bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Antihypertensive Medication on Cerebral Small Vessel Disease
Authors: van Middelaar Tessa , Argillander Tanja E. , Schreuder Floris H.B.M. , Deinum Jaap , Richard Edo , Klijn Catharina J.M. 
Published: May 2018

Background and Purpose—
Hypertension is an important risk factor for cerebral small vessel disease. We aimed to study the effect of antihypertensive medication (AHM) on the progression of cerebral small vessel disease.

Methods—
We performed a systematic literature search of electronic databases up to January 30, 2017, for randomized controlled trials on the effect of AHM on ≥1 cerebral small vessel disease magnetic resonance imaging markers (ie, white matter hyperintensities, lacunes, microbleeds, enlarged perivascular spaces, acute small subcortical infarcts, and brain atrophy) after ≥1 year. We performed a random-effects meta-analysis using standardized mean difference.

Results—

We included 4 trials, including patients with stroke, with diabetes mellitus, and people ≥70 years of age. Patients in the AHM group had less progression of white matter hyperintensity during 28 to 47 months (standardized mean difference, −0.19; 95% confidence interval, −0.32 to −0.06; I
2
=20%; n=1369). Two trials reported on progression of brain atrophy with conflicting results. None of the trials reported on other cerebral small vessel disease markers.

Conclusions—
AHM has a protective effect on the progression of white matter hyperintensities, but no effect on brain atrophy. There are no trials on the effect of AHM on lacunes, microbleeds, enlarged perivascular spaces, or acute small subcortical infarcts.
Impacts of the Madden–Julian Oscillation on Storm-Track Activity, Surface Air Temperature, and Precipitation over North America
Authors: Zheng Cheng , Kar-Man Chang Edmund , Kim Hye-Mi , Zhang Minghua , Wang Wanqiu 
Published: May 2018

AbstractIn this study, the intraseasonal variations in storm-track activity, surface air temperature, and precipitation over North America associated with the Madden–Julian oscillation (MJO) in boreal winter (November–April) are investigated. A lag composite strategy that considers different MJO phases and different lag days is developed. The results highlight regions over which the MJO has significant impacts on surface weather on intraseasonal time scales. A north–south shift of storm-track activity associated with the MJO is found over North America. The shift is consistent with the MJO-related surface air temperature anomaly over the eastern United States. In many regions over the western, central, and southeastern United States, the MJO-related precipitation signal is also consistent with nearby storm-track activity. An MJO-related north–south shift of precipitation is also found near the west coast of North America, with the precipitation over California being consistent with the MJO-related storm-track activity over the eastern Pacific. MJO-related temperature and storm-track anomalies are also found near Alaska. Further analyses of streamfunction anomalies and wave activity flux show clear signatures of Rossby wave trains excited by convection anomalies related to MJO phases 3 and 8. These wave trains propagate across the Pacific and North America, bringing an anticyclonic (cyclonic) anomaly to the eastern part of North America, shifting the westerly jet to the north (south), thereby modulating the surface air temperature and storm-track activity over the continent. Rossby waves associated with phases 2 and 6 are also found to impact the U.S. West Coast.
Primary Skull Base Lymphoma: Manifestations and Clinical Outcomes of a Great Imitator
Authors: Marinelli John P. , Modzeski Mara C. , Lane John I. , Van Gompel Jamie J. , Stokken Janalee K. , Thanarajasingam Gita , Carlson Matthew L. 
Published: May 2018

ObjectivesPrimary skull base lymphoma (PSBL) represents a rare manifestation of extranodal lymphoma. Presenting with nonspecific symptomatology and imaging findings, PSBL often masquerades as more common cranial base pathology and thus can present a diagnostic challenge. The objectives of this study were to characterize the manifestations and clinical outcomes of PSBL.Study DesignCase series and chart review.SettingTertiary referral center.Subjects and MethodsReview of 48 patients with PSBL treated between 1994 and 2016.ResultsThe median age at diagnosis was 60 years. Diffuse large B‐cell lymphoma comprised the most common subtype (56%). Presenting symptoms included diplopia (52%), trigeminal hypesthesia (38%), headache (29%), facial nerve weakness (25%), B‐symptoms (fevers, night sweats, and/or weight loss) (25%), and hearing loss (21%). Discrete lesions commonly mimicked meningioma, schwannoma, and nasopharyngeal carcinoma. Diffuse lesions imitated neurosarcoidosis, granulomatosis with polyangiitis, and carcinomatosis meningitis. Only 26% of all initial clinical evaluations suspected lymphoma. The combination of restricted diffusion on diffusion‐weighted imaging, an absence of flow voids or surrounding hyperostosis, bony erosion and/or marrow signal replacement, and heterogeneous contrast enhancement facilitated delineation between PSBL and common skull base pathology. Cerebrospinal fluid (CSF) analysis was diagnostic of lymphoma in 24% of cases. Lymphoma within CSF portended significantly worse overall survival (85% vs 18% at 3‐years; P <. 001).ConclusionA history significant for multiple cranial nerve palsies, B‐symptoms, and imaging findings inconsistent with common skull base pathology should raise suspicion for PSBL. CSF analysis in the setting of PSBL can provide diagnostic and prognostic value for patients.
In‐Office Endoscopic Laryngeal Laser Procedures: A Patient Safety Initiative
Authors: Anderson Jennifer , Bensoussan Yael , Townsley Richard , Kell Erika 
Published: May 2018

ObjectiveTo review complications of in‐office endoscopic laryngeal laser procedures after implementation of standardized safety protocol.MethodsA retrospective review was conducted of the first 2 years of in‐office laser procedures at St Michaels Hospital after the introduction of a standardized safety protocol. The protocol included patient screening, procedure checklist with standardized reporting of processes, medications, and complications. Primary outcomes measured were complication rates of in‐office laryngeal laser procedures. Secondary outcomes included hemodynamic changes, local anesthetic dose, laser settings, total laser/procedure time, and incidence of sedation.ResultsA total of 145 in‐office KTP procedures performed on 65 patients were reviewed. In 98% of cases, the safety protocol was fully implemented. The overall complication rate was 4.8%. No major complications were encountered. Minor complications included vasovagal episodes and patient intolerance. The rate of patient intolerance resulting early termination of anticipated procedure was 13.1%. Total local anesthetic dose averaged 172.9 mg lidocaine per procedure. The mean amount of laser energy dispersed was 261.2 J, with mean total procedure time of 48.3 minutes. Sixteen percent of patients had preprocedure sedation. Vital signs were found to vary modestly. Systolic blood pressure was lower postprocedure in 13.8% and symptomatic in 4.1%.DiscussionThe review of our standardized safety protocol has revealed that in‐office laser treatment for laryngeal pathology has extremely low complication rates with safe patient outcomes.Implications for PracticeThe trend of shifting procedures out of the operating room into the office/clinic setting requires new processes designed to promote patient safety.
Changing pattern and outcome of pediatric chest injuries in urban Syria
Authors: Darwish Bassam , Mahfouz Mohammad Z , Al-Nosairat Saeed , Izzat Mohammad Bashar 
Published: May 2018

Background Pediatric chest injuries were infrequent in our practice, but the outbreak of the Syrian crisis resulted in an increase in number and a change in the pattern of thoracic trauma incidents. We compared our experience of pediatric chest injuries before and during the crisis. Methods We reviewed the records of 256 children aged 12.8 ± 5 years who were admitted to our hospital with the diagnosis of chest trauma over a 12-year period. Collected data included mechanism of injury, associated injuries, method of management, length of hospital stay, complications, and mortality. Results The incidence of pediatric chest injuries increased significantly following the outbreak of the crisis, and penetrating injuries prevailed, mainly due to shrapnel, bullets, and stab wounds. Forty percent of patients with blunt injuries and 20% of those with penetrating injuries were managed conservatively, whereas urgent thoracotomies were indicated in 10%, mostly in patients with penetrating injuries. Associated injuries were more frequent in patients with blunt injuries and resulted in a longer hospital stay and an increased mortality rate. The overall mortality rate was 7.8% and it was higher in children younger than 7 years of age and in patients who had been subjected to blunt injuries. Conclusions There has been a recent substantial upsurge in the incidence of pediatric thoracic trauma, with a predominance of penetrating injuries. Most patients could be managed nonoperatively, but a small subset required an open thoracotomy. The presence of associated injuries constitutes the main determinant of prognosis in this group of patients.
Does Tai Chi improve balance and reduce falls incidence in neurological disorders? A systematic review and meta-analysis
Authors: Winser Stanley John , Tsang William WN , Krishnamurthy Karthikeyan , Kannan Priya 
Published: May 2018

Objective: To evaluate the effect of Tai Chi on balance and reducing falls incidence in neurological disorders. Data sources: AMED, Embase, Web of Science, SCOPUS, EBSCO and Medline from inception until February 2018. Review method: Randomized controlled trials of Tai Chi compared with active or no treatment control, measuring balance with the Berg Balance Scale or the Timed Up and Go Test and number of falls in neurological disorders were included. Methodological quality was assessed using PEDro and quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Results: A total of 10 studies involving 720 participants were reviewed. Seven studies were in Parkinson’s disease and three in stroke. Seven studies were of high methodological quality and three were low. Meta-analyses of balance measured with the Timed Up and Go Test in Parkinson’s disease revealed a statistically significant effect of Tai Chi compared to no treatment (weighted mean difference (WMD), –2.13; 95% confidence interval (CI), −3.26 to −1.00; P < 0.001) and was insignificant (WMD, −0.19; 95% CI, −1.74 to 1.35; P = 0.81) when compared with active treatment. Tai Chi significantly reduced falls incidence in Parkinson’s disease (odds ratio (OR), 0.47; 95% CI, 0.29 to 0.77; P = 0.003) and stroke (OR, 0.21; 95% CI, 0.09 to 0.48; P < 0.001). Balance measured with the Timed Up and Go Test comparing Tai Chi and active treatment was insignificant (WMD, 0.45; 95% CI, –3.43 to 2.54; P = 0.77) in stroke. Conclusion: Tai Chi is effective in reducing falls incidence in Parkinson’s disease and stroke. This systematic review did not find high-quality studies among other neurological disorders.
Palliative care volunteerism across the healthcare system: A survey study
Authors: Vanderstichelen Steven , Houttekier Dirk , Cohen Joachim , Van Wesemael Yanna , Deliens Luc , Chambaere Kenneth 
Published: May 2018

Background: Volunteers fulfil several roles in supporting terminally ill people and their relatives and can positively influence quality of care. Healthcare in many countries faces resource constraints and some governments now expect communities to provide an increasing proportion of palliative care. However, systematic insights into volunteer presence, tasks and training and organisational challenges for volunteerism are lacking. Aim: Describe organised volunteerism in palliative direct patient care across the Flemish healthcare system (Belgium). Design: A cross-sectional postal survey using a self-developed questionnaire was conducted with 342 healthcare organisations. Setting/participants: The study included full population samples of palliative care units, palliative day-care centres, palliative home care teams, medical oncology departments, sitting services, community home care services and a random sample of nursing homes. Results: Responses were obtained for 254 (79%) organisations; 80% have volunteers providing direct patient care. Psychosocial, signalling and existential care tasks were the most prevalent volunteer tasks. The most cited organisational barriers were finding suitable (84%) and new (80%) volunteers; 33% of organisations offered obligatory training (75% dedicated palliative care, 12% nursing homes). Differences in volunteer use were associated with training needs and prevalence of organisational barriers. Conclusion: Results suggest potential for larger volunteer contingents. The necessity of volunteer support and training and organisational coordination of recruitment efforts is emphasised. Organisations are encouraged to invest in adequate volunteer support and training. The potential of shared frameworks for recruitment and training of volunteers is discussed. Future research should study volunteerism at the volunteer level to contrast with organisational data.
Autologous Osteochondral Mosaicplasty for Centrally and Laterally Located, Advanced Capitellar Osteochondritis Dissecans in Teenage Athletes: Clinical Outcomes, Radiography, and Magnetic Resonance Imaging Findings
Authors: Funakoshi Tadanao , Momma Daisuke , Matsui Yuki , Kamishima Tamotsu , Matsui Yuichiro , Kawamura Daisuke , Nagano Yusuke , Iwasaki Norimasa 
Published: May 2018

Background: Autologous osteochondral mosaicplasty (ie, mosaicplasty) results in satisfactory clinical outcomes and reliable return to play for patients with large or unstable lesions due to osteochondritis dissecans (OCD) of the humeral capitellum. However, the association between the healing of the reconstructed cartilage and clinical outcomes remains unclear. Purpose: To evaluate the efficacy of mosaicplasty in teenage athletes through use of clinical scores and imaging. The secondary purpose was to compare the clinical outcomes with images of centrally and laterally located lesions. Study Design: Case series; Level of evidence, 4. Methods: This study analyzed 22 elbows (all male patients; mean age, 13.5 ± 1.2 years) with capitellar OCD managed with mosaicplasty. Patients were divided into 2 groups according to the location of the lesions: central (10 patients) and lateral (12 patients). Evaluation was performed through use of the clinical rating system of Timmerman and Andrews, plain radiographs, and magnetic resonance imaging (MRI; the cartilage repair monitoring system of Roberts). The mean follow-up period was 27.5 months (range, 24-48 months). Results: Lateral lesions were significantly larger than central lesions (147.1 ± 51.9 mm2 vs 95.5 ± 27.4 mm2, P = .01). No other significant differences were found between central and lateral lesions. Timmerman and Andrews scores for both central and lateral lesions improved significantly from 125.0 ± 30.1 points and 138.3 ± 34.5 points preoperatively to 193.5 ± 11.3 points and 186.7 ± 18.1 points, respectively, at final follow-up ( P < .0001, P < .0001). Radiography identified complete graft incorporation in all cases and the absence of severe osteoarthritic changes or displaced osteochondral fragments. In the lateral group, the radial head ratio at final follow-up (1.83 ± 0.23) was significantly larger than the preoperative findings (1.75 ± 0.14, P = .049). The quality of joint surface reconstruction was found to be acceptable for central and lateral lesions on MRI evaluation. Conclusion: Mosaicplasty resulted in satisfactory clinical outcomes and smooth cartilage surface integrity in teenage athletes with OCD on their return to competition-level sports activities irrespective of lesion location.
Associations between Depression and Health Behaviour Change: Findings from 8 Cycles of the Canadian Community Health Survey
Authors: Clayborne Zahra M. , Colman Ian 
Published: May 2018

Objectives: The primary objective of this study was to examine associations between depression and several measures of health behaviour change across 8 cycles of a population-based, cross-sectional survey of Canadians. The secondary objective of this study was to describe the prevalence of the types of health behaviour changes undergone/sought and types of barriers to change reported, comparing those with and without depression. Methods: The sample comprised 65,801 respondents to the Canadian Community Health Survey between 2007 and 2014. Past-year depression was assessed via structured interview (CIDI-SF). Measures of health behaviour change included recent changes made, desire to make changes, and barriers towards making changes. Analyses involved logistic regression, with estimates across cycles pooled using fixed-effects meta-analyses. Pooled prevalences of types of health behaviour changes undergone/sought and types of barriers to change experienced were reported, and associations with depression were examined. Results: Depression was associated with higher odds of reporting a recent health behaviour change (pooled odds ratio [OR] = 1.39; 95% confidence interval [CI], 1.30 to 1.48), desire to make health behaviour changes (pooled OR = 1.61; 95% CI, 1.49 to 1.74), and barriers towards change (pooled OR = 1.54; 95% CI, 1.44 to 1.65). The most common change undergone and sought was increased exercise; the most common barrier reported was a lack of willpower. Conclusions: Individuals dealing with depression are more likely to report recent health behaviour changes and the desire to make changes but are also more likely to report barriers towards change.
Estimating Prison Stays Among Current Prison Populations
Authors: Luallen Jeremy , Gaes Gerald , Cutler Christopher 
Published: May 2018

Background: Reporting estimates of length of stay in prison populations is a common objective in corrections research. Researchers and prison administrators use these estimates for many different purposes. These include projecting future prison operational and capacity needs, describing levels of punitiveness among states, and explaining the drivers of prison growth or decline. Because of their critical importance to so many dimensions of corrections and criminal justice, researchers have compared the merits of various methods to estimate prison length of stay. Objective: This article revisits a survival-based approach for estimating length of stay originally described in Patterson and Preston and uses historical prison data from the Bureau of Justice Statistics National Corrections Reporting Program to compare this method to alternatives. It also describes and tests the merits of extending this method to parametric frameworks. Method: Using 20 years of data in nine states, we model estimates of (1) average length of stay for the 1995 prison admission cohort and (2) length of stay distributions for the 1995 prison stock and compare estimates to true values for these samples over a 20-year period. We compare results derived from adjusted and unadjusted stock-flow calculations, release cohorts, and nonparametric and parametric survival models. Results: We demonstrate that estimates of length of stay using survival-based estimators consistently perform much better than other estimators and that there are advantages to using parametric estimation techniques over nonparametric ones. Parametric-based estimates are less variable and more reliable on average. Conclusion: We conclude that in the future, stay length estimates should be estimated using survival models like the ones we describe and that data exist which provide the means to do so effectively.
Acrylamide exerts its cytotoxicity in NIH/3T3 fibroblast cells by apoptosis
Authors: Sahinturk Varol , Kacar Sedat , Vejselova Djanan , Kutlu Hatice Mehtap 
Published: May 2018

Objective: Acrylamide is a chemical utilized in various industries, and many studies have demonstrated its toxicity. The NIH/3T3 mouse embryonic cell line is the standard cell line of fibroblasts, which have a pivotal role with their versatile functions in the body. However, only two studies have attempted to investigate the effect of acrylamide on these crucial cells. To fill this knowledge gap, we aimed to determine the effects of acrylamide on NIH/3T3 cells. Method: First, we performed the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide assay and calculated the IC50 dose of acrylamide. Then, we treated cells with the IC50 dose of acrylamide for 24 h and determined whether the dominant death mode of NIH/3T3 cells was apoptosis or necrosis by annexin V and caspase 3/7 assays. Finally, we performed confocal microscopy and transmission electron microscope (TEM) analysis for observing the morphological alterations. Results: MTT assay results showed that acrylamide treatment reduced the viability of NIH/3T3 cells dose-dependently and that the IC50 of acrylamide was 6.73 mM. Based on annexin V and caspase 3/7 assays, the dominant death mode of NIH/3T3 cells was determined to be apoptosis. Also, caspase 3/7 activities of the acrylamide-treated NIH/3T3 cells were three times greater than those of the untreated NIH/3T3 cells. Furthermore, we observed membrane blebbing, nuclear chromatin clumping, and cytoplasmic vacuolization in TEM analysis and apparent apoptotic bodies, nuclear fragmentations, and condensations in confocal microscopy. Conclusions: In conclusion, our results suggested that the IC50 of acrylamide against NIH/3T3 cells for 24 h was 6.73 mM and that acrylamide exerted its cytotoxic and anti-proliferative effects on these cells mainly via apoptosis.
Cancer nurses’ perceptions of ethical climate in Greece and Cyprus
Authors: Constantina Cloconi , Papastavrou Evridiki , Charalambous Andreas 
Published: May 2018

Background: In recent years, the interest in ethical climate has increased in the literature. However, there is limited understanding of the phenomenon within the cancer care context as well as between countries. Aim: To evaluate cancer nurses’ perceptions of hospital ethical climate in Greece and Cyprus. Research design: This was a quantitative descriptive–correlational comparative study with cancer nurses. Data were collected with the Greek version of the Hospital Ethical Climate Survey questionnaire in addition to demographic data. Participants and research context: In total, n = 235 cancer nurses working in cancer care settings in Greece and Cyprus were recruited at two national oncology nursing conferences. Ethical considerations: The study conforms to the principles of the World Medical Association Declaration of Helsinki and the relevant ethical approvals were obtained according to national law. Results: The results showed that in terms of the “Managers” dimension, participants working in Greek hospitals (4.30 ± 0.73) had a higher score compared to the Cyprus participants (3.66 ± 0.93) (t = −5.777, p ≤ 0.001). The perceptions of nurses working in oncology units in Greece regarding the ethical climate were more positive compared to Cyprus (M = 3.67 for Greece and M = 3.53 for Cyprus, p ≤ 0.001). Nurses with a higher level of education had a lower average ethical climate score across all dimensions. All dimensions exhibit positive and moderate to high correlations between them (r = 0.414–0.728, p < 0.01). Conclusion: It is imperative to evaluate and improve the hospital ethical climate that prevails in each cancer care department. This highlights the fact that nurses working in seemingly similar cultural and organizational contexts might still have different perceptions of the ethical climate. Despite these differences, it is necessary to create the right conditions to address ethical issues. A positive ethical climate requires good relationships between healthcare professionals and the presence of good teamwork in order to ensure better healthcare provision.