bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shared decision-making about cardiovascular disease medication in older people: a qualitative study of patient experiences in general practice
Authors: Jansen Jesse , McKinn Shannon , Bonner Carissa , Muscat Danielle Marie , Doust Jenny , McCaffery Kirsten 
Published: March 2019

ObjectivesTo explore older people’s perspectives and experiences with shared decision-making (SDM) about medication for cardiovascular disease (CVD) prevention.Design, setting and participantsSemi-structured interviews with 30 general practice patients aged 75 years and older in New South Wales, Australia, who had elevated CVD risk factors (blood pressure, cholesterol)orhad received CVD-related lifestyle advice. Data were analysed by multiple researchers using Framework analysis.ResultsTwenty eight participants out of 30 were on CVD prevention medication, half with established CVD. We outlined patient experiences using the four steps of the SDM process, identifying key barriers and challenges: Step 1. Choice awareness: taking medication for CVD prevention was generally not recognised as a decision requiring patient input; Step 2. Discuss benefits/harms options: CVD prevention poorly understood with emphasis on benefits; Step 3. Explore preferences: goals, values and preferences (eg, length of life vs quality of life, reducing disease burden vs risk reduction) varied widely but generally not discussed with the general practitioner; Step 4. Making the decision: overall preference for directive approach, but some patients wanted more active involvement. Themes were similar across primary and secondary CVD prevention, different levels of self-reported health and people on and off medication.ConclusionsResults demonstrate how older participants vary widely in their health goals and preferences for treatment outcomes, suggesting that CVD prevention decisions are preference sensitive. Combined with the fact that the vast majority of participants were taking medications, and few understood the aims and potential benefits and harms of CVD prevention, it seems that older patients are not always making an informed decision. Our findings highlight potentially modifiable barriers to greater participation of older people in SDM about CVD prevention medication and prevention in general.
Radiation protection effect of mobile shield barrier for the medical personnel during endoscopic retrograde cholangiopancreatography: a quasi-experimental prospective study
Authors: Chung Kwang Hyun , Park Young Sook , Ahn Sang Bong , Son Byoung Kwan 
Published: March 2019

ObjectiveTo investigate the effectiveness of radiation protection offered by a newly designed mobile shield barrier for medical personnel during endoscopic retrograde cholangiopancreatography (ERCP).DesignQuasi-experimental prospective study.SettingERCP procedures conducted between October 2016 and June 2017 at a single secondary referral hospital that performs approximately 250 therapeutic ERCP procedures annually.InterventionsThe mobile shield barrier was a custom-made 2 mm Pb shielding plate (width: 120 cm, height: 190 cm) with a 0.5 mm Pb window (width: 115 cm, height: 60 cm) on its upper part was used. Four wheels were attached to the bottom to allow easy moving.Primary and secondary outcome measuresThe radiation doses were measured during ERCP using personal thermoluminescence dosimetry (TLD) badges on both sides of the mobile shield barrier (patient’s side: TLD1 and medical staff’s side: TLD2). The radiation doses were also measured on the outer surface of the thyroid shield of the endoscopist (TLD3), and on the chest area inside the protective apron of the endoscopist (TLD4) and the main assistant (TLD5). The TLD was changed and reported once every 3 months. The radiation dose measured by TLD badges were compared.ResultsDuring the study period, a total of 128 ERCP procedures were performed. The mean fluoroscopy time per procedure was 244.9±257.0 s and the mean number of digital radiographs per procedure was 3.7±1.0. TLD1 (outside the barrier) had a mean radiation dose of 26.85±3.47 mSv and all the other TLDs (inside the barrier) had less than 1 mSv (p<0.001). In the post hoc analysis, the difference between TLD1 and others showed a statistical significance; however, there were no significant differences between the TLDs inside the barrier.ConclusionOur mobile shield barrier was useful to reduce the radiation exposure of medical personnel during ERCP.
External continuous ECG versus loop recording for atrial fibrillation detection in patients who had a stroke
Authors: Sejr Michala Herskind , May Ole , Damgaard Dorte , Sandal Birgitte Forsom , Nielsen Jens Cosedis 
Published: March 2019

BackgroundDetection of atrial fibrillation (AF) in patients who had ischaemic stroke and transient ischaemic attack (IS/TIA) is recommended. We aimed to compare external loop recording (ELR) against simultaneous continuous ECG recording for AF detection in patients who had acute IS/TIA and determine sensitivity, specificity and positive predictive value of AF detection using ELR. We hypothesised ELR to detect 15% fewer patients with AF than continuous ECG recording.MethodsIn this prospective cohort study, we included 1412 patients who had acute IS/TIA without prior AF. Monitoring was 48 hours. Primary outcome was AF >30 s. Cardiologist verified AF in continuous ECG was gold standard.ResultsIn continuous ECG, 38 (2.7%) patients had AF. ELR automatically categorised 219/1412 patients (15.5%) with AF, including 32/38 (85%) patients with AF in continuous ECG. After cardiologist adjudication of ELR recordings, AF was diagnosed in 57/219 patients, of which 32 (56%) had AF in continuous ECG. For adjudicated AF detection by ELR, sensitivity was 84%, 95% CI (69% to 94%), specificity was 98%, 95% CI (97% to 99%) and positive predictive value was 56%, 95% CI (42% to 69%).ConclusionAutomatic AF detection with ELR results in an AF diagnosis in more than five patients without AF for each patient with AF as verified in continuous ECG. For adjudicated AF detection by ELR, sensitivity was confirmed to 84% and specificity 98%. Automatic ELR as investigated in this study may be considered to rule out AF, but it is not suitable as a single monitoring device for AF screening in patients early after stroke.Trial registration numberNCT02155907.
Thermodynamic properties of a multiferroic antiferromagnetic spin system: The influence of Dzyaloshinskii Moriya interaction
Authors: Tchoffo Martin , Gueagni William Degaulle Waladi , Fouokeng Georges Collince , Kenfack Lionel Tenemeza , Fai Lukong Cornelius 
Published: March 2019

In this paper, we address the influence of Dzyaloshinskii Moriya (DM) interaction on the thermodynamic properties of a multiferroic antiferromagnetic spin system using the spin wave theory (SWT) as a diagonalization method which, associated to the statistical physics, helps to evaluate the statistical sum. The basic factors in thermodynamics, such as the Boltzmann entropy and the specific heat capacity at thermal equilibrium, are obtained. Analyzing the numerical results, it follows that the DM interaction is the best candidate that can help to maintain in long time the system in its coherent state. Furthermore, we find that the influence of the DM interaction is more accentuated at low-temperature and that it enables the system to release heat energy. On the other hand, the fact that the specific heat capacity tends to the constant clearly shows that the system obeys the Dulong–Petit law. In addition, our results also show that for high magnetic field (greater than B[Formula: see text]=[Formula: see text]30 Tesla), the magnetic field dependence of both entropy and specific heat shows a peak-like behavior and that the DM interaction raises the corresponding critical magnetic field but lowers the peak amplitude. It follows that the spin-flop transition occurs in the system and that the strong magnetic field withdraw the antiferromagnetic phase. Overall, we find that the DM interaction is a promising candidate for the control of our system.
Artificial neural network assisted by first-principles calculations for predicting transformation temperatures in shape memory alloys
Authors: Minami Daichi , Uesugi Tokuteru , Takigawa Yorinobu , Higashi Kenji 
Published: March 2019

A key property for the design of new shape memory alloys is their working temperature range that depends on their transformation temperature T0. In previous works, T0 was predicted using a simple linear regression with respect to the energy difference between the parent and the martensitic phases, [Formula: see text]E[Formula: see text]. In this paper, we developed an accurate method to predict T0 based on machine learning assisted by the first-principles calculations. First-principles calculations were performed on 15 shape memory alloys; then, we proposed an artificial neural network method that used not only computed [Formula: see text]E[Formula: see text] but also bulk moduli as input variables to predict T0. The prediction error of T0 was improved to 49 K for the proposed artificial neural network compared with 188 K for simple linear regression.
Elevated plasma homocysteine and cysteine are associated with endothelial dysfunction across menopausal stages in healthy women
Authors: Keller Amy C. , Klawitter Jelena , Hildreth Kerry L. , Christians Uwe , Putnam Kelly , Kohrt Wendy M. , Reusch Jane E. B. , Moreau Kerrie L. 
Published: March 2019

Hyperhomocysteinemia is associated with endothelial dysfunction and increased cardiovascular disease (CVD). We determined whether elevated homocysteine (Hcy) and markers of Hcy metabolism were associated with the previously reported endothelial dysfunction across stages of the menopause transition. Brachial artery flow-mediated dilation (FMD) and plasma concentrations of Hcy, cysteine, and methionine were measured in healthy women ( n = 128) 22–70 yr of age categorized as premenopausal ( n = 35), perimenopausal (early: n = 16; late: n = 21), and postmenopausal (early: n = 21; late: n = 35). Dietary intake of micronutrients involved in Hcy metabolism (e.g., vitamins B6, B12, folate) was assessed in a subpopulation of women. Hcy and cysteine concentrations were progressively higher, and methionine was progressively lower across menopausal stages (all P < 0.005). The higher Hcy and cysteine concentrations correlated with lower circulating estradiol levels ( r = −0.49 and −0.50, respectively, both P < 0.001). FMD was inversely correlated with Hcy ( r = −0.25, P = 0.004) and cysteine ( r = −0.39, P < 0.001) and positively correlated with methionine concentrations ( r = 0.25, P = 0.005). Dietary intake of vitamins B6 and B12 (both P < 0.05) were lower in postmenopausal women. Vitamin B12 intake correlated with FMD ( r = 0.22, P = 0.006). These data suggest that declines in estradiol across stages of the menopause transition may lead to elevations in Hcy and cysteine that may contribute to endothelial dysfunction in postmenopausal women. Future studies should examine whether targeting Hcy metabolism during the perimenopausal to early postmenopausal period with interventions, including diet, attenuates or reverses the decline in endothelial function in women.NEW & NOTEWORTHY Declines in circulating estradiol across the stages of the menopausal transition may lead to elevations in Hcy and cysteine concentrations that may contribute to endothelial dysfunction. Abnormalities in the Hcy metabolic pathways, possibly related to dietary deficiencies of vitamins B12 and B6 and folate, may contribute to elevations in Hcy and cysteine concentrations. Findings also suggest that higher cysteine levels may be more damaging to the vascular endothelium than Hcy.
Seven days of cold acclimation substantially reduces shivering intensity and increases nonshivering thermogenesis in adult humans
Authors: Gordon Kyle , Blondin Denis P. , Friesen Brian J. , Tingelstad Hans Christian , Kenny Glen P. , Haman François 
Published: March 2019

Daily compensable cold exposure in humans reduces shivering by ~20% without changing total heat production, partly by increasing brown adipose tissue thermogenic capacity and activity. Although acclimation and acclimatization studies have long suggested that daily reductions in core temperature are essential to elicit significant metabolic changes in response to repeated cold exposure, this has never directly been demonstrated. The aim of the present study is to determine whether daily cold-water immersion, resulting in a significant fall in core temperature, can further reduce shivering intensity during mild acute cold exposure. Seven men underwent 1 h of daily cold-water immersion (14°C) for seven consecutive days. Immediately before and following the acclimation protocol, participants underwent a mild cold exposure using a novel skin temperature clamping cold exposure protocol to elicit the same thermogenic rate between trials. Metabolic heat production, shivering intensity, muscle recruitment pattern, and thermal sensation were measured throughout these experimental sessions. Uncompensable cold acclimation reduced total shivering intensity by 36% ( P = 0.003), without affecting whole body heat production, double what was previously shown from a 4-wk mild acclimation. This implies that nonshivering thermogenesis increased to supplement the reduction in the thermogenic contribution of shivering. As fuel selection did not change following the 7-day cold acclimation, we suggest that the nonshivering mechanism recruited must rely on a similar fuel mixture to produce this heat. The more significant reductions in shivering intensity compared with a longer mild cold acclimation suggest important differential metabolic responses, resulting from an uncompensable compared with compensable cold acclimation. NEW & NOTEWORTHY Several decades of research have been dedicated to reducing the presence of shivering during cold exposure. The present study aims to determine whether as little as seven consecutive days of cold-water immersion is sufficient to reduce shivering and increase nonshivering thermogenesis. We provide evidence that whole body nonshivering thermogenesis can be increased to offset a reduction in shivering activity to maintain endogenous heat production. This demonstrates that short, but intense cold stimulation can elicit rapid metabolic changes in humans, thereby improving our comfort and ability to perform various motor tasks in the cold. Further research is required to determine the nonshivering processes that are upregulated within this short time period.
Recombinant LCAT (Lecithin:Cholesterol Acyltransferase) Rescues Defective HDL (High-Density Lipoprotein)-Mediated Endothelial Protection in Acute Coronary Syndrome
Authors: Ossoli Alice , Simonelli Sara , Varrenti Marisa , Morici Nuccia , Oliva Fabrizio , Stucchi Miriam , Gomaraschi Monica , Strazzella Arianna , Arnaboldi Lorenzo , Thomas Michael J. , Sorci-Thomas Mary G. , Corsini Alberto , Veglia Fabrizio , Franceschini Guido , Karathanasis Sotirios K. , Calabresi Laura 
Published: March 2019

Objective—
Aim of this study was to evaluate changes in LCAT (lecithin:cholesterol acyltransferase) concentration and activity in patients with an acute coronary syndrome, to investigate if these changes are related to the compromised capacity of HDL (high-density lipoprotein) to promote endothelial nitric oxide (NO) production, and to assess if rhLCAT (recombinant human LCAT) can rescue the defective vasoprotective HDL function.

Approach and Results—
Thirty ST-segment–elevation myocardial infarction (STEMI) patients were enrolled, and plasma was collected at hospital admission, 48 and 72 hours thereafter, at hospital discharge, and at 30-day follow-up. Plasma LCAT concentration and activity were measured and related to the capacity of HDL to promote NO production in cultured endothelial cells. In vitro studies were performed in which STEMI patients’ plasma was added with rhLCAT and HDL vasoprotective activity assessed by measuring NO production in endothelial cells. The plasma concentration of the LCAT enzyme significantly decreases during STEMI with a parallel significant reduction in LCAT activity. HDL isolated from STEMI patients progressively lose the capacity to promote NO production by endothelial cells, and the reduction is related to decreased LCAT concentration. In vitro incubation of STEMI patients’ plasma with rhLCAT restores HDL ability to promote endothelial NO production, possibly related to significant modification in HDL phospholipid classes.

Conclusions—
Impairment of cholesterol esterification may be a major factor in the HDL dysfunction observed during acute coronary syndrome. rhLCAT is able to restore HDL-mediated NO production in vitro, suggesting LCAT as potential therapeutic target for restoring HDL functionality in acute coronary syndrome.
Should skin picking disorder be considered a diagnostic category? A systematic review of the evidence
Authors: Jenkins Zoe , Zavier Hyacinta , Phillipou Andrea , Castle David 
Published: March 2019

Objectives: The aim of this study was to conduct a systematic review of the literature to collect, analyse and synthesise the evidence on skin picking disorder as defined by Arnold’s criteria or the Diagnostic and Statistical Manual of Mental Disorders – fifth edition (DSM-5) and to examine whether skin picking disorder warrants inclusion in the DSM-5 as a distinct disorder. Method: The databases CINAHL, Medline, Embase and PsycINFO were searched for articles published between January 2008 and May 2018. Eligible articles were empirical studies that used Arnold’s or DSM-5 criteria to diagnose skin picking disorder, published in English, with participants aged 18 years or older. The methodological quality of included studies was assessed according to the National Health and Medical Research Council’s guidelines and suggested nosological classification of skin picking disorder were summarised. Eligible studies were assessed against the five criteria proposed by Blashfield and colleagues to determine the validity of the inclusion of skin picking disorder in the DSM-5. Results: A total of 20 studies were considered eligible out of 1554. Most of the papers were case-control studies with small clinical samples. Only one out of Blashfield’s five criteria was met; there were commonly accepted diagnostic criteria and assessment scales present in the literature. However, at the time of review, the criterion of 50 published articles (25 of which are required to be empirical) was not met; there had been no publication specifically assessing the clinical utility or validity of skin picking disorder and no studies addressing the differentiation of skin picking disorder from other obsessive-compulsive and related disorders. Conclusion: Only a small proportion of published studies on skin picking disorder have employed validated criteria. The current literature fulfills only one of Blashfield’s five criteria for the inclusion of skin picking disorder as a specific entity in psychiatric diagnostic manuals. Further empirical studies on skin picking disorder are needed in order to substantiate skin picking disorder as a disorder distinct from related disorders under the obsessive-compulsive and related disorders category.
Students’ engagement with alternative discursive construction of menstruation
Authors: Agnew Shire , Gunn Alexandra C 
Published: March 2019

Objectives: Understandings of menstruation, including those within teaching, continue to draw on dominant discourses that construct menstruation as shameful and secret. This study trialled a new pedagogical approach to menstruation education that offered opportunities to engage with and mobilise alternative discourses. Design: Teachers of students (aged 10–12 years) in school years 7 to 8 were invited to participate in two workshops that used a critical literacy pedagogy to encourage learning about menstruation at schools. Classroom lessons were collaboratively planned. The teaching of the lessons was observed, and interviews with teachers and small groups of participating students were undertaken. Setting: South Island, New Zealand. Methods: Transcripts of workshops and interview data, in combination with field notes from the observed lessons, were subjected to discourse analysis. Results: Teachers still engaged with discourses of shame and secrecy in their work. Students, on the other hand, were observed to challenge discourses of shame and secrecy, and explored alternatives with which they could construct new meanings about menstruation. Conclusion: Findings suggest that it is important for teachers to examine personal constructions of menstruation. By approaching the teaching of menstruation in a way that offers space for students to engage with a variety of alternative discourses, teachers can help broaden the manner in which menstruation is understood.
Effects of a Family-Based Diabetes Intervention on Family Social Capital Outcomes for Mexican American Adults
Authors: McEwen Marylyn Morris , Pasvogel Alice , Murdaugh Carolyn 
Published: March 2019

Purpose The purpose of the study is to test the effects of a culturally tailored family-based self-management education and social support intervention on family social capital with Mexican American (MA) adults with type 2 diabetes (T2DM) and their family member. Methods Using a 2-group, experimental repeated-measures design, 157 dyads were randomly assigned to an intervention (group education and social support, home visits, and telephone calls) or a wait list control group. Data were collected at baseline, immediately postintervention (3 months), and 6 months postintervention. A series of 2 × 3 repeated-measures analyses of variance with interaction contrasts were used to test the hypotheses regarding the differential effects on family social capital. Results Social capital outcomes included social integration, social support, and family efficacy. Social integration scores, high for family members and friends and low for community engagement, did not change over time for participants or family members. Participants perceived high support from family for physical activity with an immediate increase postintervention and moderate sabotage for healthy eating with no change over time. A sustained intervention effect was noted for family efficacy for general health and total family efficacy in participants and family members. Conclusions This family-based culturally tailored intervention demonstrated the potential to improve social capital, specifically social support for physical activity and family efficacy for diabetes management for MA adults with T2DM. Ongoing research that examines the family as a critical context in which T2DM self-management occurs and that targets strategies for sustained family social capital outcomes for T2DM is needed.