bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personal understandings and cultural conceptions of family in European societies
Authors: Lück Detlev , Castrén Anna-Maija 
Published: October 2018

ABSTRACT
Family lives in Europe have undergone considerable changes during the past decades. These changes have made it difficult or even impossible to grasp what people mean by ‘a family’ in their everyday life by an objective, pre-defined set of criteria. Marriage, a couple relationship, parent–child relationships based on shared bio-genetic substance, a shared household or functions such as reproduction or primary socialisation remain important characteristics of some of the most frequent family forms. However, against the background of an increasing destandardisation of family trajectories, growing importance of family ties across households, complex stepfamily constellations, advanced reproductive technology and negotiated gender relations, they do not hold up as definitions for the family as such.
ELMER v.2: an R/Bioconductor package to reconstruct gene regulatory networks from DNA methylation and transcriptome profiles
Authors: Silva Tiago C , Coetzee Simon G , Gull Nicole , Yao Lijing , Hazelett Dennis J , Noushmehr Houtan , Lin De-Chen , Berman Benjamin P 
Published: October 2018

Abstract

Motivation
DNA methylation has been used to identify functional changes at transcriptional enhancers and other cis-regulatory modules (CRMs) in tumors and other disease tissues. Our R/Bioconductor package ELMER (Enhancer Linking by Methylation/Expression Relationships) provides a systematic approach that reconstructs altered gene regulatory networks (GRNs) by combining enhancer methylation and gene expression data derived from the same sample set.

Results
We present a completely revised version 2 of ELMER that provides numerous new features including an optional web-based interface and a new Supervised Analysis mode to use pre-defined sample groupings. We show that Supervised mode significantly increases statistical power and identifies additional GRNs and associated Master Regulators, such as SOX11 and KLF5 in Basal-like breast cancer.

Availability and implementation
ELMER v.2 is available as an R/Bioconductor package at http://bioconductor.org/packages/ELMER/.

Supplementary information
Supplementary data are available at Bioinformatics online.
Multisystem Trajectories Over the Adult Life Course and Relations to Cardiovascular Disease and Death
Authors: Niiranen Teemu J , Enserro Danielle M , Larson Martin G , Vasan Ramachandran S 
Published: October 2018

Abstract

Background
Comprehensive conjoint characterization of long-term trajectories representing several biological systems is lacking.

Methods
We measured serially indicators representing 14 distinct biological systems in up to 3,453 participants attending four Framingham Study examinations: bone mineral density, body mass index (BMI), C-reactive protein, glomerular filtration rate, forced vital capacity (FVC), 1 second forced expiratory volume/FVC ratio (FEV1/FVC), gait speed, grip strength, glycosylated hemoglobin (HbA1c), heart rate, left ventricular mass, Mini-Mental State Examination (MMSE), pulse pressure, and total/high-density lipoprotein cholesterol ratio (TC/HDL).

Results
We observed that correlations among the 14 sex-specific trajectories were modest (r &lt; .30 for 169 of 182 sex-specific correlations). During follow-up (median 8 years), 232 individuals experienced a cardiovascular disease (CVD) event and 393 participants died. In multivariable regression models, CVD incidence was positively related to trajectories of BMI, HbA1c, TC/HDL, gait time, and pulse pressure (p &lt; .06); mortality risk was related directly to trajectories of gait time, C-reactive protein, heart rate, and pulse pressure but inversely to MMSE and FEV1/FVC (p &lt; .006). A unit increase in the trajectory risk score was associated with a 2.80-fold risk of CVD (95% confidence interval [CI], 2.04–3.84; p &lt; .001) and a 2.71-fold risk of death (95% CI, 2.30–3.20; p &lt; .001). Trajectory risk scores were suggestive of a greater increase in model c-statistic compared with single occasion measures (delta-c compared with age- and sex-adjusted models: .032 vs .026 for CVD; .042 vs .030 for mortality).

Conclusions
Biological systems age differentially over the life course. Longitudinal data on a parsimonious set of biomarkers reflecting key biological systems may facilitate identification of high-risk individuals.
Long-term evolution of CFS-unstable neutron stars and the role of differential rotation on short time-scales
Authors: Chugunov A I 
Published: October 2018

Abstract
I consider differential rotation, associated with radiation-driven Chandrasekhar–Friedman–Schutz (CFS) instability, and respective observational manifestations. I focus on the evolution of the apparent spin frequency, which is typically associated with the motion of a specific point on the stellar surface (e.g. polar cap). I start from long-term evolution (on the time-scale when instability significantly changes the spin frequency). For this case, I reduce the evolution equations to one differential equation and I demonstrate that it can be directly derived from energy conservation law. This equation governs the evolution rate through a sequence of thermally equilibrium states and it provides linear coupling for the cooling power and rotation energy losses via gravitational wave emission. In particular, it shows that differential rotation does not affect long-term spin-down. In contrast, on short time-scales, differential rotation can significantly modify the apparent spin-down, if we examine a strongly unstable star with a very small initial amplitude for the unstable mode. This statement is confirmed by considering a Newtonian non-magnetized perfect fluid and dissipative stellar models as well as a magnetized stellar model. For example, despite the fact that the widely applied evolution equations predict effective spin to be constant in the absence of dissipation, the CFS-unstable star should be observed as spinning-down. However, the effects of differential rotation on apparent spin-down are negligible for realistic models of neutron star recycling, unless the neutron star is non-magnetized, the r-mode amplitude is modulated faster than the shear viscosity dissipation time-scale, and the amplitude is large enough that spin-down can be measured on a modulation time-scale.
Concept Evaluation Using the PDSA Cycle for Continuous Quality Improvement
Authors: Laverentz Delois Meyer , Kumm Sharon 
Published: October 2018

Abstract
As concept-based nursing education gains popularity, there is little literature on how to sustain quality after initiation of the curriculum. Critical appraisal of concepts in a university program revealed varying definitions, attributes, and exemplars resulting in student confusion. The Plan, Do, Study, Act (PDSA) cycle for continuous quality improvement was used for concept evaluation. The goals of the evaluation project were: 1) to develop common definition and attributes for concepts and 2) to develop horizontal and vertical leveling of exemplars to build on prior student learning. The continuous quality improvement process can be used to prevent “concept creep” and ensure internal consistency of concept definitions, attributes, and exemplars.
Predictors of Nursing Graduate School Success
Authors: Patzer Brady , Lazzara Elizabeth H. , Keebler Joseph R. , Madi Maha H. , Dwyer Patricia , Huckstadt Alicia A. , Smith-Campbell Betty 
Published: October 2018

Abstract
Several factors influence success in nursing graduate school. This study collected retrospective data from students in a nursing graduate program to determine which factors predict success. Data were analyzed using a multiple regression analysis to predict success (i.e., graduation grade point average [GPA]) from student characteristics. The predictors were nursing course GPA, undergraduate science GPA, GPA upon admission to nursing graduate school, experience in a specialty, and the duration of that experience. Results indicate that admission, nursing, and undergraduate science GPA are more important for predicting success than previous experience. The predictors account for approximately 80 percent of the variance (R
2 = .80).
Global Consensus Guidelines for the Injection of Diluted and Hyperdiluted Calcium Hydroxylapatite for Skin Tightening
Authors: Goldie Kate , Peeters Wouter , Alghoul Mohammed , Butterwick Kimberly , Casabona Gabriela , Chao Yates Yen Yu , Costa Joana , Eviatar Joseph , Fabi Sabrina Guillen , Lupo Mary , Sattler Gerhard , Waldorf Heidi , Yutskovskaya Yana , Lorenc Paul 
Published: October 2018

BACKGROUND
Calcium hydroxylapatite (CaHA) is approved to correct moderate-to-severe wrinkles and folds and soft-tissue volume loss in the face and hands. More recently, subdermal injection using diluted CaHA has been used to improve skin laxity.

OBJECTIVE
To review evidence for the safe and effective use of diluted CaHA in the face and body and provide best practice recommendations.

METHODS
A global panel of expert aesthetic physicians convened to develop consensus-based guidelines for treating laxity and superficial wrinkles using diluted (ratio of 1:1) and hyperdiluted (≥1:2) CaHA.

RESULTS
Diluted and hyperdiluted CaHA stimulates targeted neocollagenesis in the injection area to improve laxity and skin quality in the mid- and lower face, neck, décolletage, upper arms, abdomen, upper legs, and buttocks. Treatment can be used as an adjunct to volume augmentation or combined with additional modalities for optimal results. Adverse events are related to the injection and include bruising, swelling, mild pain, and induration. In thinner and darker skin, too-superficial injections of less diluted CaHA can lead to more adverse events.

CONCLUSION
This report provides preliminary guidelines for the novel off-label use of CaHA for biostimulation in the face and body. Further trials will provide additional clarity regarding treatment paradigms for optimal outcomes.
Long-term postmenopausal estrogen therapy may be associated with increased risk of breast cancer: a cohort study
Authors: Ettinger Bruce , Quesenberry Charles , Schroeder David A. , Friedman Gary 
Published: October 2018

Abstract
Reports of a role of postmenopausal estrogen replacement therapy in the development of breast cancer have been inconsistent. Although many epidemiologic studies have failed to show an association between short-term use of estrogen and breast cancer, there are indications that long-term use may present an increased risk. We undertook a long-term, retrospective cohort study of the incidence of breast cancer in women who had taken long-term estrogen (average 17.2 years), compared to women who had not taken estrogen. Subjects were 454 women born between 1900 and 1915, who were members of a large health maintenance organization in northern California. By the end of 1995, 26 (11.2%) of estrogen users developed breast cancer, as did 9 (4.1%) of the nonusers; the relative risk (RR) for estrogen use was 2.8 [95% confidence interval (95% CI) 1.3-5.9]. Adjustment for age and multiple breast cancer risk factors, including breast cancer surveillance, reduced the RR for estrogen to 2.0 (95% CI 0.9-4.5). We conclude that long-term estrogen use is associated with a substantially increased risk of breast cancer.
Caloric restriction reduces age at menopause: the effect of the 1944-1945 Dutch famine
Authors: Elias Sjoerd G. , van Noord Paulus A.H. , Peeters Petra H.M. , Tonkelaar Isolde den , Grobbee Diederick E. 
Published: October 2018

Abstract

Objective:
To assess the effect of caloric restriction, as endured during the 1944-1945 Dutch famine, on the age at which natural menopause occurs and to identify specific vulnerable age periods in which caloric restriction has the largest effect.

Design:
This was a population-based cohort study conducted in Utrecht, the Netherlands. Between 1983 and 1986, 9,471 women aged 40 to 73 years at the time of interview were classified regarding their exposure to the famine. Age at natural menopause was obtained from all available data, retrospectively as well as prospectively. We estimated differences in mean age at natural menopause between famine exposure categories (not, moderately, and severely exposed), with adjustment for smoking, parity, socioeconomic status, body mass index, age at menarche, and year of birth.

Results:
Women experienced natural menopause on average 0.36 years earlier (95% CI: −0.60, −0.11) when severely exposed to the famine and 0.06 years earlier (95% CI: −0.22, 0.09) when moderately exposed compared with the unexposed women. This effect was particularly pronounced in those severely exposed from 2 to 6 years of age: −1.83 years (95% CI: −3.03, −0.63).

Conclusions:
Our findings suggest that caloric restriction decreases age at natural menopause. Early childhood seems to be a particularly sensitive age period for this effect.
Long-term risk of depressive and anxiety symptoms after early bilateral oophorectomy
Authors: Rocca Walter A. , Grossardt Brandon R. , Geda Yonas E. , Gostout Bobbie S. , Bower James H. , Maraganore Demetrius M. , de Andrade Mariza , Melton L. Joseph 
Published: October 2018

Abstract

Objective:
We studied the long-term risk of depressive and anxiety symptoms in women who underwent bilateral oophorectomy before menopause.

Design:
We conducted a cohort study among all women residing in Olmsted County, MN, who underwent bilateral oophorectomy before the onset of menopause for a noncancer indication from 1950 through 1987. Each member of the bilateral oophorectomy cohort was matched by age with a referent woman from the same population who had not undergone an oophorectomy. In total, we studied 666 women with bilateral oophorectomy and 673 referent women. Women were followed for a median of 24 years, and depressive and anxiety symptoms were assessed using a structured questionnaire via a direct or proxy telephone interview performed from 2001 through 2006.

Results:
Women who underwent bilateral oophorectomy before the onset of menopause had an increased risk of depressive symptoms diagnosed by a physician (hazard ratio = 1.54, 95% CI: 1.04-2.26, adjusted for age, education, and type of interview) and of anxiety symptoms (adjusted hazard ratio = 2.29, 95% CI: 1.33-3.95) compared with referent women. The findings remained consistent after excluding depressive or anxiety symptoms that first occurred within 10 years after oophorectomy. The associations were greater with younger age at oophorectomy but did not vary across indications for the oophorectomy. In addition, treatment with estrogen to age 50 years in women who underwent bilateral oophorectomy at younger ages did not modify the risk.

Conclusions:
Bilateral oophorectomy performed before the onset of menopause is associated with an increased long-term risk of depressive and anxiety symptoms.
History of hot flashes and aortic calcification among postmenopausal women
Authors: Thurston Rebecca C. , Kuller Lewis H. , Edmundowicz Daniel , Matthews Karen A. 
Published: October 2018

Abstract

Objective:
Menopausal hot flashes are considered largely a quality-of-life issue. However, emerging research also links hot flashes to cardiovascular risk. In some investigations, this risk is particularly apparent among women using hormone therapy. The aim of this study was to determine whether a longer history of reported hot flashes over the study period was associated with greater aortic and coronary artery calcification. Interactions with hormone therapy use were examined in an exploratory fashion.

Methods:
Participants included 302 women participating in the Healthy Women Study, a longitudinal study of cardiovascular risk during perimenopause and postmenopause, which was initiated in 1983. Hot flashes (any/none) were assessed when women were 1, 2, 5, and 8 years postmenopausal. Electron beam tomography measures of coronary artery calcification and aortic calcification were completed in 1997-2004. Associations between the number of visits with report of hot flashes, divided by the number of visits attended, and aortic or coronary artery calcification (transformed) were examined in linear regression models. Interactions by hormone therapy use were evaluated.

Results:
Among women using hormone therapy, a longer history of reported hot flashes was associated with increased aortic calcification, controlling for traditional cardiovascular risk factors (b = 2.87, SE = 1.21, P < 0.05). There were no significant associations between history of hot flashes and coronary artery calcification.

Conclusions:
Among postmenopausal women using hormone therapy, a longer history of reported hot flashes measured prospectively was associated with increased aortic calcification, controlling for traditional cardiovascular risk factors. Hot flashes may signal adverse cardiovascular changes among certain postmenopausal women.
Efficacy of intravaginal dehydroepiandrosterone (DHEA) on moderate to severe dyspareunia and vaginal dryness, symptoms of vulvovaginal atrophy, and of the genitourinary syndrome of menopause
Authors: Labrie Fernand , Archer David F. , Koltun William , Vachon Andrée , Young Douglas , Frenette Louise , Portman David , Montesino Marlene , Côté Isabelle , Parent Julie , Lavoie Lyne , BSc Adam Beauregard , Martel Céline , Vaillancourt Mario , Balser John , Moyneur Érick 
Published: October 2018

Abstract

Objective:
The aim of this study is to confirm the local beneficial effects of intravaginal dehydroepiandrosterone (DHEA, Prasterone) on moderate to severe dyspareunia or pain at sexual activity, the most frequent symptom of vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause (GSM).

Methods:
In a prospective, randomized, double-blind, and placebo-controlled phase III clinical trial, the effect of daily intravaginal 0.50% DHEA (6.5 mg) (Prasterone, EndoCeutics) was examined on four coprimary objectives, namely percentage of parabasal cells, percentage or superficial cells, vaginal pH, and moderate to severe pain at sexual activity (dyspareunia) identified by the women as their most bothersome vulvovaginal atrophy symptom. The intent-to-treat population included 157 and 325 women in the placebo and DHEA-treated groups, respectively.

Results:
After daily intravaginal administration of 0.50% DHEA for 12 weeks, when compared to baseline by the analysis of covariance test, the percentage of parabasal cells decreased by 27.7% over placebo (P < 0.0001), whereas the percentage of superficial cells increased by 8.44% over placebo (P < 0.0001), vaginal pH decreased by 0.66 pH unit over placebo (P < 0.0001), and pain at sexual activity decreased by 1.42 severity score unit from baseline or 0.36 unit over placebo (P = 0.0002). On the other hand, moderate to severe vaginal dryness present in 84.0% of women improved at 12 weeks by 1.44 severity score unit compared to baseline, or 0.27 unit over placebo (P = 0.004). At gynecological evaluation, vaginal secretions, epithelial integrity, epithelial surface thickness, and color all improved by 86% to 121% over the placebo effect (P < 0.0001 for all comparisons with placebo). Serum steroid levels remained well within the normal postmenopausal values according to the involved mechanisms of intracrinology. The only side effect reasonably related to treatment is vaginal discharge due to melting of the vehicle at body temperature and this was reported in about 6% of the participants.

Conclusions:
The daily intravaginal administration of 0.50% (6.5 mg) DHEA (Prasterone) has shown clinically and highly statistically significant effects on the four coprimary parameters suggested by the US Food and Drug Administration. The strictly local action of Prasterone is in line with the absence of significant drug-related adverse events, thus showing the high benefit-to-risk ratio of this treatment based upon the novel understanding of the physiology of sex steroids in women.
A Situation-Specific Theory of Caregiver Contributions to Heart Failure Self-care
Authors: Vellone Ercole , Riegel Barbara , Alvaro Rosaria 
Published: October 2018

Background
The literature on caregiver contributions to heart failure (HF) patient self-care has grown rapidly during the last few years, but theory guiding this growth is lacking.

Objective
The purpose of this article is to describe a Situation-Specific Theory of Caregiver Contributions to HF Self-care.

Results
We describe theoretical assumptions, the process by which caregivers contribute to HF self-care, factors influencing caregiver contributions to HF self-care, known predictors (caregiver, patient, and dyadic related) and outcomes of caregiver contributions to HF. These outcomes may be caregiver and patient related and positive and/or negative. Caregiver contributions to HF self-care include interacting processes of self-care maintenance, symptom monitoring and perception, and self-care management. Caregiver confidence and cultural values are discussed as important influences on caregiver contributions to HF self-care. Recursive pathways are hypothesized between processes and outcomes. Ten theoretical propositions are proposed.

Conclusions
The Situation-Specific Theory of Caregiver Contributions to HF Self-care is still in its infancy, and more research is needed to strengthen the evidence supporting the theory. But at this point, the theory may help to guide future studies addressing caregiver contributions to HF self-care and clinical practice aimed at improving caregiver and patient outcomes.
A Multicenter Study on the Utility of EBUS-TBNA and EUS-B-FNA in the Diagnosis of Mediastinal Lymphoma
Authors: Dhooria Sahajal , Mehta Ravindra M. , Madan Karan , Vishwanath Gella , Sehgal Inderpaul S. , Chhajed Prashant N. , Prakash Gaurav , Gupta Nalini , Bal Amanjit , Agarwal Ritesh 
Published: October 2018

Background:
There is conflicting data on the utility of endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) for the detection and subtyping of lymphomas. Herein, we present our experience with EBUS-TBNA in suspected lymphoma.

Methods:
This was a multicenter retrospective study of subjects with suspected lymphoma who underwent EBUS-TBNA (July 2011 to June 2017). The performance characteristics of EBUS-TBNA were calculated separately for suspected new-onset and recurrent lymphoma as well as for subtyping. We also analyzed the factors predicting the yield of EBUS-TBNA in suspected lymphoma.

Results:
Among the 4803 EBUS procedures performed, 92 (1.9%) subjects had either suspected or proven lymphoma; 48 were finally diagnosed to have lymphoma. The diagnostic sensitivities of EBUS-TBNA in new-onset and recurrent lymphomas were 72.7% and 73.3%, respectively. Only 24.2% (8/33) subjects with new-onset lymphoma could be appropriately subtyped. This low yield was possibly due to inadequate material for cell block in 10 subjects, and performance of immunophenotyping and flow cytometry in only 5 and 1 subjects, respectively. Among the suspected cases of recurrence, EBUS-TBNA was sufficient for management in 81.8% (18/22). On a multivariate analysis, no factor (rapid onsite evaluation, needle size, number of lymph nodes sampled, passes per node, and size of the largest lymph node sampled) predicted the diagnostic yield.

Conclusion:
EBUS-TBNA is a useful investigation in the diagnostic algorithm of suspected lymphoma as it helps avoid other invasive diagnostic procedures. The sensitivity of EBUS-TBNA in subtyping new-onset mediastinal lymphoma depends on the adequacy of cell aspirate and the judicious utilization of pathologic techniques.