bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aggressive Care near the End of Life for Cancer Patients in Medicare Accountable Care Organizations
Authors: Kim Hyosin , Keating Nancy L. , Perloff Jennifer N. , Hodgkin Dominic , Liu Xiaodong , Bishop Christine E. 
Published: April 2019

OBJECTIVESTo compare aggressiveness of end‐of‐life (EoL) care for older cancer patients attributed to Medicare Shared Savings Programs with that for similar fee for service (FFS) beneficiaries not in an accountable care organization (ACO) and examine whether observed differences in EoL care utilization vary across markets that differ in ACO penetration.DESIGNCross‐sectional observational study comparing ACO‐attributed beneficiaries with propensity score–matched beneficiaries not attributed to an ACO.SETTINGA total of 21 hospital referral regions (HRRs) in the United States.PARTICIPANTSMedicare FFS beneficiaries with a cancer diagnosis who were 66 years or older and died in 2013‐2014.MEASUREMENTSOutcome measures were claims‐based quality measures of aggressive EoL care: (1) one or more intensive care unit (ICU) admissions in the last month of life, (2) two or more hospitalizations in the last month of life, (3) two or more emergency department visits in the last month of life, (4) chemotherapy 2 weeks or less before death, and (5) no hospice enrollment or hospice enrollment within 3 days of death. Analyses were adjusted for demographic and clinical characteristics of beneficiaries and practice characteristics.RESULTSCompared with beneficiaries not in an ACO, ACO‐attributed beneficiaries had a higher rate of ICU admission during the last month of life (37.7% vs 34.0%; adjusted difference = +2.8 percentage points; 95% confidence interval (CI) = 1.0‐4.6) but fewer repeated hospitalizations (14.5% vs 15.2%; adjusted difference = −1.7 percentage points; CI = −3.1 to −.3). Other measures did not differ for the two groups. Although the ICU admission rates tended to decrease as ACO‐penetration rates increased (P < .01), ACO patients had higher rates of ICU admission than non‐ACO patients in both medium and high ACO‐penetration HRRs.CONCLUSIONCancer patients attributed to ACOs had fewer repeated hospitalizations but more ICU admissions in the last month of life than non‐ACO patients; they had similar rates of other measures of aggressive care at the EoL. This suggests opportunities for ACOs to improve EoL care for cancer patients. J Am Geriatr Soc 67:961–968, 2019.
What's Mine Is Ours? Income Pooling in American Families
Authors: Eickmeyer Kasey J. , Manning Wendy D. , Brown Susan L. 
Published: April 2019

AbstractObjective: The objective of this study is to determine whether income‐pooling strategies differ between married and cohabiting individuals without children, only biological children, or any stepchildren.Background: Americans are forming families in new ways via cohabitation and stepfamilies, which may have implications for resource pooling. Although a majority of married and cohabiting couples pool their incomes, little is known about the role of children in couple's income‐pooling behaviors.Method: The authors use recently collected, nationally representative data from the Families and Relationships Study (n = 4,362). Controlling for sociodemographic, household, and relationship characteristics, the authors use logistic regression to predict the odds of income pooling among married and cohabiting individuals without children, only biological children, or any stepchildren.Results: The likelihood of income pooling remained similar among cohabitors regardless of the configuration of children in the household. Among married families, however, the likelihood of income pooling differed by the presence of resident stepchildren. Married families with resident stepchildren had a lower probability of pooling their income when compared with married families with only resident biological children.Conclusion: The ways economic resources are shared differs across family types. The findings from this study are consistent with an incomplete institutionalization perspective and demonstrate that individuals in cohabiting‐couple families and married‐couple families with resident stepchildren are less likely to pool their incomes.
Identity Management Strategies for Workers with Concealable Disabilities: Antecedents and Consequences
Authors: Santuzzi Alecia M. , Keating Robert T. , Martinez Jesus J. , Finkelstein Lisa M. , Rupp Deborah E. , Strah Nicole 
Published: April 2019

AbstractTwenty‐eight currently or recently employed adults with concealable impairments from a community in the United States completed semi‐structured interviews to capture workers’ perceptions of their internal and social experiences that contribute to their identity management decisions. Disability identity management strategies included effortful behaviors, such as avoiding relevant situations and using specific language to describe impairments. Participants suggested intraindividual factors (disability salience, disability strain) and environmental factors (disability stigma, ineffective social support) as primary reasons for their identity management decisions. The findings align with existing research on stigmatized identity management and consequences for well‐being, together informing a proposed theoretical model. Conclusions invite policy change at national and organizational levels to account for intraindividual and environmental factors that may introduce barriers to disability disclosure and effective accommodation practices.
The effects of zolpidem in obstructive sleep apnea – An open‐label pilot study
Authors: Carberry Jayne C. , Grunstein Ronald R. , Eckert Danny J. 
Published: April 2019

AbstractNew knowledge on hypnotics and their effects on the phenotypic causes of obstructive sleep apnea indicate that zolpidem has therapeutic potential for certain patients. Specifically, zolpidem increases the threshold for arousal threshold and pharyngeal dilator muscle responsiveness. However, the effects of a standard dose of zolpidem (10 mg) on obstructive sleep apnea severity and symptoms have not been investigated. In an open‐label pilot study, 12 unselected people with obstructive sleep apnea were recruited following a diagnostic in‐laboratory sleep study. Participants then returned for a single‐night sleep study in which 10 mg of zolpidem was given just prior to sleep. Tolerability, next‐day sleepiness and the effects of zolpidem on polysomnography variables were assessed. Zolpidem was well tolerated and significantly improved the sleep efficiency compared with the no‐drug night (77 ± 12% versus 84 ± 9%, p = 0.005). Individual responses on obstructive sleep apnea severity to zolpidem in this unselected obstructive sleep apnea patient population were variable with no overall systematic difference in apnea–hypopnea index (29 ± 18.2 events per hr versus 33 ± 28 events per hr, p = 0.45) or other key respiratory parameters (e.g. event duration or hypoxemia). Next‐day sleepiness assessed via the Karolinska Sleepiness Scale was not different between visits (4 ± 1 versus 4 ± 2, p = 0.85). These findings provide the first insight into the effects of a standard dose of zolpidem in obstructive sleep apnea, and highlight its tolerability and potential to improve sleep quality. The variable effects on obstructive sleep apnea severity observed in this pilot also underscore the need for larger trials that incorporate phenotypic characterisation (e.g. arousal threshold, Pcrit and muscle responsiveness) to understand inter‐individual heterogeneity and the therapeutic potential of zolpidem for certain people with obstructive sleep apnea.
Embryonic development in corkwing wrasse, Symphodus melops
Authors: Blanco Gonzalez Enrique , Torstensnes Ingrid , Naito Mana 
Published: April 2019

AbstractCorkwing wrasse, Symphodus melops, is one of the main species used as cleaner fish to combat sea lice infestation in salmon aquaculture; however, there is little knowledge about its biology. Here, we describe the embryonic development of this species and examine the viability of the eggs under three temperature regimes. The experiments were conducted at three water temperature regimes, 12, 15, and 18°C, which resemble common sea water temperatures registered during the spawning season of corkwing wrasse at different latitudes along the Norwegian coast. Corkwing wrasse spawn small spherical eggs of 0.75–0.80 mm in diameter (mean 0.78, CV = 3.6%) with several oil droplets and go through eight developmental stages until hatching. The shortest hatching time was registered after 144 hr at 18°C and after 222 and 372 hr at 15 and 12°C, respectively. These observations provide important baseline biological information to advance the establishment of commercial rearing techniques and sustainable fishing management practices for this heavily exploited species.
Importance of plant‐ and microbe‐driven metabolic pathways for plant defence
Authors: O'Brien Anna M. 
Published: April 2019

Expression of plant phenotypes can depend on both plant genomes and interactions between plants and the microbes living in, on and near their roots. We understand a growing number of the mechanistic links between plant genotypes and phenotypes, such as defence against herbivory (see brief review in Hubbard et al., 2019), yet the links between root microbiomes and the comprehensive swathe of plant phenotypes they affect (Friesen et al., 2011) remain less clear. In this issue of Molecular Ecology, Hubbard et al. (2019) follow microbe‐ and plant‐driven changes in plant defence against hervibory from molecular underpinnings to ecological consequences, contrasting both the metabolites affected and the magnitude of defensive impact. Naively, we might expect plant genomes to drive more variation in phenotype than the root microbiome, but Hubbard et al. (2019) find the opposite, implying profound consequences for plant trait evolution and ecological interactions.
The portion size effect and overconsumption – towards downsizing solutions for children and adolescents – An update
Authors: Hetherington M. M. 
Published: April 2019

AbstractThe portion size effect (PSE), where more is eaten when large amounts are offered, is robust, reliable and enduring. Although it is not known what drives the PSE, amount served may act as a guide to how much should be eaten. Over time, consumers become accustomed to particular amounts of food as the ‘social norm’ and so large portion sizes are treated as typical. For children and adolescents who are forming eating habits, long‐term exposure to large portion sizes of snacks and meal items may encourage overconsumption. Therefore, offering smaller portions to suit the age and stage of children and young people should offer a potential solution to the PSE. We have developed a series of downsizing strategies to test the effect of providing smaller portions of snacks and meal items in pre‐school children, adolescents and families. One potential consequence of downsizing is that compensation may occur, in which smaller portion sizes drive intake of other foods. Therefore, in examining downsizing strategies, measures of compensation elsewhere in the meal or across the overall diet are important. Our studies indicate that it is both feasible and desirable to offer ‘me‐sized’, smaller portions for children to facilitate portion control as food preferences and eating habits are developed. However, strategies for young adults and adolescents are more challenging and require further investigation.
Cardiovascular nurses' adherence to practice standards in in‐hospital telemetry monitoring
Authors: Fålun Nina , Oterhals Kjersti , Pettersen Trond , Brørs Gunhild , Olsen Siv S. , Norekvål Tone M. ,   On behalf of the TELMON‐NOR investigators
Published: April 2019

AbstractBackgroundCorrect electrode placement and proper skin preparation for cardiac telemetry monitoring of patients at risk for arrhythmias increase the quality of the arrhythmic surveillance. Inconsistent arrhythmia surveillance can compromise patient safety and care outcomes. An inspection of international literature demonstrates that nurses generally do not adhere to cardiac monitoring standards.AimThe aims of this study were to determine cardiovascular nurses' knowledge of and adherence to practice standards for cardiac surveillance and whether their knowledge and practice improves over time.Study designA comparative study design was applied, and data were obtained by survey methodology.MethodsNurse delegates at the Annual National Congress on Cardiovascular Nursing in Norway completed surveys in 2011 and 2017 (delegates from 44 and 38 hospitals, respectively).ResultsIn total, 363 cardiac nurses (70%) responded to the questionnaires. Of these, 95% were female, with a mean age of 41 years. In 2011, 97% of participants were unaware of international practice standards. However, by 2017 unawareness decreased to 78% (P < .001). Despite their lack of knowledge of practice standards, 94% of participants often or always prepared patients' skin for telemetry; this improved from 2011 to 2017 (P = .001). Overall, 73% of nurses never or seldom scrubbed or washed the patients' skin before electrode placement, and 38% of the electrodes were misplaced. In 2011, 49% of nurses used protective telemetry covers; this increased to 80% in 2017 (P < .001). Overall, 64% always informed patients of the purpose of cardiac monitoring.ConclusionA significant percentage of nurses fail to adhere to recommendations for electrode placement, skin preparation and providing patients with telemetry information. In order to raise the quality of arrhythmic surveillance, investment in educational programmes in cardiac telemetry monitoring is required.Relevance to Clinical PracticeImproved in‐hospital telemetry practice is required to ensure patient safety and better care outcomes.
Analysis of procedural data of pulmonary vein isolation for atrial fibrillation with the second‐generation laser balloon
Authors: Nagase Takahiko , Bordignon Stefano , Perrotta Laura , Bologna Fabrizio , Tsianakas Nikolaos , Chen Shaojie , Konstantinou Athanasios , Chun Julian K.R. , Schmidt Boris 
Published: April 2019

AbstractBackgroundThe procedural data of pulmonary vein (PV) isolation (PVI) for patients with atrial fibrillation using the second‐generation laser balloon (LB2), which became available recently, remains unclear and were evaluated.MethodsThirty consecutive patients (116 PVs) underwent PVI using LB2 (LB2 group) and were matched to 30 patients (116 PVs) treated with the first‐generation laser balloon (LB1 group). The left atrial isolated surface area (ISA) (ratio of the total isolated antral surface area excluding PV to the total isolated antral surface area including the posterior wall) was also measured after LB2 PVI.ResultsPVI was achieved in 103/116 (89%) PVs and 108/116 (93%) PVs in the LB2 and LB1 groups, respectively, after the initial circular ablation (P = 0.360) and in 115/116 (99%) PVs and 116/116 (100%) PVs in the LB2 and LB1 groups, respectively, at the end of the procedure (P = 1.000). PV occlusion grade, categorized by the degree of PV occlusion, was significantly better in the LB2 group than in the LB1 group (P < 0.001). Zero rotational maneuver was applicable in 23/116 (20%) PVs and 8/116 (7%) in the LB2 and LB1 groups, respectively (P = 0.007). There was no significant difference in the procedural time, fluoroscopic time, or complications. The mean ISA after LB2 PVI was 53 ± 14%. The application number was the only independent predictor of successful PVI after initial circular LB2 ablation (adjusted odds ratio 0.860; 95% confidence interval 0.764–0.968; P = 0.013).ConclusionLB2 displays favorable PV occlusion characteristics and enables more zero rotational maneuvers.
A randomized trial of human C1 inhibitor prophylaxis in children with hereditary angioedema
Authors: Aygören‐Pürsün Emel , Soteres Daniel F. , Nieto‐Martinez Sandra A. , Christensen Jim , Jacobson Kraig W. , Moldovan Dumitru , Van Leerberghe Arthur , Tang Yongqiang , Lu Peng , Vardi Moshe , Schranz Jennifer , Martinez‐Saguer Inmaculada 
Published: April 2019

AbstractBackgroundPatients with hereditary angioedema with C1 inhibitor deficiency or dysfunction have burdensome recurrent angioedema attacks. The safety, efficacy, and health‐related quality of life (HRQoL) outcomes of C1 inhibitor (C1‐INH) prophylaxis (intravenously administered) in patients aged 6‐11 years were investigated.MethodsEligible patients were enrolled in a randomized, single‐blind, crossover, phase 3 trial. After a 12‐week baseline observation period (BOP), patients received 500 or 1000 U C1‐INH, twice weekly, for 12 weeks before crossing over to the alternate dose for 12 weeks. The primary efficacy end‐point was the monthly normalized number of angioedema attacks (NNA). HRQoL was assessed using the EuroQoL 5‐dimensional descriptive system youth version and visual analog scale (EQ‐VAS).ResultsTwelve randomized patients had a median (range) age of 10.0 (7‐11) years. Mean (SD) percentage reduction in monthly NNA from BOP was 71.1% (27.1%) with 500 U and 84.5% (20.0%) with 1000 U C1‐INH. Mean (SD) within‐patient difference (−0.4 [0.58]) for monthly NNA with both doses was significant (P = 0.035 [90% CI, −0.706 to −0.102]). Cumulative attack severity, cumulative daily severity, and number of acute attacks treated were reduced. No serious adverse events or discontinuations occurred. Mean EQ‐VAS change from BOP to week 9 of treatment (500 U C1‐INH, 10.4; 1000 U C1‐INH, 21.6) was greater than the minimal important difference, indicating a meaningful HRQoL change.ConclusionsC1‐INH prophylaxis was effective, safe, and well tolerated in children aged 6‐11 years experiencing recurrent angioedema attacks. A post hoc analysis indicated a meaningful improvement in HRQoL with C1‐INH.Trial registrationClinicalTrials.gov identifier NCT02052141.
Negative gravitropic response of roots directs auxin flow to control root gravitropism
Authors: Ge Liangfa , Chen Rujin 
Published: April 2019

AbstractRoot tip is capable of sensing and adjusting its growth direction in response to gravity, a phenomenon known as root gravitropism. Previously, we have shown that negative gravitropic response of roots (NGR) is essential for the positive gravitropic response of roots. Here, we show that NGR, a plasma membrane protein specifically expressed in root columella and lateral root cap cells, controls the positive root gravitropic response by regulating auxin efflux carrier localization in columella cells and the direction of lateral auxin flow in response to gravity. Pharmacological and genetic studies show that the negative root gravitropic response of the ngr mutants depends on polar auxin transport in the root elongation zone. Cell biology studies further demonstrate that polar localization of the auxin efflux carrier PIN3 in root columella cells and asymmetric lateral auxin flow in the root tip in response to gravistimulation is reversed in the atngr1;2;3 triple mutant. Furthermore, simultaneous mutations of three PIN genes expressed in root columella cells impaired the negative root gravitropic response of the atngr1;2;3 triple mutant. Our work revealed a critical role of NGR in root gravitropic response and provided an insight of the early events and molecular basis of the positive root gravitropism.
Topical timolol as adjunct therapy to shorten oral propranolol therapy for infantile hemangiomas
Authors: Mannschreck Diana B. , Huang Amy H. , Lie Erina , Psoter Kevin , Puttgen Katherine 
Published: April 2019

AbstractBackground/ObjectivesFirst‐line therapy for infantile hemangiomas (IH) is oral propranolol, a systemic beta‐blocker with the risk of rare but serious adverse effects. Topical timolol presents an attractive off‐label alternative with good tolerability, but sequential therapy with propranolol followed by timolol is not well studied. Here, we report effects of topical timolol preceding or following oral propranolol as adjunct therapy for IH.MethodsA retrospective chart review of 559 patients with IH seen at the pediatric dermatology clinic of a tertiary care center between December 2008 and January 2018. Children were grouped by treatment received: propranolol only, timolol only, propranolol to timolol, timolol to propranolol to timolol, and timolol to propranolol. Patient demographics, clinical/treatment characteristics, and pairwise differences were explored between groups.ResultsAmong all patients treated with propranolol, those who received propranolol followed by timolol received the shortest duration of oral propranolol and were the youngest at the time of propranolol completion. These patients received propranolol for a median of 2.2 months duration (P = 0.006) and were a median of 1.7 months younger (P = 0.007) compared with patients who received oral propranolol only. None had treatment failure defined as requiring propranolol reinitiation, compared with 13% of patients in the propranolol only group (P = 0.036).ConclusionsSequential therapy with oral propranolol followed by topical timolol for IH may help minimize potential adverse effects of systemic beta‐blockers by reducing the duration of propranolol therapy and facilitating successful taper at a younger age without an increase in treatment failures.
Policy analysis of access to and reimbursement for nonpharmacologic therapies for cancer‐related fatigue
Authors: Djalilova Dilorom , Mandolfo Natalie , Berger Ann M. , Cramer Mary E. 
Published: April 2019

AbstractCancer‐related fatigue (CRF) is an important public health issue that involves millions of community‐dwelling cancer survivors. CRF is the most debilitating patient reported symptom related to cancer therapies and exacts a significant economic and social toll. It adversely impacts patients' work, social relationships, and overall quality of life. CRF prevalence ranges from 30% to 90% during therapy and often persists months and years afterwards. This policy analysis examines the problem of lack of patient access to evidence‐based nonpharmacologic CRF therapies. The authors use a five‐step process described by Teitelbaum & Wilenski (2017) to address the problem statement, identify key stakeholders, explore problem landscape, describe two viable policy options, and make a recommendation. The two policy options considered were: (a) insurer reimbursements modeled after existing cardiac rehabilitation programs and (b) health care provider incentives that incorporate the oncology care model (OCM) quality measure. Advantages and disadvantages of both options are presented. Public health nurses are uniquely positioned in their communities to advocate for these changes to improve population health.
Different Photosynthetic Responses of Pyropia yezoensis to Ultraviolet Radiation Under Changing Temperature and Photosynthetic Active Radiation Regimes
Authors: Bao Menglin , Hu Lili , Fu Qianqian , Gao Guang , Li Xinshu , Xu Juntian 
Published: April 2019

AbstractMacroalgae play a crucial role in coastal marine ecosystems, but they are also subject to multiple challenges due to tidal and seasonal alterations. In this work, we investigated the photosynthetic response of Pyropia yezoensis to ultraviolet radiation (PAR: 400–700 nm; PAB: 280–700 nm) under changing temperatures (5, 10 and 15°C) and light intensities (200, 500 and 800 μmol photons m−2 s−1). Under low light intensity (200 μmol photons m−2 s−1), P. yezoensis showed the lowest sensitivity to ultraviolet radiation, regardless of temperature. However, higher temperatures inhibited the repair rates (r) and damage rates (k) of photosystem II (PSII) in P. yezoensis. However, under higher light intensities (500 and 800 μmol photons m−2 s−1), P. yezoensis showed higher sensitivity to UV radiation. Both r and the ratio of repair rate to damage rate (r:k) were significantly inhibited in P. yezoensis by PAB, regardless of temperature. In addition, higher temperatures significantly decreased the relative UV‐inhibition rates, while an increased carbon fixation rate was found. Our study suggested that higher light intensities enhanced the sensitivity to UV radiation, while higher temperatures could relieve the stress caused by high light intensity and UV radiation.