bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Healthy Eating and Exercise Behaviors Among Low-Income Breastfeeding Mothers
Authors: MacMillan Uribe Alexandra L. , Olson Beth H. 
Published: May 2018

Background: Postpartum weight retention is often a significant contributor to overweight and obesity. Lactation is typically not sufficient for mothers to return to pre-pregnancy weight. Modifiable health behaviors (e.g., healthy eating and exercise) are important for postpartum weight loss; however, engagement among mothers, especially those who are resource-limited, is low. A deeper understanding of low-income breastfeeding mothers’ healthy-eating and exercise experience, a population that may have unique motivators for health-behavior change, may facilitate creation of effective intervention strategies for these women. Research Aim: To describe the healthy-eating and exercise experiences of low-income postpartum women who choose to breastfeed. Methods: Focus group discussions were conducted with low-income mothers ( N = 21) who breastfed and had a child who was 3 years old or younger. Transcript analysis employed integrated grounded analysis using both a priori codes informed by the theory of planned behavior and grounded codes. Results: Three major themes were identified from five focus groups: (a) Mothers were unable to focus on their own diet and exercise due to preoccupation with infant needs and more perceived barriers than facilitators; (b) mothers became motivated to eat healthfully if it benefited the infant; and (c) mothers did not seek out information on maternal nutrition or exercise but used the Internet for infant-health information and health professionals for breastfeeding information. Conclusion: Low-income breastfeeding mothers may be more receptive to nutrition education or interventions that focus on the mother-infant dyad rather than solely on maternal health.
Breastfeeding Intention Compared With Breastfeeding Postpartum Among Women Receiving Medication-Assisted Treatment
Authors: Yonke Nicole , Maston Rebekah , Weitzen Sherry , Leeman Lawrence 
Published: May 2018

Background: Women taking methadone or buprenorphine are encouraged to breastfeed if stable without polysubstance use. Research Aim: We aimed to determine the difference between stated intention to breastfeed prenatally in women taking methadone or buprenorphine compared with breastfeeding at discharge and 2 months postpartum. Secondary outcomes were determining whether breastfeeding was more common in women taking buprenorphine, in women without hepatitis C infection, and in women without a history of heroin use, and whether breastfeeding reduced the need for pharmacological treatment of neonatal opioid withdrawal syndrome. Methods: This was a retrospective cohort study of 228 women enrolled in a perinatal substance abuse treatment program. Electronic medical records were reviewed to abstract data on mother-infant dyads. Chi-square tests were used to analyze our outcomes. Results: Women taking buprenorphine had a higher prevalence of breastfeeding compared with women taking methadone (83% [ n = 100] vs. 71% [ n = 76]; χ2 = 4.35, p = .03), despite no difference in their prenatal intention to breastfeed (87% vs. 81%; χ2 = 1.28, p = .25). Only 31% ( n = 38) of women taking buprenorphine and 19.6% ( n = 21) of women taking methadone exclusively breastfed at discharge (χ2 = 5.43, p = .06). Exclusively breastfed infants required less pharmacological treatment for neonatal opioid withdrawal syndrome compared with formula-fed infants (15.8% [ n = 21] vs. 47.4% [ n = 38]; χ2 = 19.72, p < .05). Conclusion: Despite most women reporting a high prenatal intention to breastfeed, exclusive breastfeeding at hospital discharge postpartum was low. Breastfeeding was associated with a decreased likelihood of pharmacological treatment for neonatal opioid withdrawal syndrome.
Incidence and predictors of clinical peripheral artery disease in asymptomatic persons with a low ankle–brachial index
Authors: Weiss Noel S , McClelland Robyn , Criqui Michael H , Wassel Christina L , Kronmal Richard 
Published: May 2018

Objective To determine the occurrence of clinical peripheral artery disease in a cohort of middle-aged and older persons who, though they initially had no symptoms of peripheral artery disease, had blood pressure levels in the arteries of their ankles and feet that were at least 10% lower than those in the arteries of their arms. Methods We analyzed data obtained in the Multi-Ethnic Study of Atherosclerosis, in which lower and upper extremity blood pressures were assessed in over 6000 Americans aged 45–84 and the ratio of these (the ankle–brachial index) was calculated. During a median follow-up of 13 years, the incidence of symptomatic peripheral artery disease (identified through annual questionnaires, review of hospital records, and notations of peripheral artery disease found in data obtained from the Center for Medicare Services) was compared between persons whose ankle–brachial index was ⩽9 and persons with higher ankle–brachial index values. Results The incidence of clinical peripheral artery disease was 23.0 per 1000 person-years among the 172 participants whose baseline ankle–brachial index was <0.9, compared with 2.0 per 1000 person-years in those with a higher ratio. The incidence of clinical peripheral artery disease rose steadily with decreasing ankle–brachial index below 0.9. The excess risk associated with a low ankle–brachial index was present in persons with and without the other measured risk factors for peripheral artery disease (cigarette smoking, hyperten sion, diabetes, and obesity). Conclusions Even in persons asymptomatic for peripheral artery disease, those with a low ankle–brachial index are at an appreciable risk of the development of manifestations of peripheral arterial insufficiency.
Who Shall Investigate the Transferred Case?
Authors: Carstens C. C. , Hewins Katharine P. 
Published: May 2018

In the March number of The Family a brief review was given of the Report of the Philadelphia Intake Committee.1 Our readers will recall that the Intake Committee represents the attempt of one of our largest cities—well equipped with case working agencies—to solve the intricate problems of their inter-relationship. In this connection The Family is glad to present for consideration the following letters from two Boston correspondents. Further expressions of opinion from other cities are urgently requested. This is a subject most closely allied to the best interests of our families. In the heat of the day's work are we too prone to develop our working machinery per se, without due regard for the end which the machinery is, after all, designed to accomplish?
A case–control study analyzing mannitol dosing for prevention of cisplatin-induced acute nephrotoxicity
Authors: Dhillon Patwant , Amir Eitan , Lo Melissa , Kitchlu Abhijat , Chan Christopher , Cochlin Stephen , Yip Paul , Chen Eric , Lee Roy , Ng Pamela 
Published: May 2018

Background Mannitol is an osmotic diuretic given routinely as part of cisplatin regimens to prevent nephrotoxicity, but there are limited data on the ideal dosage. At our center, three different doses of mannitol are used: 12, 20, and 40 g per cycle for cisplatin doses of ≥50 mg/m2. The primary objective was to determine if variations in mannitol dosing significantly influence the incidence of cisplatin-induced acute nephrotoxicity. Methods A case–control study was performed. Electronic records of 1462 consecutive outpatients who received cisplatin at ≥ 50 mg/m2 per cycle between January 2010 and December 2014 were reviewed. Patients experiencing nephrotoxicity of any grade within 30 days of last cisplatin dose, as defined by NCI CTCAE 4.0, were matched to a minimum of two and maximum of five controls based on the following criteria: age ± 5 years, baseline estimated glomerular filtration rate ± 10 ml/min/1.73 m2, cisplatin dose per cycle, and presence of diabetes. Conditional logistic regression was used to identify baseline predictors of cisplatin-induced acute nephrotoxicity. Results Of the 1245 included patients, 237 had nephrotoxicity and 1008 were matched controls. Median baseline estimated glomerular filtration rate for cases and controls were 83 and 80 ml/min/1.73 m2, respectively. A total of 3.8% of cases experienced ≥ grade 3 nephrotoxicity. Univariable analysis showed that diabetes, lymphoma, low baseline estimated glomerular filtration rate, and low baseline magnesium level were significantly associated with nephrotoxicity, whereas mannitol dosing did not show any association (odds ratio 1.08; p = 0.29). In multivariable analysis, diabetes and lymphoma retained statistical significance, but baseline estimated glomerular filtration rate and baseline magnesium level showed nonsignificant associations with nephrotoxicity. Conclusions Cisplatin-induced acute nephrotoxicity remains common in patients with good baseline renal function despite preventive measures. Diabetes and lymphoma are predictors of nephrotoxicity, whereas mannitol dosing has no significant influence, suggesting that doses may be standardized across cisplatin regimens.
New insertion support device assisted the accurate placement of tunneled cuffed catheter: First experience of 10 cases
Authors: Ohara Toshiaki , Sakurama Kazufumi , Hiramatsu Satoshi , Karai Toshimasa , Sato Toshiaki , Nishina Yuta 
Published: May 2018

Introduction: The tunneled cuffed catheter is used in hemodialysis patients for whom an arteriovenous fistula or arteriovenous graft is not suitable or for bridging usage of them. Accurate placement of a tunneled cuffed catheter is necessary for safe hemodialysis, but placement is sometimes difficult because of individual body differences. We developed a new device to support accurate placement of the tunneled cuffed catheter. In this study, we report our first clinical experience of the device. Methods: We made the device by expanded polytetrafluoroethylene with some special processes. The processes enable it to maintain plasticity and temporary shape in the autoclaved condition. The device is laid on the surface of the patient’s body to mark the root of the catheter with a felt-tipped marker before catheterization. That enables us to know the accurate catheter root and tunneled cuffed catheter exit site on the body surface. Ten patients underwent tunneled cuffed catheter insertion according to the marking. Case description: The mean age was 71.3 ± 12.8 years. The tunneled cuffed catheter was safely placed according to the marking in all patients, and all catheter tips were placed in the right atrium. The mean verification tip location difference before and after catheterization was 0.70 ± 0.48 cm. This result indicated that the device could assist in inserting a catheter accurately within an error of 1.18 cm. The tunneled cuffed catheters were patent in all the cases, without replacement and complications until the end of bridging use or during the observation period. Conclusion: Our newly developed insertion support device enhances safety and prevents catheter waste during replacement.
Ultrasound-guided central venous tip confirmation via right external jugular vein using a right supraclavicular fossa view
Authors: Kosaka Mariko , Oyama Yoshimasa , Uchino Tetsuya , Ogihara Yojiro , Koga Hironori , Shingu Chihiro , Matsumoto Shigekiyo , Kitano Takaaki 
Published: May 2018

Introduction: Ultrasound-guided central venous catheter tip confirmation has a potential to precisely locate the central venous catheter, preventing its misplacement, using real-time guidance. This observational study sought to determine the accuracy of central venous catheter tip positioning via the external jugular vein via a supraclavicular fossa view under ultrasound guidance. Methods: In total, 77 patients scheduled for central venous catheter insertion via the right external jugular vein were enrolled. The depth of central venous catheter insertion was determined by advancing the tip of the guidewire to the junction of the superior vena cava and right pulmonary artery, using a right supraclavicular fossa view ultrasound method. We determined the reference insertion depth to the carina using a postoperative chest x-ray photograph method. We then compared insertion depths obtained by the ultrasound and x-ray photograph methods and body-height formula. Results: In total, 62 patients were able to advance the guidewire and underwent ultrasound-guided central venous catheter insertion. In four patients, we corrected for misplaced guidewires. According to Bland–Altman plots, the insertion depth was 0.88 cm shorter for the ultrasound method (95% limits of agreement, −1.66 to 3.41 cm) and 0.90 cm shorter for the formulaic method (95% limits of agreement, −2.77 to 4.56 cm), compared with the x-ray photograph method. The x-ray photograph method had significantly positive correlations with the ultrasound (r = 0.73) and formulaic methods (r = 0.27). Conclusion: A right supraclavicular fossa view improves the accuracy of central venous catheter tip positioning and prevents central venous catheter misplacement via the right external jugular vein.
Efficacy of rituximab in refractory RRMS
Authors: Durozard Pierre , Maarouf Adil , Boutiere Clémence , Ruet Aurelie , Brochet Bruno , Vukusic Sandra , Carra-Dalliere Clarisse , Labauge Pierre , Mathey Guillaume , Debouverie Marc , Papeix Caroline , Maillart Elisabeth , Lubetzki Catherine , Bensa Caroline , Gout Olivier , Giannesini Claire , Stankoff Bruno , Ciron Jonathan , Brassat David , Pelletier Jean , Rico Lamy Audrey , Audoin Bertrand 
Published: May 2018

Objective: To investigate the efficacy of rituximab as rescue therapy in patients with relapsing-remitting multiple sclerosis (RRMS) and persistent disease activity confirmed by magnetic resonance imaging (MRI) despite immunosuppressive disease-modifying therapy (DMT). Methods: In this observational nationwide retrospective multicenter study, we first identified 351 off-label rituximab-treated patients through a cohort of 15,984 RRMS patients. In this group, we identified patients with disease activity prior to rituximab confirmed by MRI (one or more new T2 lesion and/or gadolinium-enhancing lesion) despite immunosuppressive DMT (fingolimod, natalizumab, or mitoxantrone) with a follow-up after rituximab initiation longer than 6 months. Outcome data were collected from the French Observatory of Multiple Sclerosis (OFSEP) register and medical charts. Results: A total of 50 patients were identified. Median rituximab treatment duration was 1.1 (0.5–6.4) year. Mean annualized relapse rate significantly decreased from 0.8 during last immunosuppressive DMT to 0.18 after rituximab ( p < 0.0001). While 72% of patients showed gadolinium-enhancing lesions on the last MRI performed during last immunosuppressive DMT, 8% of them showed gadolinium-enhancing lesions on the first MRI performed 6.1 (range 1.4–18.4) months after rituximab ( p < 0.0001). Conclusion: This study provides level IV evidence that rituximab reduces clinical and MRI disease activity in patients with active RRMS despite immunosuppressive DMT.
Management of post-traumatic retained hemothorax
Authors: Bozzay Joseph D , Bradley Matthew J 
Published: May 2018

Introduction Chest injuries occur in a significant portion of trauma patients and hemothorax is a common result. While the initial management of traumatic hemothorax is most commonly treated with tube thoracostomy, the management of retained hemothorax is a subject of debate. Recent literature has proposed different methods for treating or preventing retained hemothorax, yet the approach to this pathology is not straightforward. Methods The literature was reviewed for relevant studies regarding the prevention and management of post-traumatic retained hemothorax. What follows is a review of the recent literature and an algorithm for the approach to treating a traumatic retained hemothorax. Results Identifying a traumatic retained hemothorax and preventing subsequent complications such as pneumonia, empyema, and fibrothorax are significant issues faced by surgeons. Studies for preventing retained hemothorax have focused on initial chest tube size, location, and peri-procedural placement conditions, as well as thoracic lavage. Several treatment modalities exist, including second drainage procedure and intra-pleural fibrinolytic drug instillation, but video-assisted thoracoscopic surgery is the most common and successful approach. Regardless of the approach to evacuation, early intervention is paramount. Conclusion Further studies will help characterize appropriate candidates, timing, treatment modalities, and guide therapy for retained hemothorax.
Physical Activity Intensity Among Adolescents and Association With Parent–Adolescent Relationship and Well-Being
Authors: Shennar-Golan Vered , Walter Ofra 
Published: May 2018

Participation in physical activity (PA) provides young people significant health benefits, including improved well-being. However, large percentages of children and adolescents do not meet the recommendations for PA. Given that PA patterns are established during childhood and adolescence, and evolve within the context of the family, the current study explores the relationship between perceived parent–adolescent relationships and adolescents’ PA levels, body mass index (BMI), and subjective well-being. The study was conducted in Israel, and the sample included 233 participants (126 girls, 107 boys) aged 13 to 18 years. Participants self-reported the following measures: demographic information, BMI, the Godin-Shephard Leisure-Time Physical Activity Questionnaire, the Personal Well-Being Index, and parent–adolescent relationship. The data were analyzed using Pearson analyses, t tests, and regressions. A clear difference emerged in strenuous PA activity by sex [ t(223) = 2.1, p < .01]; the average strenuous PA was greater for boys ( M = 3.9, SD = 2.4) than for girls ( M = 1.8, SD = .2.4). Furthermore, different predictors of strenuous PA by sex were found: for boys, parent–adolescent relationship was a significant predictor; for girls, subjective well-being was a predictor. The findings can shed light on the need for different intervention programs for adolescent boys and girls to increase their involvement in PA.
Association between interleukin-10 -592 A/C polymorphism and gastrointestinal tract cancer risk: A meta-analysis
Authors: Sahami-Fard Mohammad Hossein 
Published: May 2018

Background: Recent evidence suggests that -592 A/C polymorphism in the interleukin-10 (IL-10) gene may influence risk of gastrointestinal tract cancer; however, individual studies have provided conflicting and inconclusive results. Therefore, this meta-analysis was conducted to assess the association between IL-10 -592 A/C polymorphism and gastrointestinal tract cancer susceptibility. Methods: EMBASE, PubMed, Web of Science, and China National Knowledge Infrastructure databases were searched for case-control studies published before 1 May 2017. A total of 36 studies involving 8069 cases and 13,089 controls were included in the present meta-analysis according to the inclusion criteria. The random- or fixed-effect model was utilized to calculate pooled odds ratio (OR) with 95% confidence interval (CI), and to survey the association. Results: By and large IL-10 -592 A/C (rs1800872) polymorphism was not associated with gastrointestinal cancer risk in five genetic models (A vs. C: OR 1.00; 95% CI 0.93, 1.08; POR = 0.960; AA vs. CC: OR 0.98; 95% CI 0.85, 1.14; POR = 0.835; CA vs. CC: OR 1.01; 95% CI 0.94, 1.08; POR = 0.776; AA+CA vs. CC: OR 1.03; 95% CI 0.94, 1.12; POR = 0.592; AA vs. CA+CC: OR 0.98; 95% CI 0.87, 1.10; POR = 0.666). Similar results were also achieved after stratification by the Hardy–Weinberg equilibrium, ethnicity, source of controls, and cancer type. Conclusion: The results of this meta-analysis indicated that there is no association between the IL-10 -592 A/C promoter polymorphism and gastrointestinal tract cancer susceptibility.
Protocol for a prospective collaborative systematic review and meta-analysis of individual patient data from randomized controlled trials of vasoactive drugs in acute stroke: The Blood pressure in Acute Stroke Collaboration, stage-3
Authors: Sandset Else Charlotte , Sanossian Nerses , Woodhouse Lisa J , Anderson Craig , Berge Eivind , Lees Kennedy R , Potter John F , Robinson Thompson G , Sprigg Nikola , Wardlaw Joanna M , Bath Philip M ,   The Blood pressure in Acute Stroke Collaboration Investigators
Published: May 2018

Rationale Despite several large clinical trials assessing blood pressure lowering in acute stroke, equipoise remains particularly for ischemic stroke. The “Blood pressure in Acute Stroke Collaboration” commenced in the mid-1990s focussing on systematic reviews and meta-analysis of blood pressure lowering in acute stroke. From the start, Blood pressure in Acute Stroke Collaboration planned to assess safety and efficacy of blood pressure lowering in acute stroke using individual patient data. Aims To determine the optimal management of blood pressure in patients with acute stroke, including both intracerebral hemorrhage and ischemic stroke. Secondary aims are to assess which clinical and therapeutic factors may alter the optimal management of high blood pressure in patients with acute stroke and to assess the effect of vasoactive treatments on hemodynamic variables. Methods and design Individual patient data from randomized controlled trials of blood pressure management in participants with ischemic stroke and/or intracerebral hemorrhage enrolled during the ultra-acute (pre-hospital), hyper-acute (<6 h), acute (<48 h), and sub-acute (<168 h) phases of stroke. Study outcomes The primary effect variable will be functional outcome defined by the ordinal distribution of the modified Rankin Scale; analyses will also be carried out in pre-specified subgroups to assess the modifying effects of stroke-related and pre-stroke patient characteristics. Key secondary variables will include clinical, hemodynamic and neuroradiological variables; safety variables will comprise death and serious adverse events. Discussion Study questions will be addressed in stages, according to the protocol, before integrating these into a final overreaching analysis. We invite eligible trials to join the collaboration.