bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Polymorphisms in Dopamine‐Related Genes and Orthopedic Pain Expression in a Chinese Elderly Population
Authors: Chu Che‐Sheng , Chu Chin‐Liang , Liang Chih‐Kuang , Lu Ti , Lin Yu‐Te , Chou Ming‐Yueh , Chow Philip Chik‐Keung 
Published: October 2018

AbstractObjectivesThe dopaminergic pathway plays a vital role in pain expression. Here, our aim was to investigate the effects of polymorphisms in genes encoding the dopamine active transporter (SLC6A3) and dopamine receptor D2 (DRD2) on preoperative pain expression among patients preparing for orthopedic surgery.MethodsChinese elderly patients scheduled for orthopedic surgery were enrolled. The VAS was used to evaluate pain intensity (score range 0 to 10; 0 = no pain; 10 = worst pain possible). Depressive symptoms were evaluated via the 15‐item Geriatric Depression Scale. DNA was isolated from venous blood samples, and single‐nucleotide polymorphisms of SLC6A3 and DRD2 were genotyped. Multiple linear regressions analyses were carried out to adjust the results for confounders.ResultsA total of 294 patients with a mean age of 73.82 ± 8.03 years were enrolled in this study. After adjustment for confounders, rs393795 in SLC6A3 showed a significant association with preoperative VAS scores. Patients with the A/A genotype reported lower mean pain scores than did those with the A/C genotype (P = 0.026). Subsequent depression‐stratified analysis of rs6276 in DRD2 revealed that patients with the A/A genotype had higher pain scores than did those with the G/G genotype (P = 0.043). No associations were found for DRD2 rs6277 in the whole study population or depression‐stratified groups.ConclusionGenetic variations in SLC6A3 and DRD2 may play an important role in pain expression among the elderly prior to orthopedic surgery.
A vision for future work to focus on the “M” in integrated STEM
Authors: Stohlmann Micah 
Published: October 2018

AbstractThe integration of science, technology, engineering, and mathematics (STEM) education has received increased attention in the last decade. This is in part because of the need for students to increase in their STEM knowledge and competencies. Research is still needed to determine effective implementation models and curriculum for integrated STEM. Mathematics in particular has not received the focus it deserves with STEM integration. This paper discusses integration of STEM subjects that has a focus on mathematics (integrated steM); including summarizing and analyzing research done in the last ten years. A s.t.e.m. (Support, Topics, Emphasis, and Mathematical content) model for integrated steM research is presented to guide future research.
Actinomadura vinacea isolated from a nonhealing cutaneous wound in a cat
Authors: Wells Bridgette , Burnum Anne L. , Armstrong Juliet , Sanchez Susan , Stanton James B. , Camus Melinda S. 
Published: October 2018

AbstractA 6‐year‐old, spayed female, domestic shorthair cat was presented to the University of Georgia Veterinary Teaching Hospital for a 3‐year history of a nonhealing wound on the right tarsus. The wound temporarily resolved with medical management, but intermittently recurred when antimicrobials were discontinued. At presentation, the wound had become refractory to antimicrobial therapy. Physical examination revealed a 1 cm diameter crust along the medial aspect of the right tarsus. Proximal to the crust, were 2 non‐painful, fluctuant swollen areas that were free of drainage. Cytologic evaluation revealed atypical granulated cells, and a mesenchymal neoplasm was interpreted as a top differential diagnosis. Histopathology revealed marked, chronic, multifocal, pyogranulomatous dermatitis with abundant intralesional colonies of gram‐positive, acid‐fast‐negative, filamentous bacteria. PCR and sequencing confirmed the infection to be caused by Actinomadura vinacea.
Emotions experienced when receiving a temporary deferral: perspectives from staff and donors
Authors: Gemelli Carley N. , Thijsen Amanda , Van Dyke Nina , Masser Barbara M. , Davison Tanya E. 
Published: October 2018

Background and ObjectivesTemporary deferrals negatively impact on donor retention. However, little is known about why donors are deterred from returning. One unexplored area is the emotions experienced by donors when deferred. This study investigated these emotions from the perspectives of both the front‐line staff involved in applying deferrals and deferred donors themselves, with the aim of identifying which emotions impact on donors’ intention to return.Materials and MethodsTelephone interviews were conducted with front‐line staff who apply deferrals (n = 47) to explore perceived reasons for donor non‐return following a deferral. Findings informed a survey administered to donors who had received a temporary deferral 1 day prior (n = 397). The questionnaire included items about donors’ emotional reactions to receiving the deferral and intention to re‐donate.ResultsStaff reported that donors frequently had negative emotional responses to being deferred–particularly anger, frustration and rejection. Exploratory factor analysis of 31 emotions assessed in the donor survey revealed six factors. Deferred donors’ intention to re‐donate was negatively associated with anger‐related emotions and positively associated with calm‐related emotions. The association between emotions and intention was moderated by whether the deferral was applied in‐centre or during the pre‐donation telephone call.ConclusionEmotional reactions to receiving a deferral impact on donors’ intention to re‐donate, particularly among those deferred in‐centre. Blood collection staff may be able to address donors’ emotional responses to help diminish the impact of being deferred on donors’ intentions to return.
Incremental Prognostic Value of Right Ventricular Strain in Patients With Acute Decompensated Heart Failure
Authors: Hamada-Harimura Yoshie , Seo Yoshihiro , Ishizu Tomoko , Nishi Isao , Machino-Ohtsuka Tomoko , Yamamoto Masayoshi , Sugano Akinori , Sato Kimi , Sai Seika , Obara Kenichi , Yoshida Ikuo , Aonuma Kazutaka ,   for the ICAS-HF Investigators
Published: October 2018

Background:
Although 2-dimensional strain analyses based on speckle tracking echocardiography have been used to detect myocardial deformation, the prognostic impact of 2-dimensional strain is unclear in patients with acute decompensated heart failure (HF). We investigated whether left ventricular and right ventricular (RV) strain parameters assessed by speckle tracking echocardiography provide incremental prognostic information in hospitalized patients because of acute decompensated HF.

Methods and Results:

Six hundred eighteen patients (age, 72±13 years; 38% women; ejection fraction, 46±16%) hospitalized for acute decompensated HF underwent clinical and echocardiographic evaluation just before discharge. We performed strain analyses of left ventricular global longitudinal strain and left ventricular global circumferential strain. We also analyzed RV longitudinal strain only from the free wall (RV-fwLS) and from all segments of the RV global longitudinal strain wall by using Tomtec software. The primary composite end point was cardiovascular death and readmission for HF. There were 34.8% cardiac events during a median follow-up of 427 days. In multivariate Cox models, among echocardiographic parameters, only impaired RV-fwLS (≥−13.1%; hazard ratio, 1.51; 95% CI, 1.12–2.04;
P
=0.01) was independently associated with cardiac events. Adding RV-fwLS to clinical risk evaluation (age, New York Heart Association class III/IV, blood urea nitrogen, and brain natriuretic peptide) markedly improved prognostic utility and consequently increased net reclassification improvement by 0.30 (
P
=0.01).

Conclusions:
RV-fwLS is an independent predictor of cardiac events in acute decompensated HF and provides greater prognostic power than standard echocardiographic parameters.
Women Who Have Ischemic Strokes Have a Higher Burden of Left Atrial Fibrosis Than Men
Authors: Fonseca Ana Catarina , Marto João Pedro , Alves Pedro N. , Inácio Nuno , Viana-Baptista Miguel , Pinho e Melo Teresa , Ferro José M. , Almeida Ana G. 
Published: October 2018

Background and Purpose—
Women with atrial fibrillation (AF) have a higher risk of stroke than men who have AF. Atrial fibrosis is a marker of atrial disease that precedes the appearance of AF increasing the risk of ischemic stroke. We aimed to determine whether female sex is independently associated with left atrial fibrosis in stroke patients.

Methods—
We prospectively included a consecutive sample of ischemic stroke patients aged over 50 years of age. Late gadolinium enhancement cardiac magnetic resonance imaging was performed to quantify the severity of left atrial fibrosis and the wall pattern of its distribution. A multivariable linear regression analysis was performed to determine whether female sex was independently associated with left atrial fibrosis after adjusting for potential confounders namely AF and age.

Results—

One hundred twenty-four patients were deemed eligible; 117 patients were included (7 were excluded because of cardiomyopathy identified by cardiac magnetic resonance imaging). All had usable cardiac magnetic resonance imaging data. Fifty-three patients (45.3%) were women. Women were older and were less frequently treated with angiotensin-converting-enzyme inhibitors. Ninety-one patients had any degree of atrial fibrosis. Women had a higher percentage of atrial fibrosis than men—median (interquartile range)—18% (17) versus 10% (20). In a multivariable linear regression model adjusted for demographics, medications, AF, comorbidities, and cardiac parameters, female sex was found to be independently associated with left atrial fibrosis. Women were found to have more 4.70% of left atrial fibrosis than men (95% CI, 0.70–8.71%;
P
=0.02) after controlling for confounders.

Conclusions—
Female sex was found to be independently associated with left atrial fibrosis after controlling for confounders such as AF and age. Further studies are needed to understand if this contributes to the increased stroke risk related to AF in women compared with men.
HUKUK EKONOMİ İŞBİRLİĞİ: FRANZ BÖHM
Authors: Derya Hülya 
Published: October 2018

Bu
çalışmanın amacı, 19.yüzyılda
Almanya’da hukukun
yetersizliği, kartellerin
fazlalaşması ve bilimin geriye itilmesi
sorunsalına çözüm olarak Freiburg Okulu Ordo-liberalizm temsilcisi
Franz Böhm’ün ekonominin bir anayasaya
ihtiyacı olduğu yöndeki düşüncelerini incelemektir. Dönemin iktisadi ve sosyal yapısı;
Tarihçi Hareket, Alman Tarihçi Okul ve
Nasyonel Sosyalizm etkileşiminden
oluşmuştur. Bu dönemin karakteristik
yapısı, hukuksuzluğun, kartel ve
monopollerin artmasıdır. Franz Böhm,
ekonomik ve sosyal özgürlüğün gelişimi için ekonominin anayasal çerçeveye
alınmasını savunmuş ve tekel sorununu gözetim
dairelerinin kurulması ile çözülebileceği görüşlerini dillendirmiştir. Nasyonel Sosyalizim döneminin sona ermesi ile Almanya’nın
kurumsal yapısı Franz Böhm’ün
katkıları ile şekillenmeye başlamıştır. Bu çalışmada, Franz Böhm ile başlayan hukukun ekonomik
işleyiş üzerinde meydana getirdiği
etkiler değerlendirilecektir.
Multimorbidity and mortality
Authors: Willadsen TG , Siersma V , Nicolaisdóttir DR , Køster-Rasmussen R , Jarbøl DE , Reventlow S , Mercer SW , Olivarius N de Fine 
Published: October 2018

Background: Knowledge about prevalent and deadly combinations of multimorbidity is needed. Objective: To determine the nationwide prevalence of multimorbidity and estimate mortality for the most prevalent combinations of one to five diagnosis groups. Furthermore, to assess the excess mortality of the combination of two groups compared to the product of mortality associated with the single groups. Design: A prospective cohort study using Danish registries and including 3.986.209 people aged ≥18 years on 1 January, 2000. Multimorbidity was defined as having diagnoses from at least 2 of 10 diagnosis groups: lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, kidney, and sensory organs. Logistic regression (odds ratios, ORs) and ratio of ORs (ROR) were used to study mortality and excess mortality. Results: Prevalence of multimorbidity was 7.1% in the Danish population. The most prevalent combination was the musculoskeletal–cardiovascular (0.4%), which had double the mortality (OR, 2.03) compared to persons not belonging to any of the diagnosis groups but showed no excess mortality (ROR, 0.97). The neurological–cancer combination had the highest mortality (OR, 6.35), was less prevalent (0.07%), and had no excess mortality (ROR, 0.94). Cardiovascular–lung was moderately prevalent (0.2%), had high mortality (OR, 5.75), and had excess mortality (ROR, 1.18). Endocrine–kidney had high excess mortality (ROR, 1.81) and cancer–mental had low excess mortality (ROR, 0.66). Mortality increased with the number of groups. Conclusions: All combinations had increased mortality risk with some of them having up to a six-fold increased risk. Mortality increased with the number of diagnosis groups. Most combinations did not increase mortality above that expected, that is, were additive rather than synergistic.
Valuable prognostic indicators for severe burn sepsis with inhalation lesion: age, platelet count, and procalcitonin
Authors: Xu Yichao , Jin Xinyuan , Shao Xiaonan , Zheng Feng , Zhou Hong 
Published: October 2018

Abstract

Background
Severe burn sepsis can lead to high mortality. We explored the valuable prognostic indicators for severe burn sepsis with inhalation lesion.

Methods
Thirty-eight severe burn patients with sepsis who were admitted to the Third Affiliated Hospital of Soochow University from August 2014 to December 2017 were retrospectively analyzed. Among them, 22 patients were assigned to the death group and 16 patients to the survival group. Their general information, vital signs, and blood index including serum procalcitonin (PCT) and C-reactive protein (CRP) levels at admission, diagnosis of sepsis, and 1-week post-diagnosis of sepsis were compared.

Results
Patients in the death group were older and had lower platelet count (PLT) at diagnosis of sepsis and 1-week post-diagnosis as well as higher PCT level at 1-week post-diagnosis than patients in the survival group (all p &lt; 0.05). According to receiver operating characteristic (ROC) curves, the above four indicators could be used to predict the prognosis, and the area under the curve (AUC) of PLT at diagnosis and 1-week post-diagnosis was larger (0.888 and 0.911), and PLT at diagnosis had the highest sensitivity and specificity (0.842 and 0.937). In addition, these patients were divided into two groups by the optimal cutoff age of 38 years. According to multivariate logistic regression analysis and COX regression analysis, only age group and PLT at diagnosis were statistically significant (all p &lt; 0.05). The risk of death in the older group was 28 times higher than that in the younger group, and the risk of death increased by 3% for each unit reduction in PLT at diagnosis. Moreover, age group was an independent factor affecting the patients’ survival (β = − 1.370, p = 0.026). Considering the survival time after sepsis, the mortality risk was lower for patients in the older group than for patients in the younger group (hazard ratio (HR) = 0.254, 95% confidence interval (CI) 0.076–0.851).

Conclusion
Age, PLT at diagnosis of sepsis, and 1-week post-diagnosis as well as PCT level at 1-week post-diagnosis are indicators for the evaluation of prognosis of severe burn sepsis with inhalation lesion. Among them, PLT at diagnosis has the greatest prognostic value. In addition, age can predict the patients’ mortality and survival time after sepsis.
Reconfiguring in-patient services for adults with mental health problems: changing the balance of care
Authors: Tucker Sue , Hughes Jane , Jolley David , Buck Deborah , Hargreaves Claire , Challis David 
Published: October 2018

BackgroundResearch suggests that a significant minority of hospital in-patients could be more appropriately supported in the community if enhanced services were available. However, little is known about these individuals or the services they require.AimsTo identify which individuals require what services, at what cost.MethodA ‘balance of care’ (BoC) study was undertaken in northern England. Drawing on routine electronic data about 315 admissions categorised into patient groups, frontline practitioners identified patients whose needs could be met in alternative settings and specified the services they required, using a modified nominal group approach. Costing employed a public-sector approach.ResultsCommunity care was deemed appropriate for approximately a quarter of admissions including people with mild-moderate depression, an eating disorder or personality disorder, and some people with schizophrenia. Proposed community alternatives drew heavily on carer support services, community mental health teams and consultants, and there was widespread consensus on the need to increase out-of-hours community services. The costs of the proposed community care were relatively modest compared with hospital admission. On average social care costs increased by approximately £60 per week, but total costs fell by £1626 per week.ConclusionsThe findings raise strategic issues for both national policymakers and local service planners. Patients who could be managed at home can be characterised by diagnosis. Although potential financial savings were identified, the reported cost differences do not directly equate to cost savings. It is not clear whether in-patient beds could be reduced. However, existing beds could be more efficiently used.Declaration of interestNone.
Prospective, Randomized Comparison of the i-gel and the Self-Pressurized air-Q Intubating Laryngeal Airway in Elderly Anesthetized Patients
Authors: Lee Jeong Soo , Kim Do-Hyeong , Choi Seung Ho , Ha Sang Hee , Kim Sijin , Kim Min-Soo 
Published: October 2018

BACKGROUND:
Age-related changes in upper airway anatomy may affect the overall performance of supraglottic airways significantly. The clinical performance of the i-gel and the self-pressurized air-Q intubating laryngeal airways with noninflatable cuffs for elderly populations remains unknown, unlike in children. Thus, we performed a prospective, randomized comparison of these 2 supraglottic airways in elderly patients undergoing general anesthesia.

METHODS:
We recruited 100 patients, 65–90 years of age, who were scheduled for elective surgery under general anesthesia with muscle relaxation. The enrolled patients were allocated to the i-gel or self-pressurized air-Q group. We assessed oropharyngeal leak pressure as the primary outcome and fiberoptic view after placement and fixation of the airway and at 10 minutes after the initial assessment. The fiberoptic view was scored using a 5-point scale as follows: vocal cords not visible; vocal cords and anterior epiglottis visible, >50% visual obstruction of epiglottis to vocal cords; vocal cords and anterior epiglottis visible, <50% visual obstruction of epiglottis to vocal cords; vocal cords and posterior epiglottis visible; and vocal cords visible. We also investigated success rate and ease of insertion, insertion time, and manipulations during insertion as insertion variables, complications during maintenance and emergence periods, and postoperative pharyngolaryngeal complications including sore throat, dysphagia, and dysphonia.

RESULTS:
After assessing for eligibility, 48 patients were allocated to each group. Oropharyngeal leak pressures were significantly higher in the i-gel group than in the self-pressurized air-Q group (P < .001) at the 2 measurement points. The raw mean difference at initial assessment and the median difference after 10 minutes were 5.5 cm H2O (95% confidence interval, 3.3–7.6 cm H2O) and 5.0 (95% confidence interval, 2.0–7.0 cm H2O), respectively. The initial scores of fiberoptic view were similar in the 2 groups. However, the self-pressurized air-Q supraglottic airway provided a significantly improved fiberoptic view at 10 minutes after initial assessment (P = .030). We found no statistically significant differences in insertion variables and complications between the 2 groups.

CONCLUSIONS:
The i-gel provided better sealing function than the self-pressurized air-Q supraglottic airway according to the high oropharyngeal leak pressures in elderly patients during general anesthesia. The self-pressurized air-Q supraglottic airway had improved fiberoptic views in elderly patients during general anesthesia.
Fuchs heterochromic iridocyclitis-associated glaucoma: a retrospective comparison of primary Ahmed glaucoma valve implantation and trabeculectomy with mitomycin C
Authors: Esfandiari Hamed , Loewen Nils A. , Hassanpour Kiana , Fatourechi Ali , Yazdani Shahin , Wang Chao , Yaseri Mehdi , Pakravan Mohammad 
Published: October 2018

Background: The aim of this study was to compare the safety and efficacy of primary trabeculectomy with mitomycin C and Ahmed glaucoma valve (AGV) implantation in patients with Fuchs heterochromic iridocyclitis (FHIC)-related glaucoma, a rare complication of an uncommon form of uveitis. Methods: In this retrospective comparative case series, 26 FHIC-associated glaucoma patients received trabeculectomy (n=12) or an AGV (n=14). Primary outcome measures were surgical success, defined as intraocular pressure (IOP) ≤21 mmHg, decreasing ≥20% from baseline, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity (BCVA), and IOP. Results: The follow-up was 34.0±17.7 months in patients that received trabeculectomy and 33.4±18.6 months in AGV (P= 0.837). The cumulative probability of success rate was 41.7% for trabeculectomy and 85.7% for AGV, with no significant difference in complications (P>0.05). The IOP in patients that received trabeculectomy dropped from 23.4±3.3 mmHg to 21.6±5.2 mmHg at the final visit (P= 0.041). In patients that received AGV, the IOP decreased from 24±7.8 to 17.1±2.6 mmHg (P= 0.003). The number of glaucoma medications at baseline were 3.3±0.5 in those that received trabeculectomy and 3±0.6 in those that received AGV (P=0.233), and decreased to 2.4±1.0 (P=0.008) and 1.7±0.6 (P=0.002), respectively. BCVA was equal in both groups and did not change (P>0.05). Conclusion: Primary AGV had a higher success rate than trabeculectomy, with patients also needing fewer medications for the management of FHIC-associated glaucoma.