bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Low-Cost, Long-Term Indwelling Pleural Catheter (LunGO): An Inexpensive and Effective Alternative for the Management of Dyspnea Associated with Malignant Pleural Effusions
Authors: de Abreu Igor Renato Louro Bruno , Bina Biazzotto Antonio Flávio , Santos Mariana Alves , de Souza Angela Alves Correia , Abrão Fernando Conrado , Cavalcante Maria Gabriela Carvalho 
Published: April 2019

<b><i>Background:</i></b> A malignant pleural effusion (MPE) in patients with cancer is evidence of the underlying disease progression, resulting in many symptoms, and may lead to hospitalization. The treatment options include talc pleurodesis (TP) or the implantation of an indwelling pleural catheter. The costs of the latter approach are often seen to be inhibitive for the Brazilian and other emerging markets’ public health system. <b><i>Objectives:</i></b> To assess the feasibility of utilizing a low-cost device (LunGO) through a case-control study. <b><i>Methods:</i></b> Eighteen patients with recurrent neoplastic pleural effusion and contraindications to pleurodesis were recruited between June 2016 and November 2017. The patients were submitted to pleural catheter prototype implantation. Data on the underlying disease and hospital length of stay after the procedure were collected and compared with patients who underwent pleurodesis in the same period (control group, <i>n</i> = 34). <b><i>Results:</i></b> In the LunGO group, 7 patients died due to the natural evolution of the underlying disease with the drain, whereas it was removed in 11 patients at a median of 43 days. Recurrence requiring an intervention was seen with the LunGO in 2, compared to 5 (OR = 1.37, <i>p</i> = 1) with TP. Complications were observed in only 1 with the LunGO, compared to 5 with TP. The chances of recurrence in both cohorts do not have a statistically significant difference, with an OR = 1.08 (<i>p</i> = 0.93). There was a tendency towards lower mortality in the LunGO cohort, despite that fact that we did not observe statistical significance (OR = 0.16, <i>p</i> = 0.23). <b><i>Conclusion:</i></b> LunGO was shown to be a viable and safe device for the treatment of symptomatic MPE.
Ride through testing of variable speed drive due to voltage sag types (types I, II and III)
Authors: Hardi Surya , Harahap R. , Ahmad S. , Isa M. 
Published: April 2019

Variable speed drives (VSDs) are widely used in various applications mainly in process industry need constant rotational speed. It is developed from power electronic components thus saving energy in its operation. Unfortunately it is susceptible against power quality problem for example voltage sags. The VSD may be disruption or drop out when it is supplied by voltage sags and it is determined by sag characteristics. This study is to investigate effect of voltage sags Types I, II and III on VSD through laboratory testing. The voltage sags characteristics are generated from voltage sag generator (Shaffner 2100 EMC). The effects are presented in susceptibility curves in disruption and drop out conditions. The curves resulted are evaluated by standard curve recommended. Test results show that voltage sag Type I cause the VSD disruption only, whereas two types sag other result in the VSD disruption and also drop out. Evaluation results explain a few test points are in operation area for disruption condition whereas test points for dropping out far below the threshold recommended. Hence the VSD has good quality to voltage sags.
A review on optimal placement and sizing of custom power devices/FACTS devices in electrical power systems
Authors: Tejaswini V. , Susitra D. 
Published: April 2019

Power loss reduction, improvement of voltage profile, system reliability and system security are the important objectives that motivated researchers to use custom power devices/FACTS devices in power systems. The existing power quality problems such as power losses, voltage instability, voltage profile problem, load ability issues, energy losses, reliability problems etc. are caused due to continuous load growth and outage of components. The significant qualities of custom power devices /FACTS devices such as power loss reduction, improvement of voltage profile, system reliability and system security have motivated researchers in this area and to implement these devices in power system. The optimal placement and sizing of these devices are determined based on economical viability, required quality, reliability and availability. In published literatures, different algorithms are implemented for optimal placement of these devices based on different conditions. In this paper, the published literatures on this field are comprehensively reviewed and elaborate comparison of various algorithms is compared. The inference of this extensive comparative analysis is presented. In this research, Meta heuristic methods and sensitive index methods are used for determining the optimal location and sizing of custom power devices/FACTS devices. The combination of these two methods are also implemented and presented.
Comparison of Rates of Bleeding and Vascular Complications Before, During, and After Trial Enrollment in the SAFE-PCI Trial for Women
Authors: Rymer Jennifer A. , Kaltenbach Lisa A. , Kochar Ajar , Hess Connie N. , Gilchrist Ian C. , Messenger John C. , Harrington Robert A. , Jolly Sanjit S. , Jacobs Alice K. , Abbott J. Dawn , Wojdyla Daniel M. , Krucoff Mitchell W. , Rao Sunil V. 
Published: April 2019

Background:
SAFE-PCI for Women (Study of Access Site for Enhancement of PCI for Women), a randomized controlled trial comparing radial and femoral access in women undergoing cardiac catheterization or percutaneous coronary intervention (PCI), was terminated early for lower than expected event rates. Whether this was because of patient selection or better access site practice among trial patients is unknown.

Methods and Results:
SAFE-PCI was conducted within the National Cardiovascular Data Registry CathPCI registry. Using the National Cardiovascular Research Infrastructure Identification, PCI date, and age, patients enrolled in SAFE-PCI were compared with trial-eligible female CathPCI registry patients 1 year before, during, and 1 year after SAFE-PCI enrollment. Patient and procedure characteristics, predicted bleeding and mortality, and post-PCI bleeding were compared between groups. Enrolled SAFE-PCI patients and registry patients from the 3 time periods were linked to Centers for Medicare and Medicaid Services data to compare 30-day death and unplanned revascularization rates. At 54 SAFE-PCI sites, there were 496 SAFE-PCI trial patients with a PCI visit within the CathPCI registry. There were 24 958 registry patients from 1 year before and 1 year after SAFE-PCI enrollment and 15 904 trial-eligible registry patients during trial enrollment. Trial patients were younger, had lower predicted bleeding and mortality, and had lower rates of post-PCI bleeding within 72 hours compared with registry patients. Among 12 212 Centers for Medicare and Medicaid Services–linked patients, there were no significant differences in 30-day death and unplanned revascularization among the 4 groups.

Conclusions:
Lower predicted risk of bleeding and mortality among SAFE-PCI trial patients compared with registry patients suggests that lower-risk patients were selectively enrolled for the trial. These data demonstrate how registry-based randomized trials may offer methods for enrollment feedback to curb selection bias in recruitment.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01406236.
Catasetum sophiae, a new species of Orchidaceae (Catasetinae) from northern Brazil
Authors: VALSKO JEFFERSON JOSÉ , KRAHL AMAURI HERBERT , PETINI-BENELLI ADARILDA , CHIRON GUY 
Published: April 2019

A new taxon, native to the shores of the Curiquidi pond, in the State of Amazonas, is described and illustrated. In the shape of the labellum, it is similar to Catasetum callosum and to C. transversicallosum. However, as far as the antennae are considered, C. sophiae is more similar to C. yavitaense. Placed in the section Isoceras with convergent antennae, C. sophiae can be distinguished to all the members of this group by its labellum mainly characterised by its saccate portion with margin entire or sparsely ciliated, and particularly by its glabrous frontal lobe furnished with a laterally compressed table-shaped callus projected forward. Besides, the frontal lobe is elongated in C. yavitaense and short and truncate in C. sophiae.
Effects of Pentoxifylline on Choroidal Blood Flow in Nonproliferative Diabetic Retinopathy
Authors: Sebag Jerry , Tang Mai , Brown Sharon , Sadun Alfredo A. , Charles M. Arthur 
Published: April 2019

Objective: Diminished blood flow plays an important role in the progression of diabetic retinopathy. Since increased blood viscosity is a contributing factor to hypoper fusion, it was of interest to determine whether therapy intended to decrease blood viscosity and induce vasodilation could increase blood flow in patients with diabetic retinopathy Methodology: Ten patients, 4 with nonproliferative diabetic retinopathy and 6 age- matched, nondiabetic controls, were studied by a noninvasive system to index choroidal blood flow. Pentoxifylline was administered daily at an oral dose of 400 mg tid in the diabetic patients for nine months. Results: The control group had pulse amplitude=2.87 ± 0.67 mm Hg with pulsatile choroidal blood flow=714 ± 196 μL/minute. Reproducibility studies in the control group (6 patients measured on three separate occasions) demonstrated an intraclass correlation coefficient of reliability, r=0.83. In the diabetic patients, pulsatile flow=276 ± 68 μL/minute, 61% lower than the age-matched nondiabetic subjects (P=0.003). After nine months of pentoxifylline therapy the diabetic patients had an increase in pulsatile choroidal blood flow to 469 ± 152 μL/minute (P < 0.002). Conclusions: Pentoxifylline therapy brought blood flow levels in the diabetic patients closer to those of the nondiabetic age-matched control population so that following therapy there was no statistically significant difference between the two groups although the former were still lower. The potential efficacy of pentoxifylline in improving ocular blood flow in patients with diabetic retinopathy should be tested in a large controlled clinical trial.
Changes in Blood Pressure Reactivity and 24-Hour Blood Pressure Profile Occurring at Puberty
Authors: Modesti P.A. , Pela I. , Cecioni I. , Gensini G.F. , Neri Serneri G.G. , Bartolozzi G. 
Published: April 2019

To evaluate blood pressure reactivity in children and its changes in adolescents, the acute pressor response to a video-game stress test and the noninvasive ambulatory blood pressure monitoring were evaluated in 62 healthy children divided into three age groups. Basal blood pressure values were measured according to the NIH Task Force. With baseline measures and body mass index controlled for, analysis of covariance showed that the video game provoked significant and incremental cardiovascular reac tivity across the games in adolescents when compared with the two other groups of children. The same group of children showed also a significantly higher systolic ambu latory pressure during the daytime, whereas no significant difference was observed by basal BP measurement. In conclusion an increased reactivity to external stimuli was observed in adolescents, and this pattern was strictly associated with a higher daily blood pressure.
Recurrent Embolization During Intravenous Administration of Tissue Plasminogen Activator in Acute Cardioembolic Stroke
Authors: Yasaka Masahiro , Yamaguchi Takenori , Yonehara Toshiro , Moriyasu Hideki 
Published: April 2019

Treatment with recombinant tissue plasminogen activator (rt-PA) has been applied in acute cardioembolic stroke to reopen the occluded vessel and improve the patient's neurologic deficit. However, the effect of this therapy on intracardiac thrombus has not been documented previously A forty-five-year-old man with dilated cardiomyopathy developed acute cardioem bolic stroke with disturbance of consciousness, right hemianopia, right hemiplegia, and global aphasia. Cerebral angiography demonstrated occlusion of the left middle cerebral artery trunk. Intravenous administration of 30 megaunits (MU) of recombinant tissue plasminogen activator was commenced two hours after the ictus and completed within sixty minutes. Cerebral angiography was repeated just after this treatment and demon strated a new occlusion of the left intracranial internal carotid artery along with occlusion of a branch of the left external artery. The authors subsequently performed two-dimen sional echocardiography and found a mobile thrombus in the left ventricle. In patients with intracardiac mobile thrombi, recombinant tissue plasminogen activator seems to accelerate breakup or detachment of the thrombi and subsequent recurrent embolization. Therefore, it seems better to pay attention to the presence of mobile intracardiac thrombus before commencing intravenous infusion of rt-PA.
Occupational therapy and posttraumatic stress disorder: A scoping review
Authors: Edgelow Megan M. , MacPherson Megan M. , Arnaly Faye , Tam-Seto Linna , Cramm Heidi A. 
Published: April 2019

Background. People who are diagnosed with posttraumatic stress disorder (PTSD) can experience disruptions in their daily occupations. Occupational therapists may assist clients with PTSD to reengage in meaningful occupations. Purpose. This scoping review aims to identify and describe the ways occupational therapy addresses PTSD in clinical practice. Method. Scholarly databases were searched for documents relating to occupational therapy and PTSD. Two reviewers independently applied selection criteria and systematically extracted information. Data were extracted and synthesized in a narrative format. Findings. Fifty sources met inclusion criteria and three major themes were identified: recognizing trauma within specific populations, PTSD’s impact on a range of occupations, and occupational therapy’s response to PTSD. Implications. Occupational therapists are working in multidisciplinary teams to reduce the impact of PTSD on the daily occupations of their clients. More effectiveness studies are required to understand the outcomes of occupational therapy interventions for clients with PTSD.
Perceptions and Use of Computed Tomography in a Hospital Emergency Department: Technicians’ Perspectives
Authors: Parlangeli Oronzo , Liston Paul M. , Marchigiani Enrica , Bracci Margherita , Giani Alessandra 
Published: April 2019

Objective: This study traces the evolution of perceptions and use of computed tomography (CT) by radiology technicians in the emergency department (ED) of a hospital in Italy across a 7-year period. Background: The sociotechnical context of the CT room of an ED has been neglected by scientific research—potentially impacting safety. Method: Two studies were performed, one in 2011 and one in 2018. Six CT technicians were involved in each. Structured interviews were performed to gather information on perceptions related to the evolution of the use of CT according to nine different factors—e.g. the level of complexity, and mental workload. Observations were performed on duration of exams, the flow of people, conversations, and any critical issues. Results: The CT technology is appreciated, used effectively and with confidence by CT technicians. From 2011-2018, the execution times of the exams have decreased but not the proportion of time dedicated to the patient. Expectations for future improvements are limited by issues concerning the design of both the user interface and the social context of the ED workplace. Conclusions: The safety and efficiency of the system as a whole are greatly dependent on the competence of the CT technicians. CT manufacturers rely on this competence to help compensate for the deficiencies created by suboptimal user interfaces and the lack of fit of the technology with the social context of the workplace. Application: Training programs aimed at improving the management of relationships and communications between staff could improve performance and efficiency. CT manufacturers should try to better understand the cognitive and operational context of the workplaces where CT technicians work—and to design better diagnostic technology which accounts for these operational realities.
Dexmedetomidine improves cognition after carotid endarterectomy by inhibiting cerebral inflammation and enhancing brain-derived neurotrophic factor expression
Authors: Ge Yali , Li Qian , Nie Yuyan , Gao Ju , Luo Ke , Fang Xiangzhi , Wang Cunjing 
Published: April 2019

Objectives Carotid endarterectomy (CEA) is efficient in preventing stroke for patients with significant carotid stenosis, but results in mild cognitive dysfunction. Dexmedetomidine is neuroprotective in stroke models. We hypothesized that dexmedetomidine may improve cognition after CEA. Methods Forty-nine patients scheduled for elective CEA were randomly assigned to intravenous dexmedetomidine treatment group (n = 25) and control group C (normal saline, n = 24). Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA), as well as lactate, TNF-α, IL-6, and BDNF levels in blood, were assessed before, during, and after surgery. Results MMSE and MOCA scores showed subtle decline in both groups at 24 hours postoperatively; this decline remained at 48 hours postoperatively in group C. Both scores were higher in group D than in group C at 48 and 72 hours postoperatively. TNF-α and IL-6 were lower from 5 minutes post-clamping through 24 hours postoperatively in group D; lactate was lower at 5 minutes post-clamping in group D. BDNF was higher from 5 minutes post-clamping through 1 hour postoperatively in both groups, and remained high in group D at 24 hours postoperatively. Conclusions Dexmedetomidine improved recovery of cognition after CEA, potentially due to reduced inflammation and enhanced BDNF expression.
Availability of and Participation in Workplace Health Promotion Programs by Sociodemographic, Occupation, and Work Organization Characteristics in US Workers
Authors: Tsai Rebecca , Alterman Toni , Grosch James W. , Luckhaupt Sara E. 
Published: April 2019

Purpose: To examine how the availability of and participation in workplace health promotion programs (WHPPs) vary as a function of sociodemographic, occupation, and work organization characteristics. Design: Cross-sectional study. Setting: 2015 National Health Interview Survey and Occupational Health Supplement. Participants: The study sample included 17 469 employed adults who completed the WHPP questions. Measures: The 2 dependent outcome measures were availability of WHPPs and participation in these programs when available. Independent variables included occupation and 8 work organization and employment characteristics: company size, hours worked, supervisory responsibility, hourly pay, paid sick leave, health insurance offered by employer, work schedule, and work arrangement. Analysis: Poisson regression analyses were conducted with SUDAAN 11.0.1. Results: Overall, 57.8% of 46.6% employees who have WHPPs available reported participating in these programs. This study found that adults who worked ≤20 h/wk, worked regular night shifts, were paid by the hour, or worked for temporary agencies were less likely to participate in WHPPs. Workers who supervised others were 13% more likely to participate than nonsupervisors. Borderline associations were seen for having access to employer-sponsored health insurance and working at a site with <10 employees. Conclusion: Despite the potential for improving physical and mental health, only 58% of US workers participated in WHPPs. Since barriers to WHPP participation (eg, time constraints, lack of awareness, and no perceived need) may vary across occupations and work organization characteristics, employers should tailor WHPPs based on their specific work organization characteristics to maximize participation.
Validation of the Spanish Version of the Beginning Breastfeeding Survey-Cumulative: A Follow-up Study
Authors: Saus-Ortega Carlos , Oliver-Roig Antonio , Richart-Martínez Miguel , Mulder Pamela , Cabrero-García Julio 
Published: April 2019

Background: The Beginning Breastfeeding Survey-Cumulative (BBSC) is an instrument that assesses the overall maternal perception of breastfeeding effectiveness during the early postpartum period. Research aims: The aims of this study were to adapt and validate a Spanish version of the BBSC and provide new evidence regarding its validity. Methods: A standard forward and back-translation process was used to obtain the Spanish version of the questionnaire (BBSC-E). A sample of 793 breastfeeding mothers was used. Data were obtained from clinical records and questionnaires self-administered at discharge and at 1–4 months postpartum. The factorial structure of the BBSC-E was examined with both an exploratory and confirmatory approach. Internal consistency, comparisons between known groups, and correlations with other variables were also assessed, and receiver operating characteristics (ROC) curves were used to determine its predictive validity. Results: Analysis revealed a two-dimensional structure, with infant and maternal subscales, and adequate fit statistics. The Root Mean Squared Error of Approximation (RMSEA) was .067. The Cronbach’s α of the overall scale was .91. There were statistically significant associations between the BBSC-E and (1) previous breastfeeding experience, early skin-to-skin contact, exclusive breastfeeding, breastfeeding difficulty and self-efficacy, and infant weight loss during hospitalization and (2) at 1–4 months postpartum, with the breastfeeding status, the intensity of breastfeeding problems, and satisfaction with breastfeeding. The total BBSC-E area under the ROC curve for any breastfeeding at 60 days postpartum was .73, and a score of 88 was the most discriminative cut-off point for maximum performance. Conclusion: The BBSC-E is a reliable and valid instrument for measuring breastfeeding effectiveness during early postpartum.
Transfer of Cyclobenzaprine into Human Milk and Subsequent Infant Exposure
Authors: Burra Bhaskari , Datta Palika , Rewers-Felkins Kathleen , Baker Teresa , Hale Thomas W. 
Published: April 2019

Introduction: Cyclobenzaprine is a skeletal muscle relaxant primarily used in the treatment of pain. Its use during lactation is a matter of concern as its level of exposure to infants through human milk is still unknown. Main issue: The aim of this study was to determine cyclobenzaprine concentrations in the milk samples collected from two lactating mothers. Management: The present study describes the analysis of cyclobenzaprine in human milk using liquid chromatography mass spectrometry, which determined the drug concentration-time profiles in human milk. Conclusion: This study shows low levels of concentrations of cyclobenzaprine in human milk with calculated relative infant dose of 0.5%. However, due to the sedative properties of cyclobenzaprine, regular clinical assessment of the infant is recommended to evaluate for long-term effects.