bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and risk factors of uncorrected refractive error among an elderly Chinese population in urban China: a cross-sectional study
Authors: Ye Hehua , Qian Yiyong , Zhang Qi , Liu Xiaohong , Cai Xuan , Yu Wenjing , Li Xiang , Zhao Peiquan 
Published: March 2018

ObjectivesTo investigate the prevalence and risk factors of uncorrected refractive error (URE) in an elderly urban Chinese population in China.DesignA population-based cross-sectional study.MethodsThe study was conducted using a cluster random sample of residents aged 50 years or older living in the Jiangning Road subdistrict, Shanghai, China. All participants underwent a standardised interview and eye examinations, including presenting visual acuity (PVA) and best-corrected visual acuity (BCVA) between November 2012 and February 2013. URE was defined as an improvement of two lines or more in the BCVA compared with the PVA in the better eye of <20/40.ResultsA total of 1999 subjects (an 82.5% response rate) completed both the questionnaire and ophthalmic examination. The prevalence of URE was 20.1% (95% CI 18.0% to 22.2%) in the study sample. After age standardisation, the prevalence of URE in Chinese people aged 50 years or older was 18.7% (95% CI 17.0% to 20.4%). Under multiple logistic regression analysis, older age (per 1-year increase, OR 1.04, 95% CI 1.03 to 1.05) and a lower level of education (OR 1.34, 95% CI 1.07 to 1.69) were significantly related to URE. A history of ocular diseases (OR 0.71, 95% CI 0.55 to 0.92) was a protective factor for URE.ConclusionsURE is highly prevalent among the elderly urban Chinese population, which should raise awareness of the URE burden in China to meet the Vision 2020 goal to eliminate preventable blindness.
Nursing students’ experience in performing intimate clinical procedures via high fidelity Mask-Ed simulation
Authors: Frost Jane , Delaney Lori J 
Published: March 2018

BackgroundDidactic clinical skills training employing low fidelity simulation has been the traditional approach to teaching undergraduate nursing students the insertion of an indwelling urinary catheter. This approach, however, does not adequately prepare students for the intricacies and complexity of this procedure in the real world, which is associated with high rates of infection secondary to procedural contamination.ObjectivesTo explore students’ confidence levels in developing clinical psychomotor skills associated with the insertion of an indwelling urinary catheter in a high-fidelity simulation using Mask-Ed.MethodsA mixed methods study was conducted involving final year Bachelor of Nursing students. Preproceduraland postprocedural confidence was rated by students using a 5-point Likert scale. A focus group consisting of eleven students was conducted to further explore student’s experience of engaging with a Mask-Ed character and the procedural experience from a learning perspective.ResultsThe findings indicated that students increased their procedure confidence when engaging with the Mask-Ed simulation (P=0.025). The ability to maintain procedural asepsis and ability to accurately identify the correct anatomical structures related to indwelling urinary catheter insertion were found to be related (rs=0.71, P<0.05). Three primary themes were identified: caring of a person, intimate care and communication.ConclusionPsychomotor skills related to communication, support and maintaining procedural asepsis were areas that required further clinical development, which are not concurrently integrated into the simulation approach using manikin based simulation. Mask-Ed provided a unique learning opportunity to replicate a clinically and anatomically realistic experience.
Functional neurological disorders in Parkinson disease
Authors: Wissel Benjamin D , Dwivedi Alok K , Merola Aristide , Chin Danielle , Jacob Cara , Duker Andrew P , Vaughan Jennifer E , Lovera Lilia , LaFaver Kathrin , Levy Ariel , Lang Anthony E , Morgante Francesca , Nirenberg Melissa Jill , Stephen Christopher , Sharma Nutan , Romagnolo Alberto , Lopiano Leonardo , Balint Bettina , Yu Xin X , Bhatia Kailash P , Espay Alberto J 
Published: March 2018

ObjectiveTo ascertain demographic and clinical features of Parkinson disease (PD) associated with functional neurological features.MethodsA standardised form was used to extract data from electronic records of 53 PD patients with associated functional neurological disorders (PD-FND) across eight movement disorders centres in the USA, Canada and Europe. These subjects were matched for age, gender and disease duration to PD patients without functional features (PD-only). Logistic regression analysis was used to compare both groups after adjusting for clustering effect.ResultsFunctional symptoms preceded or co-occurred with PD onset in 34% of cases, nearly always in the most affected body side. Compared with PD-only subjects, PD-FND were predominantly female (68%), had longer delay to PD diagnosis, greater prevalence of dyskinesia (42% vs 18%; P=0.023), worse depression and anxiety (P=0.033 and 0.025, respectively), higher levodopa-equivalent daily dose (972±701 vs 741±559 mg; P=0.029) and lower motor severity (P=0.019). These patients also exhibited greater healthcare resource utilisation, higher use of [(123)I]FP-CIT SPECT and were more likely to have had a pre-existing psychiatric disorder (P=0.008) and family history of PD (P=0.036).ConclusionsA subtype of PD with functional neurological features is familial in one-fourth of cases and associated with more psychiatric than motor disability and greater use of diagnostic and healthcare resources than those without functional features. Functional manifestations may be prodromal to PD in one-third of patients.
Randomised controlled trial of a self-guided online fatigue intervention in multiple sclerosis
Authors: Pöttgen Jana , Moss-Morris Rona , Wendebourg Janina-Maria , Feddersen Lena , Lau Stefanie , Köpke Sascha , Meyer Björn , Friede Tim , Penner Iris-Katharina , Heesen Christoph , Gold Stefan M 
Published: March 2018

ObjectiveFatigue is a major disabling symptom in many chronic diseases including multiple sclerosis (MS), but treatment options are limited.Here, we tested the effectiveness of a self-guided , interactive, online fatigue management programme (ELEVIDA) based on principles of cognitive behavioural therapy (CBT) and related psychotherapeutic approaches (eg, mindfulness) for reducing fatigue in MS.MethodsPatients with MS and self-reported fatigue were recruited via the website of the German MS Society and assigned via an automated randomisation generator (1:1, no blocking or stratification) to a 12-week online intervention (ELEVIDA, n=139, 82% female, mean age 40.8, median patient determined disease steps (PDDS) 3.0) or a waitlist control group (n=136, 79% female, mean age 41.9, median PDDS 3.0). The primary outcome was the Chalder Fatigue Scale. Outcomes were assessed at baseline, at week 12 (postintervention) and at follow-up (week 24).ResultsCompared with the control group, significantly greater reductions in Chalder Fatigue Scale scores were seen in the ELEVIDA group at week 12 (primary endpoint, intention-to-treat analysis: between-group mean difference 2.74 points; 95% CI 1.16 to 4.32; p=0.0007; effect size d=0.53), with effects sustained at week 24 (intention-to-treat analysis: between-group mean difference 2.19 points; 95% CI 0.57 to 3.82; p=0.0080).ConclusionsOur trial provides evidence for the effectiveness of a self-guided , internet-based intervention to reduce fatigue in MS. Interventions such as ELEVIDA may be a suitable low barrier, cost-effective treatment option for MS fatigue.Trial registration numberISRCTN registry (number ISRCTN25692173).
Blood pressure management in older people: balancing the risks
Authors: Naschitz Jochanan E 
Published: March 2018

AbstractGuidelines of arterial hypertension treatment based on individualised expected outcomes are not available for frail older persons. In this paper, we review the evidence, concerning management of arterial blood pressure (BP) in frail older patients. We focused on the best affordable methods for BP measurement; the age-related optimum BP; specific BP goals in agreement with the patients’ general heath, frailty status, orthostatic and postprandial hypotension; balancing the benefits against risks of antihypertensive treatment. Lenient BP goals are generally recommended for older persons with moderate or severe frailty, multimorbidity and limited life expectancy. To this aim, there may be a need for deintensification of antihypertensive treatment.
Hypothesis: role for ammonia neutralization in the prevention and reversal of heart failure
Authors: Bing Oscar H. L. 
Published: March 2018

Ammonia plays a central role in the life and death of all living organisms and has been studied for over 100 yr. Ammonia is necessary for growth and development, but it is toxic in excess, and, as a result, differing methods of ammonia neutralization have evolved. After physiological and pathological stress to the heart, tissue ammonia levels rise. Local ammonia neutralization may be inadequate, and excess ammonia may exert its toxic effects. Phenylbutyrate (PBA), which is Federal Drug Administration approved for the treatment of elevated blood ammonia in urea cycle disorders, provides an accessory pathway for ammonia excretion. Recently, PBA has also been found to prevent specific cardiomyopathies. The central theme presents the hypothesis that stress to the myocardium from a variety of environmental sources causes injury, cell death, necrosis, and ammonia production. Ammonia, if not neutralized, exerts downstream toxic effects. Here, data are presented showing that neutralization with PBA alone and PBA combined with angiotensin-converting enzyme inhibition prevent and reverse pathophysiology associated with specific cardiomyopathies.NEW & NOTEWORTHY Ammonia produced after myocardial injury is hypothesized to be an upstream stress contributing to the pathophysiology of heart failure, effects that may be attenuated by a documented ammonia-reducing treatment. Reversal of heart failure can be achieved using an angiotensin-converting enzyme inhibitor combined with an ammonia-reducing treatment.
Racial Differences in Characteristics and Outcomes of Patients With Heart Failure and Preserved Ejection Fraction in the Treatment of Preserved Cardiac Function Heart Failure Trial
Authors: Lewis Eldrin F. , Claggett Brian , Shah Amil M. , Liu Jiankang , Shah Sanjiv J. , Anand Inder , O’Meara Eileen , Sweitzer Nancy K. , Rouleau Jean L. , Fang James C. , Desai Akshay S. , Retta Tamrat M. , Solomon Scott D. , Heitner John F. , Stamos Thomas D. , Boineau Robin , Pitt Bertram , Pfeffer Marc A. 
Published: March 2018

Background:
Black patients have been shown to have different baseline characteristics and outcomes compared with nonblack patients in cohort studies. However, few studies have focused on heart failure (HF) with preserved ejection fraction (HFpEF) patients. We aimed to determine the difference in cardiovascular outcomes in black and nonblack patients with HFpEF and to determine the relative efficacy and safety of spironolactone in black and nonblack patients.

Methods and Results:

Patients with HFpEF, randomized to spironolactone versus placebo in the TOPCAT trial (Treatment of Preserved Cardiac Function Heart Failure With an Aldosterone Antagonist) in North and South America, were grouped according to self-described black and nonblack race. Black HFpEF patients (n=302) were younger and were more likely to have diabetes mellitus and hypertension than nonblack patients but had similar HFpEF severity. Black patients had higher risk for the primary outcome (hazard ratio [HR], 1.34; 95% confidence interval, 1.06–1.71;
P
=0.02) and first HF hospitalization (HR, 1.51; 95% confidence interval, 1.167–1.97;
P
=0.002)], but no significant difference in cardiovascular mortality risk (HR, 0.78; 95% confidence interval, 0.51–1.20;
P
=0.326). In black and nonblack patients, randomization to spironolactone conferred similar efficacy in the primary outcome (HR, 0.83 versus 0.79;
P
for interaction=0.49), HF hospitalization (HR, 0.67 versus 0.82;
P
for interaction=0.76), and cardiovascular mortality (
P
for interaction=0.19). The risk of hyperkalemia and worsening renal function with spironolactone and study drug adherence were also similar.

Conclusions:
Black patients with HFpEF have a higher HF hospitalization risk than nonblack patients, but spironolactone is similarly effective and safe in both groups.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT00094302.
Impact of Coronary Artery Revascularization Completeness on Outcomes of Patients With Coronary Artery Disease Undergoing Transcatheter Aortic Valve Replacement
Authors: Witberg Guy , Zusman Oren , Codner Pablo , Assali Abid , Kornowski Ran 
Published: March 2018

Background—
Coronary artery disease (CAD) is highly prevalent in patients undergoing transcatheter aortic valve replacement. In the overall CAD population, complete revascularization or reasonable incomplete revascularization (ICR) is associated with improved outcomes; whether the same applies for the transcatheter aortic valve replacement population is still a matter of debate.

Methods and Results—

We conducted a systematic review and meta-analysis of studies that examined the prognostic effect of revascularization completeness in patients undergoing transcatheter aortic valve replacement using the residual SYNTAX score (Synergy Between PCI With Taxus and Cardiac Surgery) to separate between reasonable ICR and ICR (using the individual threshold used by each study). Six studies with a total of 3107 patients were included. The duration of follow-up ranged from 0.7 to 3 years. Overall, ICR was associated with an increased risk for mortality. This was true when comparing ICR patients to those with no CAD (odds ratio, 1.85; 95% confidence interval, 1.42–2.40;
P
<0.01), to those with reasonable ICR (odds ratio, 1.69; 95% confidence interval, 1.26–2.28;
P
<0.001), or to both groups combined (odds ratio, 1.71; 95% confidence interval, 1.36–2.16;
P
<0.001). On the contrary, patients in the reasonable ICR category did not show an increased risk for mortality when compared with those with no CAD (odds ratio, 1.11; 95% confidence interval, 0.89–1.39;
P
=0.33).

Conclusions—
Our results suggest that for patients with CAD undergoing transcatheter aortic valve replacement, a residual SYNTAX score–guided revascularization strategy may carry significant benefits in terms of mortality. Adequate revascularization may offer a unique and valuable opportunity to improve the prognosis of these patients.
Association of Body Fat Mass and Fat Distribution With the Incidence of Hypertension in a Population‐Based Chinese Cohort: A 22‐Year Follow‐Up
Authors: Chen Yongjie , Liang Xuan , Zheng Senshuang , Wang Yuan , Lu Wenli 
Published: March 2018

Background
There have been few studies on the association between the incidence of hypertension and the presence and distribution of body fat. The aim of this article was to evaluate this association.

Methods and Results

Data were obtained from the China Health Nutrition Survey, a 22‐year cohort study of 12 907 participants. Body mass index and triceps skinfold thickness were used as markers of body fat, whereas waist circumference (
WC
) was used as a marker of fat distribution. Cox regression was used to examine the association of body mass index,
WC
, and skinfold thickness with the incidence of hypertension. The interval between the baseline and hypertension diagnosis was the time variable, and hypertension was the end event. The mean age and proportion of men and women were 38.29 and 38.03 years and 45.63% and 54.37%, respectively. Compared with normal
WC
, abdominal obesity was associated with hypertension (
P
<0.001; crude hazard ratio, 2.11; 95% confidence interval, 1.89–2.37). Similarly, overweight (crude hazard ratio, 1.75; 95% confidence interval, 1.64–1.87) and obesity (crude hazard ratio, 3.19; 95% confidence interval, 2.80–3.63) were risk factors for hypertension (all
P
<0.001). When stratified by sex, the results confirmed that
WC
and body mass index predicted the development of hypertension in both men and women but not skinfold thickness in women.

Conclusions

Body mass index and
WC
were independent risk factors for hypertension, but skinfold thickness was a poor marker of body fat and could not be used to predict hypertension.
Employment Effects of Financial Constraints during the Great Recession
Authors: Siemer Michael 
Published: March 2018

Abstract
Employment declined substantially during the 2007–2009 recession, especially in small and young firms. Using confidential firm-level data of the universe of firms and a difference-in-differences methodology, this paper estimates that financial constraints reduced employment growth by 4 to 8 percentage points in small firms relative to large firms and by 7 to 9 percentage points in young relative to old firms. I find that the effect of financial constraints on small firms is driven to a large extent by young firms. I then document that financial constraints affected employment growth in small and young firms strongly through the entry and exit of firms.
Canis in Fabula
Authors: Pigoń Jakub 
Published: March 2018

Abstract
The story of the astrologer Ascletario is introduced by Suetonius as the last item in a series of portents and predictions presaging Domitian’s violent death. This paper gives an analysis of this episode, discussed in the wider context of the catalogue of portents in Dom. 15.2-3 and, indeed, of the whole death narrative of the biography. A comparison to the parallel story in Cassius Dio (67.16.3) reveals important differences between the two authors; it is argued that Suetonius is closer to the original version of the anecdote and that Dio may have been influenced by Herodotus’ story of Croesus on the pyre. It is also argued that Suetonius expects his readers to connect the Ascletario episode with another Flavian portent, reported at Ves. 7.4 (dogs are prominent in both). Two other ‘canine’ passages of the Domitian, 10.1 and 23.1, are briefly discussed. The proposed analysis supports the view of Suetonius as an author who carefully structured his biographical rubrics and invited his readers to make connections within both a single biography and wider textual units.
Spectral Signatures of Moisture–Convection Feedbacks over the Indian Ocean
Authors: Ahmed Fiaz , Schumacher Courtney 
Published: March 2018

Abstract
Positive feedbacks between the cloud population and the environmental moisture field are central to theoretical expositions on the Madden–Julian oscillation (MJO). This study investigates the statistical incidence of positive moisture–convection feedbacks across multiple space and time scales over the tropical Indian Ocean. This work uses vertically integrated moisture budget terms from the ECMWF interim reanalysis [ERA-Interim (ERA-I)] in a framework proposed by Hannah et al. Positive moisture–convection feedbacks are primarily a low-frequency, low-wavenumber phenomenon with significant spectral signatures in the 32–48-day time scale. The efficacy of these feedbacks, however, is subject to horizontal moisture advection variations, whose relative importance varies with scale. Wave-filtered Tropical Rainfall Measuring Mission (TRMM) satellite precipitation is used to show that these moisture–convection feedbacks contribute more to moisture increases in the MJO than in other equatorial waves. A moving-window correlation analysis suggests that instances of moisture–convection feedbacks are more frequent in drier conditions, when column water vapor (CWV) is below its climatological mean value, with the implication that positive moisture–convection feedbacks shape the mean CWV field by moistening drier air columns, but that they are less effective in moistening already moist environments. Ground radar observations show that stratiform rain damps local CWV increases on short time scales (&lt;2 days) and therefore precludes positive moisture–convection feedbacks in high-CWV environments. Vertical coherence structures from ERA-I confirm that relatively bottom-heavy cloud ensembles (i.e., peaks between 700 and 850 hPa) are more effective in inducing low-frequency positive moisture–convection feedbacks than ensembles with other vertical structures. Low-frequency horizontal advective drying damps moisture increases and is strongly coherent with upper-level rising motion.
Diurnal Cycle of Rainfall and Winds near the South Coast of China
Authors: Du Yu , Rotunno Richard 
Published: March 2018

AbstractThe characteristics and mechanisms of diurnal rainfall and winds near the south coast of China are explored using satellite data (CMORPH), long-term hourly WRF Model data (Du model data), a simple 2D linear model, and 2D idealized simulations. Both the CMORPH and Du model data indicate that the diurnal cycle of rainfall has two propagation modes near the coast: onshore and offshore. The diurnally periodic winds (vertical motions) also show a similar propagation feature. Analysis of the rainfall budget indicates that vertically integrated vertical vapor advection plays a key role in the diurnal cycle of rainfall and thus provides a physical connection between winds and rainfall in the diurnal cycle. It was found that a simple 2D linear land–sea breeze model with a background wind can well capture the two propagation modes, which are associated with inertia–gravity waves, in terms of speed and phase. The background wind changes the pattern of the inertia–gravity waves and further affects the diurnal propagation. The effect of the background wind on the diurnal propagation was verified through idealized simulations using a simplified version of the WRF Model that can also capture the diurnal features.
Care ethics: An ethics of empathy?
Authors: van Dijke Jolanda , van Nistelrooij Inge , Bos Pien , Duyndam Joachim 
Published: March 2018

Background: Empathy is a contested concept in the field of care ethics. According to its proponents, empathy is a unique way to connect with others, to understand what is at stake for them, and to help guide moral deliberation. According to its critics, empathy is biased, inaccurate or a form of projection that does not truly grasp and respect the otherness of the other, and that may be distorted by prejudices. Objectives: We aim to contribute to a better understanding of the significance of empathy in care ethics by reviewing both the functions and limitations of empathy in this field. Research design: Drawing on literature from care ethics and closely related fields, we identify the relevant functions and limitations of empathy from the relational, epistemic, normative, and political perspectives. These perspectives are drawn from four main characteristics of care ethics, which serve as a concise framework for understanding the significance of empathy. Participants and research context: This article is written as part of an empirical and theoretical research project that aims to better understand the functions and limitations of empathy in care practices, from the perspective of care ethics. Ethical considerations: We try to do justice to both the appraisal and critique of empathy in the care ethics literature. Findings: Our findings stress that the relationship between care ethics and empathy is complicated and rife with opposing views. Therefore, we conclude that care ethics is not an ethics of empathy. Discussion and conclusion: Based on our findings, we formulate pathways that may guide the further analysis of empathy in care practices and care ethics.