluate the clinical and cost-effectiveness of web-based rehabilitation interventions in rheumatoid arthritis.