bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adverse political incentives and obstinate behavioural norms: a study of social safety nets in Bangladesh
Authors: Sarker Abu Elias , Nawaz Faraha 
Published: June 2019

Despite the relative success of poverty alleviation over the last two decades, the issue of social safety nets remains an intriguing issue in the area of the strategic intervention of the government of Bangladesh. This article aims at exploring two sets of challenges: adverse political incentives and obstinate behavioural norms. In doing so, the current article proposes a conceptual framework that highlights the effects of clientelism, institutional frameworks and their enforcements, and social, human and technological factors on social safety nets. Further, it also shows how social safety nets influence the reduction of poverty, vulnerabilities and risks, leading towards the capacity building and empowerment of vulnerable people. The case of Bangladesh is discussed in the light of the proposed conceptual framework. Points for practitioners State decision-makers and implementers may take cognizance of the importance of the participation of pro-poor civic forums at different stages of social safety net intervention, the allocation of adequate resources, and addressing numerous management deficits confronting social safety nets. International development organizations also need to consider the contextual variables while providing assistance to developing countries in general and Bangladesh in particular. Political actors and administrators also need to take into account major contradictions in the formulation and implementation of social safety net programmes in Bangladesh.
Doing Politics Differently: Middle-Class Youth and Politics in Contemporary Lima
Authors: Winter Franka 
Published: June 2019

Two recent studies of the political identities, discourses, utopias, and practices of young middle-class people in contemporary Lima indicate that, contrary to a common narrative of “antipolitics,” they had a critical rather than a negative relationship with politics. While they largely rejected traditional political institutions and identities, they had strong political values and ideals and many ideas for change. They were looking for a different way of doing politics rather than a retreat from it and pursued this through a diverse range of political practices. However, these discourses and practices had certain limitations, in particular with respect to their ability to forge strong alliances and bring about substantial change. Dos estudios recientes sobre las identidades políticas, discursos, utopías y prácticas de jóvenes de clase media en Lima contemporánea indican que, contrariamente a una narrativa común de “antipolítica”, tenían una relación crítica más que negativa con la política. Si bien rechazaron en gran medida las instituciones e identidades políticas tradicionales, tenían fuertes valores e ideales políticos y muchas ideas para el cambio. Estaban buscando una forma diferente de hacer política en vez de retirarse de ella y la persiguieron a través de una amplia gama de prácticas políticas. Sin embargo, estos discursos y prácticas tenían ciertas limitaciones, en particular con respecto a su capacidad para forjar alianzas sólidas y lograr cambios sustanciales.
Making healthcare decisions in a person’s best interests when they lack capacity: clinical guidance based on a review of evidence
Authors: Wade Derick T , Kitzinger Celia 
Published: June 2019

Objective: To clarify the concept of best interests, setting out how they should be ascertained and used to make healthcare decisions for patients who lack the mental capacity to make decisions. Context: The legal framework is the Mental Capacity Act (MCA) 2005, which applies to England and Wales. Theory: Unless there is a valid and applicable Advance Decision, an appointed decision-maker needs to decide for those without capacity. This may be someone appointed by the patient through a Lasting Power of Attorney, or a Deputy appointed by the court. Otherwise the decision-maker is usually the responsible clinician. Different approaches exist to surrogate decision-making cross-nationally. In England and Wales, decision-making is governed by the MCA 2005, which uses a person-centred, flexible best interests (substituted interests) approach. Observations: The MCA is often not followed in healthcare settings, despite widespread mandatory training. The possible reasons include its focus on single decisions, when multiple decisions are made daily, the potential time involved and lack of clarity about who is the responsible decision-maker. Solution: One solution is to decide a strategic policy to cover more significant (usually health-related) decisions and to separate these from day-to-day relational decisions covering care and activities. Once persistent lack of capacity is confirmed, an early meeting should be arranged with family and friends, to start a process of sharing information about the patient’s medical condition and their values, wishes, feelings and beliefs with a view to making timely treatment decisions in the patient’s best interests.
Cognitive function in aging cocaine smokers
Authors: Chao Thomas , Haney Margaret , Cooper Ziva D , Vadhan Nehal P , Van Dam Nicholas T , Van Snellenberg Jared , Bedi Gillinder 
Published: June 2019

Background: Little is known about the functional status of older drug users, who may pose challenges to public health systems in coming years. Here, we assessed cognitive function in aging cocaine smokers compared to demographically matched controls. Methods: A total of 22 non-treatment-seeking aging (50–60 years old) cocaine smokers (⩾twice/week; ⩾15 years of weekly use) and 19 controls completed a comprehensive cognitive battery. Controls with cannabis, tobacco, and alcohol use were included to better match the cocaine users. All cocaine users, and current cannabis- or alcohol-using controls, completed testing after 4 drug-free inpatient days to better control for acute and residual drug effects. Results: Cocaine users (52.9 ± 2.5 years old, four female; cocaine use 3.9 ± 1.4 days/week) and controls (52.7 ± 2.6 years old, four female) were well matched demographically, but cocaine users reported a more extensive substance use profile. Cocaine users showed marginally worse verbal learning than controls, recalling on average one word fewer across immediate and delayed word recall trials. Their performance was intact relative to controls across all other measures of cognitive function. Bayesian analysis indicated the absence of group differences was not due to power limitations. Conclusion: These data suggest that aging, long-term cocaine users have similar cognitive functioning to appropriately matched controls when tested under drug-free conditions, with only marginal decreases in verbal learning. Findings, although reassuring with regard to broad cognitive capacities in aging cocaine smokers, suggest that future investigations of cognitive function in aging drug users are warranted.
Rheumatoid cervical pannus: feasibility of volume and perfusion quantification using dynamic contrast enhanced time resolved MRI
Authors: Fasler David A , Ingrisch Michael , Nanz Daniel , Weckbach Sabine , Kyburz Diego , Fischer Dorothee R , Guggenberger Roman , Andreisek Gustav 
Published: June 2019

Background Dynamic contrast-enhanced magnetic resonance imaging has the potential to show disease activity of rheumatoid arthritis even in complex anatomic areas as the atlantodental region. Purpose To demonstrate the technical feasibility of measuring synovial volume and perfusion characteristics with dynamic contrast-enhanced magnetic resonance imaging of the atlantodental region in patients with rheumatoid arthritis. Material and Methods Ten patients with rheumatoid arthritis and cervical spine involvement underwent dynamic contrast-enhanced magnetic resonance imaging of the cervical spine at 1.5 T. For each patient, 80 3D datasets were acquired using the commercialized Time Resolved Imaging of Contrast KineticS (TRICKS) sequence. Volumes of synovia with active synovitis on anatomical and parametric images were segmented. Synovial tissue perfusion parameters, namely plasma flow (Fp), relative plasma volume (vp), and the permeability-surface area product (PS), were calculated using a two-compartment uptake model. Statistical analysis included calculation of intra- and inter-reader agreement and a correlation of perfusion parameters with Outcome Measures in Rheumatology Clinical Trials (OMERACT) criteria. Results Dynamic contrast-enhanced magnetic resonance imaging as well as quantification of volume and perfusion characteristics of synovia was successful in most patients (80%). Intra- and inter-reader agreement was excellent (0.89–0.99). There was a positive correlation between OMERACT score and the permeability-surface product. Conclusion Dynamic contrast-enhanced magnetic resonance imaging using a 4D angiography sequence for the atlantodental region in patients with rheumatoid arthritis for quantitative and qualitative assessment of synovial volume and perfusion characteristics is technically feasible.
Influence of Cognition on Length of Stay and Rehospitalization in Older Veterans Admitted for Post-Acute Care
Authors: Stelmokas Julija , Rochette Amber D. , Hogikyan Robert , Kitchen Andren Katherine A. , Reckow Jaclyn , Sciaky Alexandra , Bieliauskas Linas , Alexander Neil B. 
Published: June 2019

Objectives: Evaluate the relative contribution of cognitive test performance to post-acute care (PAC) length of stay (LOS) and rehospitalization while controlling for key demographic, medical, and functional outcomes. Methods: Retrospective medical record review of 160 older Veterans, including cognitive test performance (Addenbrooke’s Cognitive Examination–Revised [ACE-R]), on admission to a Veterans Administration Hospital Community Living Center (CLC) PAC. Results: Individuals with impaired scores on the ACE-R had a longer LOS (10 median days longer; U = 2,547.00, p = .028). Of those rehospitalized, 71.4% ( n = 20) screened positive for cognitive impairment. Key medical factors explained the largest amount of variance in CLC-PAC LOS (29.8%), followed by admission ADL (activities of daily living) dependency (4.6%) and ACE-R total score (3.30%). Discussion: Cognitive screening should be considered on PAC admission, with impairment on ACE-R predicting geriatric rehabilitation outcomes such as risk of increased LOS and rehospitalization.
Association of Daytime Napping and Diagnosed Diabetes in Middle-Aged Premenopausal, Middle-Aged Postmenopausal, and Older Postmenopausal Chinese Women
Authors: Fang Shu , Zhou Junmin 
Published: June 2019

Purpose: To examine associations of daytime napping and diagnosed diabetes in middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal Chinese women. Design: Quantitative, cross-sectional. Setting: 2015 cross-sectional data from China Health and Retirement Longitudinal Study. Participants were recruited from 150 counties/districts and 450 villages/resident committees. Participants: Six thousand nine hundred and forty women aged 45 years and older (mean age = 61 years) stratified by age and menopausal status. Measures: The outcome was self-reported diagnosed diabetes. The exposure was self-reported daytime napping (0, >0-≤60, or >60 min/d). Participants were stratified to middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal women according to their age (≤60 or >60 years) and menopausal status. Analysis: One-way analysis of variance and χ2 tests were conducted to explore differences on characteristics of middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal women. Multiple logistic regressions were used to estimate adjusted odds ratios (ORs) for diagnosed diabetes according to daytime napping in the total sample, middle-aged premenopausal, middle-aged postmenopausal, and older postmenopausal Chinese women. Results: Participants’ mean self-reported daytime napping duration was 34 minutes. Women who napped more than 60 minutes were more likely to report diagnosed diabetes (OR = 1.39, 95% confidence interval (CI), 1.09-1.76) comparing to those who did not nap, after adjusting for potential confounders. No statistical significance of interaction term between daytime napping and age/menopausal status was detected ( P = .602 and P = .558) among total women. The stratified analysis revealed the significant association among middle-aged postmenopausal women napping more than 60 minutes (OR = 1.81, 95% CI, 1.18-2.77). The association, however, was found to be insignificant in middle-aged premenopausal women and older postmenopausal women. Conclusions: Long daytime nap (>60 min/d) was associated with diagnosed diabetes in middle-aged postmenopausal women in China.
The Impact of Cognitive Impairment on Poststroke Outcomes: A 5-Year Follow-Up
Authors: Rohde Daniela , Gaynor Eva , Large Margaret , Mellon Lisa , Hall Patricia , Brewer Linda , Bennett Kathleen , Williams David , Dolan Eamon , Callaly Elizabeth , Hickey Anne 
Published: June 2019

Aim: To explore the impact of cognitive impairment poststroke on outcomes at 5 years. Methods: Five-year follow-up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) prospective cohort. Two hundred twenty-six ischemic stroke survivors completed Montreal Cognitive Assessments at 6 months poststroke. Outcomes at 5 years included independence in activities of daily living, receipt of informal care, quality of life, and depressive symptoms. Data were analyzed using logistic and linear regression models. Adjusted odds ratios (ORs; 95% confidence interval [CI]) and β coefficients (95% CI) are reported. Results: One hundred one stroke survivors were followed up at 5 years. Cognitive impairment at 6 months was independently associated with worse quality of life (B [95% CI]: −0.595 [−0.943 to −0.248]), lower levels of independence (B [95% CI]: −3.605 [−5.705 to −1.505]), increased likelihood of receiving informal care (OR [95% CI]: 6.41 [1.50-27.32]), and increased likelihood of depressive symptoms (OR [95% CI]: 4.60 [1.22-17.40]). Conclusion: Cognitive impairment poststroke is associated with a range of worse outcomes. More effective interventions are needed to improve outcomes for this vulnerable group of patients.
Identification of separated lenticular planes using optical coherence tomography
Authors: Zheng Ke , Han Tian , Zhao Feng , Han Yinan , Zhou Xingtao 
Published: June 2019

Purpose: To discuss how optical coherence tomography can be used to identify separated lenticular planes during small incision lenticule extraction (SMILE). Methods: SMILE procedures were performed on 26 eyes of 13 patients. An anterior segment optical coherence tomography examination was performed after laser scan. Anterior segment optical coherence tomography examinations were conducted again both after separation of the anterior lenticular plane in the right eye and after separation of the posterior lenticular plane in the left eye. Lenticule extraction was then completed, followed by another anterior segment optical coherence tomography examination. Anterior segment optical coherence tomography was also conducted on both eyes on the first day after surgery. Each measurement consisted of four line scans along the 45°, 90°, 135°, and 180° meridians. The brightness scores were compared between the two planes after the separation of one plane. Results: Anterior segment optical coherence tomography showed two bright lines after laser scan. Along with all meridians, the brightness of the anterior plane was less in the right eye, for which only the anterior plane was separated, and the brightness of the posterior plane was less in the left eye, for which only the posterior plane was separated (all P < 0.001). After lenticule extraction in both eyes, anterior segment optical coherence tomography revealed that a smooth hyperreflective line existed between the cap and the residual stromal bed, and this line remained throughout the first day after surgery. Conclusion: The bubbles produced by the creation of the lenticule in SMILE mostly disappear by manual separation, and anterior segment optical coherence tomography can help the surgeon identify the separated lenticular planes.
Vision-related quality of life in patients treated for myopic choroidal neovascularization: A post hoc analysis of the OLIMPIC study
Authors: Virgili Gianni , Parravano Mariacristina , Viola Francesco , Varano Monica 
Published: June 2019

Purpose: To investigate vision-related quality of life in patients referred to the Italian Retina Services for intravitreal ranibizumab treatment for choroidal neovascularization due to pathologic myopia. Design: Post hoc analysis of a multicenter, interventional phase IIIb study (OLIMPIC). Methods: Patients with either previously untreated (naïve) or treated choroidal neovascularization due to pathologic myopia were enrolled. Vision-related quality of life was measured using the Italian version of the Impact of Vision Impairment Questionnaire with scores from 0 (no impact) to 5 (severe impact). Burden of illness data were collected regarding income, and personal and public resource use. Results: In the 200 included subjects, mean best-corrected visual acuity in the better eye was 68.3 Early Treatment Diabetic Retinopathy Study letters (standard deviation: 15.2) compared with 42.5 Early Treatment Diabetic Retinopathy Study letters (standard deviation: 23.3) in the worse eye. The proportion of better eyes affected by choroidal neovascularization was 147/200 (73.5%). In multivariable analyses, lower better eye, but not worse eye, best-corrected visual acuity was associated with lower vision-related quality of life (per 10 fewer letters, beta: + 0.17, p < 0.001). An annual income below 20,000 euros was also associated with lower vision-related quality of life (beta: + 0.38; standard error: 0.13, p = 0.004). Moreover, in univariate analyses, increasing income level was linearly associated with better presenting best-corrected visual acuity in the better eye (p < 0.003), with a difference of 15 Early Treatment Diabetic Retinopathy Study letters for patient income <20,000 euros compared with >70,000 euros. Conclusion: Italian patients with myopic choroidal neovascularization and a low income presented with lower better-eye best-corrected visual acuity and lower vision-related quality of life compared with those with a higher income. Future research should investigate disease awareness and candidacy issues that may influence the quality of life of patients.
Videoconference clinics improve efficiency of inflammatory bowel disease care in a remote and rural setting
Authors: Ruf Benjamin , Jenkinson Phillip , Armour David , Fraser Mhairi , Watson Angus JM 
Published: June 2019

Introduction Patients with inflammatory bowel disease (IBD) require long-term secondary care with periodic specialist follow-up. This can be especially challenging for patients living in remote areas. One possible solution is the implementation of videoconference (VC) clinics as a distance-management tool. Here we assessed the use of VC clinics for IBD in terms of patient safety and economic benefit for patients with IBD living in rural areas in the Scottish Highlands and Islands. Methods Eighty-eight patients participating in the IBD specialist nurses VC clinic administered via Raigmore Hospital, Inverness, Scotland, UK, between January 2016 and June 2017 were included in this study. A total of 229 appointments were assessed. Results We found the use of a VC clinic to be safe and effective as only 0.9% of appointments required urgent medical assessment and 92% of the VC clinic appointments resulted in further VC clinic follow-up. A total travelling distance of 72,245.3 km and a total travelling time of 71,688 minutes were saved in this patient cohort. It was shown that an average of US$36.61 of potential travelling cost could be saved per appointment. Discussion VC clinics represent a patient-centred participatory model of care for IBD patients living in remote areas with enormous time- and cost-saving potential while being safe and effective. Further investigations into patient satisfaction and the combination with other telemedicine tools such as telephone conferencing and mobile phone applications are needed to evaluate the full potential of the concept.
Evaluating Prognostic Factors for Liver Transplantation Among United States Patients With Hereditary Transthyretin-Mediated (hATTR) Amyloidosis Using National Registry Data
Authors: Brandman Danielle , Lin Hollis , McManus Anastasia , Agarwal Sonalee , Gache Larry M. , Irish William , Gollob Jared , Živković Saša A 
Published: June 2019

Introduction: Orthotopic liver transplantation has been used as a treatment for hereditary transthyretin-mediated (hATTR) amyloidosis, a rare, progressive, and multisystem disease. Research Question: The objective is to evaluate survival outcomes post-liver transplantation in patients with hATTR amyloidosis in the United States and assess whether previously published prognostic factors of patient survival in hATTR amyloidosis are generalizable to the US population. Design: This cohort study examined patients with hATTR amyloidosis undergoing liver transplant in the United States (N = 168) between March 2002 and March 2016 using data reported to the Organ Procurement and Transplantation Network (UNOS)/United Network for Organ Sharing (OPTN). Results: A multivariable Cox hazards regression model showed among all factors tested, only modified body mass index (kg/m2 × g/L) at the time of transplant was significantly associated with survival. Higher modified BMI was associated with lower risk of death relative to a reference population (<600) with historically poor post-transplant outcomes. Patients with modified BMI 1000 to <1200 (hazard ratio [HR] = 0.27; 95% confidence interval [CI] = 0.10-0.73), 1200 to <1400 (HR = 0.20; 95% CI = 0.06-0.75), and ≥1400 (HR = 0.15; 95% CI = 0.04-0.61) exhibited improved adjusted 5-year post-transplant survival of 74%, 80%, and 85%, respectively, versus 33% in the reference population. Discussion: The association between a higher modified BMI threshold at the time of transplant and improved post-transplant survival suggests that the previously published patient selection criterion for modified BMI may not be applicable to the US population.