bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-invasive assessment of arterial pulsatility in patients with continuous-flow left ventricular assist devices
Authors: Cross Troy J , Sajgalik Pavol , Fabian Vratislav , Matera Lukas , Kushwaha Sudhir S , Maltais Simon , Stulak John M , Schirger John A , Johnson Bruce D 
Published: August 2019

Introduction: Long-term use of continuous-flow left ventricular assist devices may have negative consequences for autonomic, cardiovascular and gastrointestinal function. It has thus been suggested that non-invasive monitoring of arterial pulsatility in patients with a left ventricular assist device is highly important for ensuring patient safety and longevity. We have developed a novel, semi-automated frequency-domain-based index of arterial pulsatility that is obtained during suprasystolic occlusions of the upper arm: the ‘cuff pulsatility index’. Purpose: The purpose of this study was to evaluate the relationship between the cuff pulsatility index and invasively determined arterial pulsatility in patients with a left ventricular assist device. Methods: Twenty-three patients with a left ventricular assist device with end-stage heart failure (six females: age = 65 ± 9 years; body mass index = 30.5 ± 3.7 kg m−2) were recruited for this study. Suprasystolic occlusions were performed on the upper arm of the patient’s dominant side, from which the cuff pressure waveform was obtained. Arterial blood pressure was obtained from the radial artery on the contralateral arm. Measurements were obtained in triplicate. The relationship between the cuff pressure and arterial blood pressure waveforms was assessed in the frequency-domain using coherence analysis. A mixed-effects approach was used to assess the relationship between cuff pulsatility index and invasively determined arterial pulsatility (i.e. pulse pressure). Results: The cuff pressure and arterial blood pressure waveforms demonstrated a high coherence up to the fifth harmonic of the cardiac frequency (heart rate). The cuff pulsatility index accurately tracked changes in arterial pulse pressure within a given patient across repeated measurements. Conclusions: The cuff pulsatility index shows promise as a non-invasive index for monitoring residual arterial pulsatility in patients with a left ventricular assist device across time.
Effectiveness of an Advanced Critical Care Echocardiography Course
Authors: Sarkar Pralay Kumar , Boivin Michel , Mayo Paul H. 
Published: August 2019

Background: Advanced critical care echocardiography (CCE) involves comprehensive assessment of cardiac structure and function for frontline critical care applications. This study reports the effectiveness of a 3-day course in advanced CCE. Methods: We studied the outcome of 5 consecutive advanced CCE courses delivered between 2013 and 2017. A total number of 239 learners were studied. The course included didactic lectures, image interpretation sessions, and hands-on training with normal individuals as models. Training domains included left ventricular structure and function, right ventricular structure and function, valve function using comprehensive 2-dimensional imaging, and Doppler-based measurements for cardiac pressures and flows. Measurements of course outcome included pre- and postcourse assessment of knowledge, image acquisition, and image interpretation skills. Learners rotated between hands-on training and interpretation sessions. The teacher-to-learner ratio was 1:3 during hands-on training. Interpretation sessions consisted of review of normal and abnormal echocardiographic videos with interactive small groups. Learners completed a video-based knowledge assessment examination before and after completion of the course. Hands-on image acquisition skills were tested at the completion of the course during all the years. For years 2016 and 2017, a precourse hands-on skill test was also performed. Results: There was a statistically significant improvement in knowledge and image interpretation skills in the cohort of 239 learners over 5 years of study period. There was improvement in image acquisition skills over the 2-year period when it was measured pre- and postcourse. Conclusions: A 3-day course on advanced CCE resulted in improvement knowledge/image interpretation and hands-on image acquisition skills. Clinical Implications: Advanced CCE has assumed an important place in hemodynamic monitoring of critically ill patients. A course of similar design may facilitate training of frontline clinicians in advanced CCE.
Exploring North Carolina Family and Consumer Sciences Teachers’ Attitudes Towards Breastfeeding and Infant Feeding Education Practices
Authors: Singletary Nicola , Goodell L. Suzanne , Fogleman April 
Published: August 2019

Background The World Health Organization (WHO) and the United Kingdom Committee for UNICEF recommend that secondary schools include infant feeding education in the curriculum. However, little attention has been given to the study of educators’ views and practices regarding infant feeding education. Aims The aims of this research were to (1) explore North Carolina Family and Consumer Sciences teachers’ attitudes towards infant feeding education in secondary schools and (2) describe North Carolina Family and Consumer Sciences teachers’ infant feeding education practices. Methods Researchers conducted interviews ( N = 19) and a survey ( N = 137) using a sequential mixed methods design. The constant comparative method was used to analyze interview transcripts. Subsequently, a 33-item survey was developed to assess teachers’ attitudes and practices, and this survey was tested for validity and reliability. Results The majority of participants supported including infant feeding ( n = 119, 86.9%) and breastfeeding ( n = 116, 84.7%) education in high school. Approximately half of the participants supported including infant feeding ( n = 71, 51.9%) and breastfeeding ( n = 64, 46.7%) education in middle school. Participants reported that they taught infant feeding at both levels; topics taught included complementary foods, patterns of infant feeding, and the safe preparation of infant formula. Breastfeeding content was covered primarily in the high school Parenting and Child Development course. Conclusions North Carolina Family and Consumer Sciences teachers have positive attitudes towards teaching about breastfeeding at the secondary school level. Content about infant nutrition and breastfeeding is currently included in courses that cover child development and human nutrition.
What Predicts Hospital Admissions in Community-Dwelling People With Parkinsonism?
Authors: Sebastian Roshan , Gray William K. , Foley Aishling , Trendall Lydia , Oh Doori , Hand Annette , Dodds Steve , McClenaghan Elliot , Santos Vasco Dos , Oates Lloyd L. , Fisher James , Walker Richard W. 
Published: August 2019

Objectives: Previous studies have looked at the reasons for hospital admission in people with parkinsonism (PwP), yet few have looked at factors that precipitate admission. Methods: People with parkinsonism with a diagnosis of idiopathic Parkinson disease of Hoehn and Yahr stage III-V and those with Parkinson plus syndromes were assessed for motor and nonmotor symptoms, quality of life, and functional performance. Logistic regression was used to investigate predictors of hospital admission over the subsequent 2 years. Results: Overall, 162 patients consented to be part of the study. Seventy-one PwP (43.8%) had at least 1 hospital admission, and 17 (10.5%) patients had 3 or more admissions to hospital. Poorer cognition, more nonmotor symptoms, poorer quality of life, slower timed-up-and-go test scores, and abnormal swallow predicted a subsequent hospital admission. Discussion: Our study emphasizes the importance of nonmotor symptoms in predicting admission. A cost–benefit analysis of early intervention to prevent admission should be considered.
Impact of Incorporating Pharmacy Residents Into a Pharmacist-Managed Culture Review Service During Weekend Staffing Commitments
Authors: Campo Melissa , Samai Kathryn E. , Dean Jaymes E. , Lund Jeremy A. 
Published: August 2019

Background: Clinical pharmacy continues to rapidly evolve as does the need to incorporate unique learning opportunities in pharmacy residency training (eg, transitions of care). Objective: To describe the impact of incorporating pharmacy residents into a pharmacist-managed emergency department culture review service (CRS). Methods: This retrospective study included 500 cultures with positive results evaluated by a pharmacy resident during weekend staffing shifts for patients discharged from the emergency department or urgent care center (UCC). The primary outcome of this study was the number of interventions performed by pharmacy residents. Results: Of the 500 cultures evaluated, 275 (55%) required action by the pharmacy residents, resulting in 233 interventions. Modification of antimicrobial therapy occurred 70 times. When surveyed, a majority of residents strongly agreed that the CRS had a positive impact. Based on evaluations, residents achieved mastery of pertinent residency performance objectives. Conclusion: Incorporation of pharmacy residents into a pharmacist-managed emergency department CRS promotes safe and effective medication use to patients discharged from an emergency department or UCC while providing residents additional experience in designing a therapeutic regimen, providing education to patients, and communicating with health-care teams to manage medication therapy.
Process of Change and Effectiveness of Family Constellations: A Mixed Methods Single Case Study on Depression
Authors: Ramos Sandra , Ramos Jorge A. 
Published: August 2019

Aims: To analyze the process of change and the effectiveness of five sessions of family constellations (FC) using mixed methods in mixed settings (videoconference and in person). To obtain variables associated with processes and results. Methods: Using an exploratory design with mixed methods, this single case study used a triangulation of data: quantitative ( Escala de Ansiedade, Depressão e Stresse-21) and qualitative (the notes from the consultations and the patient’s responses to the Psychotherapeutic Process Data Mining Questionnaire [PPDMQ]). Results: The patient’s symptoms of depression went from a level of severe to normal, and the posttest results persisted after a 3-month follow-up. The severe depression seems to have been mitigated through interventions that promoted contact with reality, self-determination, the psychoemotional establishment of systemic places, and through finding meaning in autobiographical events. Conclusions: This article may encourage further studies that use the PPDMQ to create a metasynthesis and to gauge whether the effectiveness of FC, as a systemic, intergenerational, and integrative psychotherapy, could plausibly contribute to enrich the body of scientific evidence–based psychotherapies and mitigate the global escalation of depression.
Histologic evaluation of parovarian nodules in the cat
Authors: Haase-Berglund Meghann L , Yang Ching , Premanandan Christopher 
Published: August 2019

Objectives A notable, although relatively uncommon, finding during feline ovariohysterectomy is the presence of parovarian nodules, located proximal to the ovary, near or within the ovarian vascular bundle. They are usually 2–3 mm in diameter, white-to-tan in color and glandular in appearance. The objective of this study was to either decisively reinforce the existing findings reported in the literature, which suggest that these parovarian nodules are incidental adrenocortical nodules that are clinically and surgically insignificant, or capture any samples that were not ectopic adrenal tissue in order to characterize them histologically. Methods Ninety-one formalin-preserved tissue sections containing parovarian nodules were collected during routine feline elective ovariohysterectomy and evaluated histologically. Results Definitive histologic information was obtained from 73/91 (80.2%) submitted samples. Fifty-two of 73 (71.2%) samples were determined to contain accessory adrenal gland cortex. Twenty of 73 (27.4%) samples were determined to contain residual mesonephric structures. While accessory adrenocortical nodules were found bilaterally in cats of all ages, mesonephric structures were predominantly right-sided, and only found in one cat over the age of 1 year. Ectopic or accessory ovarian tissue was not found in any of the samples. Conclusions and relevance This study adds to the existing body of data which suggest these nodules are incidental structures that do not need to be removed during surgical sterilization. However, further in vivo studies with larger sample sizes and years of follow-up would be required to more definitively prove this theory.
Consumer Perception of Biotin Supplementation
Authors: John Jason J. , Lipner Shari R. 
Published: August 2019

Background Biotin is an essential cofactor for metabolic pathways in humans. It is frequently self-prescribed by consumers and often recommended by dermatologists and primary care physicians, despite limited evidence of its effect on skin, hair, and nail disorders. A recent Food and Drug Administration (FDA) warning stated that biotin can interfere with laboratory tests. Objectives Our objectives were to determine the perception of biotin by Amazon consumers, including perception of improvement in hair, skin, or nails with biotin supplementation and consumers’ awareness of the FDA warning on biotin. Methods The keyword biotin was searched on Amazon.com, and the top 1 percentile of biotin products according to average consumer review were analyzed for dosage, indications, price, quantity, warnings, number, and average score of reviews. Results From 16 biotin products analyzed, the mean review score was 4.38. The mean percentage of reviews stating that biotin helped hair, nails, and skin was 27.2%, 15.03%, and 2.8%, respectively. No biotin products mentioned the FDA warning, and only 1 reviewer referenced the warning. Conclusions These findings suggest that biotin supplementation is prevalent and perceived as helpful despite limited evidence of improvement. The majority of biotin users were unaware that biotin interacted with laboratory testing demonstrating the need for biotin manufacturers to include a warning label about the FDA warning and for physicians to warn their patients on the risks and benefits of biotin supplementation.
Assessing the Effect of Clinical Trial Evidence and Anecdote on Caregivers’ Willingness to Use Corticosteroids: A Randomized Controlled Trial
Authors: Johnson Matthew C. , Pona Adrian , Adler-Neal Adrienne L. , Kesty Chelsea , Cline Abigail , Feldman Steven R. 
Published: August 2019

Background: Treatment of childhood atopic dermatitis (AD) is hindered by nonadherence, but caregiver reassurance may help overcome this hurdle. Objectives: To assess caregivers’ willingness to treat childhood AD with a corticosteroid when presented with clinical trial evidence, anecdote, or both. Methods: A total of 476 caregivers were recruited through a dermatology clinic and online crowdsourcing platform. Subjects were randomized to receive clinical trial evidence, anecdote, or both, using either the term “medication” or “topical steroid.” Additional caregivers were queried about their willingness to treat with the doctor’s recommendation or without knowledge of its safety information. Responses were recorded on a 10-point Likert scale. Results: Caregivers’ willingness to treat was higher in all information assignment groups compared to those not provided with safety information: clinical trial evidence of a “medication” ( P = .003; Cohen’s d = 0.83) or “topical steroid” ( P = .030; d = 0.55), anecdote of a “medication” ( P < .0001; d = 1.37) or “topical steroid” ( P < .0001; d = 0.85), both clinical trial evidence and anecdote of a “medication” ( P < .0001; d = 1.00) or “topical steroid” ( P = .000; d = 0.89), and simply the doctor’s recommendation ( P < .0001; d = 0.92). Significance was corrected for multiple comparisons to 0.0018. There were no differences between caregivers of children with and without AD ( P = .36). Conclusions: Providing anecdotal reassurance, even in the setting of reported high willingness to treat with the doctor’s recommendation, may be an effective strategy to improve caregivers’ perceptions of starting new medications.
Computed tomography perfusion in stroke mimics
Authors: Siegler James E , Rosenberg Jon , Cristancho Daniel , Olsen Andrew , Pulst-Korenberg Johannes , Raab Lindsay , Cucchiara Brett , Messé Steven R 
Published: August 2019

Objective To describe the prevalence and patterns of abnormal findings on automated computed tomography perfusion in patients with stroke mimic. Methods We reviewed a retrospective multi-site cohort of consecutive patients undergoing computed tomography perfusion for suspected acute ischemic stroke within 24 h from last normal (June 2017 to December 2017). The primary outcome was the diagnosis of stroke mimic. Hypoperfusion abnormalities on iSchemaView RAPID automated computed tomography perfusion were compared between patients with stroke/transient ischemic attack and stroke mimic using mixed-effects multivariable logistic regression, focusing on absence of perfusion abnormalities and discordance with clinical symptoms and computed tomography angiography findings. Results Of 410 consecutive patients who underwent computed tomography perfusion, 348 met inclusion criteria (178 (51%) stroke, 19 (6%) transient ischemic attack, and 151 (43%) mimic). Time-to-maximum of the tissue residue function (Tmax>6s) abnormalities were seen in 42 (28%) patients with stroke mimic and 122 (62%) patients with stroke/transient ischemic attack ( p < 0.001). Patients with stroke mimic were more likely to have a normal Tmax pattern (volume = 0mL; adjusted OR: 2.2, 95% CI: 1.1–4.3, p = 0.02). When the Tmax pattern was abnormal, a higher proportion of patients with stroke mimic had Tmax patterns fully discordant with clinical symptoms than patients with stroke/transient ischemic attack (28/39 (71%) vs. 10/115 (9%), p < 0.001). Fully discordant Tmax abnormalities were strongly associated with stroke mimic (adjusted OR: 48.6, 95% CI: 7.0–336, p < 0.001), with a negative predictive value for identifying mimic of 91% (95% CI: 85–94%). Conclusion While one-quarter of patients with stroke mimic show Tmax abnormalities on automated RAPID computed tomography perfusion imaging, the majority of patterns were discordant with symptoms and vessel status. Normal or fully discordant Tmax abnormalities are were more common with stroke mimic and may inform stroke treatment decision making.
Distribution and current problems of acute endovascular therapy for large artery occlusion from a two-year national survey in Japan
Authors: Takagi Toshinori , Yoshimura Shinichi , Sakai Nobuyuki , Iihara Koji , Oishi Hidenori , Hirohata Masaru , Matsumaru Yuji , Matsumoto Yasushi , Yamagami Hiroshi , Menon Bijoy K , Almekhlafi Mohammed , Holodinsky Jessalyn K , Kamal Noreen , Hill Michael D , Goyal Mayank 
Published: August 2019

Background Endovascular treatment is recommended in clinical practice in Japan. However, its utilization and comprehensiveness are less well described. Aims To report endovascular treatment utilization and overall geographical coverage in Japan and to analyze regional differences in the number of endovascular treatments, specialists, and endovascular treatment-capable hospitals. Methods A national survey of members of the Japanese Society for NeuroEndovascular Therapy (JSNET) was conducted in 2017 and 2018. The total number of endovascular treatment cases per year was estimated, and the number of endovascular treatment cases per 100,000 people was calculated using the 2015 census. The distribution of treatment hospitals and JSNET specialists was mapped and the population coverage rate was determined. Results The total number of endovascular treatment cases in Japan increased by 34.5% from 2016 (7702) to 2017 (10,360). The number of endovascular treatment-capable hospitals in Japan increased from 597 in 2016 to 693 in 2017, with an average annual caseload of 14.9 in 2017. The number of JSNET specialists per hospital decreased from 1.81 in 2016 to 1.76 in 2017 because of the increase in endovascular treatment-capable hospitals. Only 50 (7.2%) hospitals had > 40 endovascular treatment cases annually. The majority (97.7%) of the Japanese population lives within a 60-min drive of any endovascular treatment-capable hospital. However, only 70.4% live within a 60-min drive of a high-volume center (>40 cases annually). Conclusions Utilization of endovascular treatment in Japan is increasing; however, the number of cases per hospital remains low, as is the number of specialists per endovascular treatment-capable hospital. Increased number of specialists and centralization of endovascular treatment services may improve patient outcomes.
Association between circulating tumor cells and peripheral blood monocytes in metastatic breast cancer
Authors: De Giorgi Ugo , Mego Michal , Scarpi Emanuela , Giordano Antonio , Giuliano Mario , Valero Vicente , Alvarez Ricardo H. , Ueno Naoto T. , Cristofanilli Massimo , Reuben James M. 
Published: August 2019

Background: We retrospectively evaluated the correlation between a baseline measurement of circulating tumor cells (CTCs) and inflammation-based scores in patients with metastatic breast cancer (MBC). Methods: The optimal value of inflammation-based scores as the neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), monocyte–lymphocyte ratio (MLR) and systemic immune-inflammation index (SII) to predict survival was determined and compared with CTC <5 or ⩾5 per 7.5 ml of blood. Results: In the overall population of 516 women with MBC, CTCs correlated with peripheral blood monocytes ( p = 0.008) and neutrophils ( p = 0.038). In triple-negative tumors, CTCs correlated with monocyte count ( p = 0.009); in HER2+ tumors, CTCs correlated with neutrophil count ( p = 0.009), with a trend versus monocyte count ( p = 0.061), whereas no correlation was found in HER2– estrogen receptor-positive (ER+) tumors. In multivariate analysis only monocytes were associated with ⩾5 CTCs (OR = 2.72, 95% CI 1.09–6.80, p = 0.033). In multivariable analysis for predictors of overall survival, CTC (⩾5 versus <5), number of metastatic sites (>1 versus 1), tumor subtypes (triple-negative versus HER2– ER+ tumors) and MLR only remained significant. Conclusions: CTC and MLR are predictors of overall survival in MBC. CTC correlates with monocytes, in particular in triple-negative tumors.