bluuebunny/crossref_metadata_2025_split huggingface dataset:
Harnessing technology to deliver care by physical therapists for people with persistent joint pain: Telephone and video‐conferencing service models
Authors: Hinman Rana S. , Lawford Belinda J. , Bennell Kim L. 
Published: October 2018

AbstractPurposeThe burden of musculoskeletal conditions, particularly osteoarthritis (OA), is expected to increase in coming decades as the world's population ages, and obesity rates continue to rise. Self‐management via lifestyle interventions, such as exercise and physical activity, is integral to minimizing pain and maintaining physical function, yet access to qualified health professionals for evidence‐based advice and support is difficult for many people. This article discusses how technology provides new opportunities for delivering physiotherapy services remotely to people with persistent joint pain, through telephone, and internet‐mediated video conferencing.MethodsThe evidence for effectiveness of such service models is reviewed. Key challenges to implementation are discussed, and future directions for research in the field are highlighted.ResultsThere is emerging evidence that the provision of care via telephone and internet‐mediated video technologies is effective for, and acceptable to, people with OA. Advantages include its convenience and accessibility, as well as the “hands‐off” nature of consultations. Challenges include patient safety and privacy and workforce willingness and capacity to deliver care via non‐traditional methods.ConclusionsUsing technology to deliver physiotherapy services to people with OA is feasible and acceptable to users; however, further research is required to expand the evidence‐base for remotely‐delivered physiotherapy service models.
Extra pulmonary vein driver mapping and ablation in paroxysmal atrial fibrillation by electrogram dispersion analysis
Authors: Qin Mu , Lin Rong‐Jie , Wu Shao‐Hui , Liu Xu 
Published: October 2018

AbstractBackgroundThe adjunctive approach is still unknown for atrial fibrillation (AF), which cannot be terminated after pulmonary vein isolation (PVI). We hypothesized that the driver ablation plus PVI was superior to PVI alone.Methods and ResultsA total of 98 patients with paroxysmal AF were enrolled in this study and were divided into two groups, with one group undergoing PVI (n = 49) and the other group undergoing PVI + driver ablation (n = 49). The driver regions were defined as clusters of bipolar electrograms that displayed spatial dispersion spread over mean AF cycle length at a minimum of three adjacent bipolars of a PentaRay catheter. During the procedure, the most prominent driver regions before PVI were the roof (n = 27; 55.1%), PV antrum (n = 23; 46.9%), and the inferoposterior wall (n = 11; 22.4%). PVI can eliminate all drivers at PV antrum, but only terminate 30.4% of AF in the driver group. The AF termination rate in the driver ablation group was significantly higher than that in conventional ablation (93.9% vs 40.6%; P < 0.001). The rate of freedom from atrial tachyarrhythmia episodes by a single procedure at 6 months was significantly higher in the driver group than in the conventional group (91.6% vs 72.4%; P = 0.02).ConclusionThe present method is effective for AF driver identification. It guided ablation adjunctive to PVI increasing the rate of AF termination and improving the outcomes in patients with paroxysmal AF.
Clinical outcomes in hypertensive patients treated with a single‐pill fixed‐dose combination of renin‐angiotensin system inhibitor and thiazide diuretic
Authors: Ho Chien-Te , Tung Ying‐Chang , Chou Shing‐Hsien , Hsiao Fu‐Chih , Lin Yu‐Sheng , Chang Chee‐Jen , Chu Pao‐Hsien 
Published: October 2018

Two or more antihypertensive agents are required to achieve blood pressure control for the most hypertensive patients. However, comparison of clinical outcomes between fixed‐dose combinations (FDC) and free‐equivalent combinations of renin‐angiotensin system (RAS) inhibitor and thiazide diuretic is lacking nowadays. Patients who were newly diagnosed with hypertension between July 1st, 2008 and December 31st, 2011 and prescribed with FDC (n = 13 176) or free combinations of RAS inhibitors and thiazide diuretic (n = 4392) were identified from the National Health Insurance Research Database of Taiwan and matched in 3:1 ratio using the propensity score method. The primary end point was major adverse cardiovascular events (MACE). The secondary end points were hospitalization of heart failure, new diagnosis of chronic kidney disease, and the initiation of dialysis. Compared with he FDC group was associated with better medication adherence compared with the free combination group. FDC of RAS inhibitor and thiazide diuretic reduced MACE (hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.74‐0.97; P = 0.017), hospitalization for heart failure and initiation of dialysis compared with the free combination regimens. The outcome benefits of FDC was mainly driven by reduced cardiovascular and renal events in the patients with proportion of days covered <80%. In this retrospective claims database analysis, compared with the free combination regimens, the use of FDC of RAS inhibitor and thiazide diuretic was associated with improved medication compliance and clinical outcomes in the management of hypertension, particularly in the patients with poor medication adherence.
Sleep duration and 24‐hour ambulatory blood pressure in adults not on antihypertensive medications
Authors: Shulman Rachel , Cohen Debbie L. , Grandner Michael A. , Gislason Thorarinn , Pack Allan I. , Kuna Samuel T. , Townsend Raymond R. , Cohen Jordana B. 
Published: October 2018

Short sleep duration has been widely linked to increased cardiovascular morbidity and mortality. We performed a post hoc analysis of 24‐hour ambulatory blood pressure monitoring (ABPM) in the Lifestyle Modification in Blood Pressure Lowering Study (LIMBS) and Penn Icelandic Sleep Apnea (PISA) Study. The 24‐hour mean systolic blood pressure (BP) was 12.7 mm Hg higher in LIMBS (P < 0.001; n = 66) and 4.7 mm Hg higher in PISA (P = 0.005; n = 153) among participants with shorter sleep duration (less than 7 hours) compared to those with longer sleep duration (at least 7 hours). In multivariable adjusted models, shorter sleep duration was strongly associated with higher systolic BP on 24‐hour ABPM, independent of nocturnal BP and in‐office BP. There was no effect modification by obstructive sleep apnea. Adults with shorter sleep duration may benefit from screening with 24‐hour ABPM to promote earlier detection of hypertension and potentially mitigate their increased risk for future cardiovascular disease.
Association Between Sarcopenic Obesity and Falls in a Multiethnic Cohort of Postmenopausal Women
Authors: Follis Shawna , Cook Alan , Bea Jennifer W. , Going Scott B. , Laddu Deepika , Cauley Jane A. , Shadyab Aladdin H. , Stefanick Marcia L. , Chen Zhao 
Published: October 2018

OBJECTIVESTo investigate associations between sarcopenia, obesity, and sarcopenic obesity and incidence of falls in a racially and ethnically diverse cohort of healthy postmenopausal women.DESIGNProspective cohort study.SETTINGThree Women's Health Initiative (WHI) clinical centers (Tucson‐Phoenix, AZ; Pittsburgh, PA; Birmingham, AL).PARTICIPANTSPostmenopausal women aged 50 to 79 enrolled in the WHI who underwent bone and body composition scans using dual‐energy x‐ray absorptiometry at baseline (N = 11,020).MEASUREMENTSSarcopenia was defined as the lowest 20th percentile of appendicular lean mass, correcting for height and body fat. Obesity was defined as a body fat percentage greater than 42%. Sarcopenic obesity was defined as co‐occurrence of sarcopenia and obesity. The fall outcome was defined as falling 2 or more times in any year during 7 years of follow‐up. The risk of falls associated with sarcopenic obesity were analyzed using log binomial regression models stratified according to age and race/ethnicity.ResultsSarcopenic obesity was associated with greater risk of falls in women aged 50 to 64 (relative risk (RR) = 1.35, 95% confidence interval (CI)=1.17–1.56) and 65 to 79 (RR = 1.21, 95% CI=1.05–1.39). Sarcopenic obesity related fall risk was higher in Hispanic women (RR = 2.40, 95% CI=1.56–3.67) than non‐Hispanic white women (RR = 1.24, 95% CI=1.11–1.39).ConclusionIn a multiethnic cohort of postmenopausal women, sarcopenic obesity–related fall risk was high in women younger than 65 and those age 65 and older. Sarcopenic obesity posed the highest risk for falls in Hispanic women. The findings support identification of causal factors and health disparities in sarcopenic obesity to customize fall prevention strategies and ameliorate this significant public health burden. J Am Geriatr Soc 66:2314–2320, 2018.
Men and women with Down syndrome exhibit different kinematic (but not spatio‐temporal) gait patterns
Authors: Pau M. , Condoluci C. , Zago M. , Galli M. 
Published: October 2018

AbstractBackgroundGait phenotypes are well documented in people with Down syndrome (pwDS), but sex‐related differences are still unexplored. This study investigated the existence of possible differences in spatio‐temporal and kinematic parameters of gait between men and women with DS using quantitative three‐dimensional gait analysis.MethodsGait patterns of 117 pwDS (53 F, 64 M) who underwent a computerised gait analysis from 2002 to 2017 were retrospectively analysed to obtain spatio‐temporal gait parameters and kinematics in the sagittal plane at hip, knee and ankle joints, as well as foot progression.ResultsOverall, when considered as a single group, the gait patterns found for pwDS confirmed the findings of previous studies. However, when analysed by sex, our data revealed that women with DS exhibit a larger hip flexion at late stance (42% to 54% of the gait cycle) and reduced knee flexion at the beginning of the swing phase (61% to 69% of the gait cycle). In contrast, men are characterised by larger foot extra‐rotation angles through most of the stance phase (from 0% to 55% of the gait cycle) and at the end of the swing phase (92% to 99% of the gait cycle). No differences between men and women with DS were found concerning ankle dorsi‐ plantar‐flexion or in all spatio‐temporal parameters normalised by individuals' anthropometry, excluding cadence (higher in women).ConclusionsThe findings of the present study highlight the need to investigate gait dysfunctions in pwDS by taking their sex into consideration. Such an approach may be useful not only in gaining a better understanding of the pathophysiology of gait disturbances associated with DS but also in supporting a better orientation of rehabilitative treatments.
Integrative Literature Review Examining Factors Affecting Patient Safety With Robotic‐Assisted and Laparoscopic Surgeries
Authors: Mathew Reshmi , Markey Kathleen , Murphy Jill , Brien Brid O’ 
Published: October 2018

AbstractPurposeThe purpose of this integrative literature review is to examine the evidence on factors affecting patient safety during robotic‐assisted and laparoscopic surgeries.DesignSystematic review of papers published between 2011 and 2016 that identified factors affecting safety during robotic‐assisted and laparoscopic surgeries, in the areas of colorectal, general, urological, and gynecological surgeries.MethodsA systematic literature search of the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, and Medline databases were performed. Twelve studies met the inclusion criteria outlining factors affecting safety in robotic‐assisted and laparoscopic surgeries. All 12 studies selected were quality appraised using the Critical Appraisal Skills Programme.FindingsUsing thematic analysis, the outcomes from the 12 studies were categorized into three thematic categories. Intraoperative communication, teamwork, and disruptions are the key factors affecting patient safety during robotic‐assisted and laparoscopic surgeries.ConclusionsThis integrative literature review identifies a dearth of evidence examining factors affecting patient safety during robotic‐assisted and laparoscopic surgeries. It draws attention to the complexities with teamwork, intraoperative communication and disruptions during robotic‐assisted and laparoscopic surgeries. Although robotic‐assisted surgery is generally seen as safe and effective, this review highlights the need for education and training that focuses on non‐technical skills development, disruption prevention and alertness in anticipating and minimising risk.Clinical RelevanceThe evidence from this review identifies the different demands and diverse challenges in maintaining safety during robotic‐assisted and laparoscopic surgery. Although specific technical knowledge and skills are essential, this review highlights the importance of developing new ways of thinking with regard to assessment and management of disruptions, developing different teamwork patterns and communication skills, and overcoming challenges introduced during technology advanced surgeries. Nurses in the perioperative setting have an increased responsibility to continue professional development and remain vigilant to factors affecting patient safety. Early identification and management of factors leading to disruptions is imperative in the provision of safe perioperative care.
Differin® and depilation, a word of warning
Authors: Harris Blair , Bitner Benjamin , Thomas Logan 
Published: October 2018

SummaryBackground: Retinoid products are becoming increasingly popular due to their efficacy and mild side effect profile. A few cases of epidermal stripping with wax depilation have been reported, but all have been associated with oral retinoid use.Aims: We aim to increase awareness of this adverse effect.Methods: N/AResults: N/AConclusion: While retinoid products are effective and have a low side effect profile, they may still cause adverse effects including the possibility of epidermal stripping with wax depilation.
The role of long‐wavelength ultraviolet A1 (UVA1) in acral vitiligo
Authors: El‐Zawahry Bakr Mohamed , Elmasry Maha Fathy , Ragab Amira 
Published: October 2018

SummaryIntroductionAcral vitiligo is a resistant subtype of vitiligo that does not respond easily to any treatment modality. Ultraviolet A1 (UVA1) (340‐400 nm) therapy can penetrate the deep dermis of the skin and is relatively free of adverse effects associated with different phototherapeutic modalities. This study's objective was to evaluate the effect of medium‐dose long‐wavelength UVA1 (40‐70 J) in acral vitiligo treatment and compare it with topical psoralen plus ultraviolet A (topical PUVA).MethodsPatients in this randomized‐controlled comparative clinical trial were divided into two groups, medium‐dose UVA1 group and topical PUVA group (10 acral vitiligo patients each). Patients received 36 sessions of phototherapy over a period of 12 weeks. Every patient was clinically evaluated monthly as regards the appearance of new lesions or increase in diameter of the current lesion according to point counting and vitiligo area severity index.ResultsNo statistically significant clinical difference was found between patients in UVA1 and topical PUVA groups regarding response and pattern of response (P > 0.05).ConclusionUltraviolet A1 seems to be of limited use as a monotherapy in acral vitiligo treatment. However, more studies combining it with other treatment modalities as systemic steroids and/or using higher UVA1 doses may prove beneficial.
Diffusely Abnormal White Matter, T2 Burden of Disease, and Brain Volume in Relapsing‐Remitting Multiple Sclerosis
Authors: Vertinsky Alexandra T. , Li David K.B. , Vavasour Irene M. , Miropolsky Vladislav , Zhao Guojun , Zhao Yinshan , Riddehough Andrew , Moore G.R. Wayne , Traboulsee Anthony , Laule Cornelia 
Published: October 2018

ABSTRACTBACKGROUND AND PURPOSEMultiple sclerosis (MS) diffusely abnormal white matter (DAWM) is a mildly hyperintense magnetic resonance imaging abnormality distinct from typical lesions. Our goal was to investigate the prevalence and natural history of DAWM in a large cohort (n = 348) of relapsing–remitting MS (RRMS) patients.METHODSThe presence of DAWM and relationship to changes in T2 burden of disease (BOD), brain volume (brain fractional ratio, BFR), and disability (Expanded Disability Status Scale, EDSS) were investigated at baseline and year 7–8 (long‐term follow‐up, LTF).RESULTSDAWM was present in 25.3% (88 of 348) of patients at baseline. At LTF, DAWM was unchanged in 69.3% (61 of 88), decreased in 28.4% (25 of 88), and increased in 2.3% (2 of 88) of patients. Baseline BOD and change in BOD did not significantly differ between patients with and without DAWM. DAWM was associated with greater reduction in BFR at LTF (P = .038). DAWM and DAWM change did not predict EDSS or EDSS progression.CONCLUSIONSDAWM is present in a quarter of RRMS patients, and rarely increases or develops de novo. DAWM predicts brain atrophy but does not predict physical disability. Because of its posterior periventricular location, further investigation is warranted to evaluate its relationship to other measures of disability, including visual spatial processing and cognitive function.
The smelly path to sympatric speciation?
Authors: Brock Chad D. , Wagner Catherine E. 
Published: October 2018

AbstractIn this issue of Molecular Ecology, Poelstra et al. () use genomic data to show that cichlid species in the adaptive radiation in Lake Ejagham, Cameroon, experienced gene flow with a riverine relative, primarily prior to their diversification. Intriguingly, this introgression brought with it olfactory alleles that the authors suggest may play a sensory role in speciation. As a classic example of sympatric speciation due to the highly restricted geography of this small (0.49 km2) crater lake (Schliewen et al., ), this result sheds new light on the history of this fascinating radiation. As genomic data for cichlid radiations accumulate, finding evidence of introgression increasingly appears to be the rule rather than the exception (Kautt et al., ; Meier et al., , ). However, two points are pressing as evidence for introgression mounts: (a) It is crucial to understand the assumptions of analytical approaches used and (b) it is important to think clearly about the divergent contexts in which evidence for introgression has been invoked as an important feature of adaptive radiation.
The Symptoms and Clinical events associated with Automatic Reprogramming (SCARE) at replacement notification study
Authors: Sinha Sunil K. , Carlson Daniel , Chrispin Jonathan , Barth Andreas S. , Rickard John Jack , Spragg David D. , Berger Ronald , Love Charles , Calkins Hugh , Tomaselli Gordon F. , Marine Joseph E. 
Published: October 2018

AbstractBackgroundPacemaker patients experience battery depletion that activates pacemaker's alert for replacement notification. Automatic reprogramming at replacement notification can result in loss of rate response and atrioventricular (AV) synchrony.ObjectiveTo determine if relevant symptoms or clinical events may be associated with automatic reprogramming at replacement notification.MethodsElectronic medical record review was undertaken for 298 patients referred for pacemaker generator replacement. Primary endpoints were symptoms or clinical events during replacement notification period.ResultsFollowing elimination of duplicate pacemaker replacements (n = 12), “near‐replacement notification” or “recalled” (n = 15) and pacemakers at “end of life” (n = 5), 266 subjects were included. Three distinct reprogramming cohorts were identified; those with no change (control) in pacing mode (n = 46), those with loss of rate response (n = 154), and those with loss of AV synchrony ± rate response (n = 66). In total, 83 subjects (31.2%) had symptoms with significant differences seen between groups (control = 4.3%, loss of rate response = 26.0%, loss of AV synchrony ± rate response = 62.1%, P < 0.001). Overall, 28 subjects (10.5%) experienced clinical events with significant differences seen between groups (control = 0.0%, loss of rate response = 6.5%, loss of AV synchrony ± rate response = 27.3%, P < 0.001).ConclusionsAutomatic reprogramming at replacement notification was associated with significant symptoms in 26% of those who lost rate response and in 62% of those who lost AV synchrony ± rate response. Additionally, 27% of the latter cohort required nonelective clinical care.
Parental satisfaction of child's perioperative care
Authors: Shafer Jonathan S. , Jenkins Brooke N. , Fortier Michelle A. , Stevenson Robert S. , Hikita Natasha , Zuk Jeannie , Gold Jeffrey I. , Golianu Brenda , Kaplan Sherrie H. , Mayes Linda , Kain Zeev N. 
Published: October 2018

SummaryBackgroundSatisfaction in the hospital setting is an important component of both hospital funding and patient experience. When it comes to a child's hospital experience, parent satisfaction of their child's perioperative care is also necessary to understand. However, little research has been conducted on the predictors of this outcome. Therefore, the purpose of this current study was to validate a priori selected predictors for parental satisfaction in their child's perioperative process.MethodsEight hundred and ten pediatric patients who underwent tonsillectomy and adenoidectomy surgery and their parents were included in this study. The primary outcome was assessed using a 21‐item parent satisfaction questionnaire resulting in three satisfaction scores: overall care satisfaction, OR/induction satisfaction, and total satisfaction.ResultsDescriptive statistics and correlational analysis found that sedative‐premedication, parental presence at anesthesia induction, child social functioning, parental anxiety, and language were all significant predictors of various components of the satisfaction score. Regression models, however, revealed that only parent anxiety and child social functioning remained significant predictors such that parents who reported lower state anxiety (OR/induction satisfaction: OR = 0.975, 95% CI [0.957, 0.994]; total satisfaction: OR = 0.968, 95% CI [0.943, 0.993]) and who had higher socially functioning children (overall care satisfaction: OR = 1.019, 95% CI [1.005, 1.033]; OR/induction satisfaction: OR = 1.011, 95% CI [1.000, 1.022]) were significantly more satisfied with the perioperative care they received.ConclusionLower parent anxiety and higher child social functioning were predictive of higher parental satisfaction scores.