bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heart Rate Response to Exercise
Authors: Thomas Gregory S. 
Published: January 2019

Abstract
The chapter Heart Rate Response to Exercise reviews the studies performed to estimate a patient’s maximum predicted heart rate. While the commonly used formula (220 – age), developed in 1971, is easy to remember, it underestimates the actual maximum heart rate in older persons. Studies of large sample size have found the maximum heart rate to be relatively independent of sex and physical fitness but to incrementally decline with age. The decrease with age is less than 1 beat per minute per year, however. A more accurate and recommended formula is [(208) – (0.7)(age)] as developed by Tanaka and colleagues.
Stress Testing in Women
Authors: Mehta Puja K. , Isiadinso Ijeoma , Wann L. Samuel 
Published: January 2019

Abstract
The chapter Stress Testing in Women reviews the clear sex-specific differences in the presentation and pathophysiology of ischemic heart disease (IHD). Women tend to have more atypical and more subtle symptoms such as dyspnea or fatigue than men. Symptomatic women are also more likely to have no obstructive coronary artery disease (CAD) on coronary angiography, but still have adverse clinical outcomes. Coronary microvascular dysfunction. Exercise testing is frequently the first test of choice to diagnose IHD in women. When resting electrocardiogram abnormalities precludes exercise testing or exercise testing is inconclusive, stress imaging with echocardiography or myocardial perfusion imaging can be added. Routine stress testing is designed to detect flow-limiting, obstructive CAD. When stress imaging is negative or “falsely positive” in a symptomatic patient, nonobstructive causes of IHD including coronary microvascular dysfunction should be considered.
Stress Testing of Athletes and Those in High-Risk Occupations
Authors: Wann L. Samuel 
Published: January 2019

Abstract
The chapter Stress Testing of Athletes and Those in High Risk Occupations reviews expectations and challenges of exercise testing in amateur athletes, firefighters, police, pilots, and astronauts. Cardiac events, including sudden cardiac death, occurring in amateur athletes are rare and difficult to predict with cost-effective population screening, and routine stress testing is not recommended. However, for higher risk individuals and those in high risk occupations, stress testing may have a role in screening and reassuring individual participants and the public. Abnormal studies may preclude individuals from occupations that require medical clearance.
Sports Medicine and Cardiac Rehabilitation for Coronary and Peripheral Artery Disease Patients
Authors: Thomas Gregory S. , Ellestad Myrvin H. 
Published: January 2019

Abstract
The chapter Sports Medicine and Cardiac Rehabilitation for Coronary and Peripheral Artery Disease (CAD) reviews the benefits and potential risks of physical activity and the opportunity for particular benefit in patients with coronary artery disease and peripheral artery disease (PAD). Longitudinal studies of large populations have found a benefit to habitual exercise on cardiovascular health, including decreasing cardiovascular mortality. A physiologic training effect is not required for benefit. Mild exercise is better than inactivity and increasing activity provides even greater benefit. Athletic training induces expected electrocardiographic changes at rest in athletes. Prescribing exercise with or without an exercise test is discussed in asymptomatic individuals as well as prior to participation in traditional cardiac rehabilitation or a supervised exercise program for patients with peripheral artery disease. PAD patients often do not have classic intermittent claudication yet are able to benefit from exercise therapy.
Stress Testing in Children
Authors: Hattendorf Brandy 
Published: January 2019

Abstract
The chapter Stress Testing in Children reviews the opportunity to evaluate children with congenital and acquired cardiovascular disease. Clinical pediatric exercise testing differs from adult testing in both disease etiology as well as the characteristics of cardiovascular response. Unlike exercise testing in adults, the indications for testing in pediatrics generally are not to evaluate for ischemia. Commonly, pediatric exercise testing is used to evaluate specific signs and symptoms induced or aggravated by exercise, including identification of exercise induced arrhythmias, whereas metabolic testing can provide further patient information regarding cardiac output, maximal oxygen consumption, and lung capacity. Exercise testing can also assess the efficacy of medical or surgical treatments for individual congenital heart disease patients. Functional capacity can be used to determine patient safety for recreational, athletic, and vocational activities. Exercise modification and restrictions are necessary for some patients based on the data provided by exercise testing.
Perspectives on the Future of Stress Testing
Authors: Wann L. Samuel , Thomas Gregory S. 
Published: January 2019

Abstract
The chapter Perspectives on the Future of Stress Testing forecasts changes in the ability to detect atherosclerosis in the form of obstructive and non-obstructive coronary artery disease and ischemia. These will continue to include low cost and widely available exercise testing as well as embracing new technology such as mobile sensors, biomarkers, and genetic testing. Continued advancements in positron emission tomography, cardiac computed tomography, and cardiac magnetic resonance imaging will create new opportunities for better definition of myocardial blood flow and prediction of prognosis. While we will continue to expand our ability to measure greater detail of aspects of cardiac structure, function and metabolism, the humanity of a clinician being at the side of the treadmill while our whole patients exercise to their individual capacity remains a valuable diagnostic, educational and bonding opportunity
Pulse Oximetry
Authors: Liebling Storm , Langhan Melissa 
Published: January 2019

Abstract
This section focuses on the use of pulse oximetry during procedural sedation and analgesia (PSA). Pulse oximetry is the most common monitoring method used during PSA. It is a noninvasive method for monitoring a patient’s peripheral oxygen saturation (SpO2) of hemoglobin. Its use is recommended in the monitoring of children undergoing various levels of sedation as a means to detect hypoxemia and decrease the likelihood of adverse outcomes, including cardiopulmonary arrest and death. It is a highly reliable modality for detecting oxygen desaturation events. However, understanding its indications and limitations will allow the user to properly identify and manage a desaturation event during PSA.
Solid Organ Biopsies
Authors: Biber Jennifer , Wheeler Jenna 
Published: January 2019

Abstract
While solid organ biopsies are routinely done on adults with only local anesthesia or minimal sedation, children frequently require deep sedation or general anesthesia to achieve acceptable conditions (stillness, anxiolysis, analgesia) to facilitate these procedures. This is more frequently being done with pediatric sedation/anesthesia outside the operating room. Issues unique to sedation for these procedures are pain, the need for relative patient immobility (both during the procedure and following it), and the nonstandard positioning required during the procedure. Regardless of the medications chosen, adequate monitoring should occur during the procedure as well as during the recovery period. With a good sedation plan for both sedation and analgesia, adequate monitoring, and contingency planning for adverse events, this can safely be performed in institutions with highly motivated and organized sedation services.
What Is Personality Disorder?
Authors: Svrakic Dragan M. , Divac-Jovanovic Mirjana 
Published: January 2019

Abstract
The central problem with persons suffering from personality disorder is not their extreme behaviors but rather a fragmented substrate of personality, while extreme behaviors merely represent specific compensatory strategies. The pathodevelopment of personality disorder involves multiple interacting factors (e.g., biogenetic dispositions, early adversity), leading to aberrant brain and mind organization, notably a hypofunctional prefrontal cortex and fragmented object relations, respectively. Such fragmented personality is adaptively dysfunctional and thus vulnerable to disintegration, particularly under stress and strong affects. Consequently, these patients continue to need sources of organization, both internally (through fantasy and exaggerations) and interpersonally (through self-objects who define and maintain the pathological albeit compensatory self-image). Interpersonal conflicts are actively sought and reflect either trait aggression and/or alloplastic adaptation. Personality disorder can be thought of as a homeostatic attempt of the mind to heal itself, akin to callus formation, a form of psychological survival through mental deviance.
Dynamic Nosology and Clinical Assessment of Fragmented Personality
Authors: Svrakic Dragan M. , Divac-Jovanovic Mirjana 
Published: January 2019

Abstract
This chapter introduces a dynamic, personalized, context- and time-sensitive diagnosis of personality in health and disorder. Adaptive flexibility of the mind implies that its component subsystems and functions must also be flexible and semistable, including healthy personality and personality disorder. The model defines a 3D diagnostic space, in which each individual is uniquely and flexibly positioned. “Vertical diagnosis” is based on the duration, pervasiveness, and frequency of periods of fragmented functioning. It is cross-matched with “horizontal diagnosis,” based on the predominant adaptive style. Such dynamic nosology accounts for fluctuations in mental functioning as the individual “moves” in the diagnostic space. The approach captures the flexibility of the mind, self-reorganizing to adapt to changing conditions, and champions the positive connotation of change, challenging the widespread therapeutic nihilism about severe personality pathology. Clinical diagnosis of personality disorder, notably interpersonal (relational), behavioral, and intrapersonal approaches, together with psychological testing are discussed in detail.
Prelude, War, and Aftermath
Authors: Turse Nick 
Published: January 2019

Abstract
This chapter presents a broad summary of this conflict, beginning with its roots in nineteenth-century colonial French Indochina. It details the buildup of U.S. military and economic aid to the South Vietnamese regime after French withdrawal, early U.S. intervention in the ongoing civil war between North and South Vietnam, and the gradual escalation of America’s presence in Southeast Asia under presidents Kennedy, Johnson and Nixon. It describes how and where the war was fought, who served and why, and on-going political and social movements in the U.S. throughout the war and after U.S. withdrawal. It summarizes the human costs in Vietnam and the United States. It describes attempts by psychiatrists to create frameworks for understanding and addressing the trauma, anguish, alienation, and rage experienced and expressed by the U.S. veterans who fought this controversial war, including official recognition in the new diagnosis of post-traumatic stress disorder.
Measurement of Severity of Combat, Involvement in Harming Civilians and Prisoners, and Personal Vulnerability Load
Authors: Dohrenwend Bruce P. , Yager Thomas J. , Wall Melanie M. , Adams Ben G. , Turse Nick 
Published: January 2019

Abstract
This chapter presents detailed measures of each of the three factors that most strongly affect the psychological impact of the Vietnam war on U.S. male veterans. These descriptions build on the detailed accounts in Chapter 2 of the use of military records to develop more comprehensive measures of war-zone experiences. The measures of harm to civilians and prisoners are based on veteran self-reports. The measures of pre-Vietnam vulnerability load include data from military records, such as the Armed Forces Qualification Test (AFQT), pre-war education levels, and NVVRS interview data that enable diagnoses of important types of psychiatric disorder other than PTSD. Less central, but perhaps no less important, other risk factor variables and their measurement are set forth in later chapters at the point they are first introduced.
Harming Civilians or Prisoners
Authors: Dohrenwend Bruce P. , Yager Thomas J. , Lewis-Fernández Roberto , Adams Ben G. , Turse Nick 
Published: January 2019

Abstract
This chapter uses responses to direct, closed questions about personal involvement to identify 12.8% of veterans as harmers. It examines qualitative information to compare self-identified harmers of civilians or prisoners with other veterans. It investigates the qualitative data to discover the specific circumstances in which this type of harm took place. It suggests that harm to prisoners may usually have occurred following attacks on clearly identifiable enemy forces. In contrast, many incidents of harm to civilians appear to have occurred in attempts by U.S. forces to implement the policy of clearing the population from areas considered to be under enemy control. Other than their much more severe combat exposure, this analysis reveals very few characteristics of the harmers that differentiated them from those not directly involved in inflicting such harm. The harmers themselves tend to suffer from persistent guilt and anger.
PTSD in Women Who Served as Nurses in Vietnam
Authors: Yager Thomas J. , Dohrenwend Bruce P. 
Published: January 2019

Abstract
This chapter reviews nurses’ traumatic events and stressful war-time experiences. Onset of war-related PTSD and its persistence many years after nurses’ service were elevated among those who had pre-Vietnam vulnerabilities, particularly pre-war psychiatric disorders. The rate of war-related PTSD onset among nurses was higher than that among male veterans with low probable combat exposure; and the odds of its persistence were nearly four times higher among nurses than among male veterans with moderate probable combat exposure. Likely sources of war-related stress among the nurses included their service in the operating room, their personal risk of enemy attack, and of sexual harassment and attack by fellow American soldiers. Nevertheless, the large majority of nurses reported a strong positive effect of military service on their lives.
The formation of compact dwarf ellipticals through merging star clusters
Authors: Urrutia Zapata F , Fellhauer M , Alarcón Jara A G , Matus Carrillo D R , Aravena C A 
Published: January 2019

Abstract
In the past decades, extended old stellar clusters have been observed. These extended objects cover a large range in masses, from extended clusters or faint fuzzies to ultracompact dwarf galaxies. It has been demonstrated that these extended objects can be the result of the merging of star clusters in cluster complexes (small regions in which dozens to hundreds of star clusters form). This formation channel is called the ‘Merging Star Cluster Scenario’. This work tries to explain the formation of compact ellipticals in the same theoretical framework. Compact ellipticals are a comparatively rare class of spheroidal galaxies, possessing very small effective radii and high central surface brightnesses. With the use of numerical simulations we show that the merging star cluster scenario, adopted for higher masses, as found with those galaxies, can reproduce all major characteristics and the dynamics of these objects. This opens up a new formation channel to explain the existence of compact elliptical galaxies.
Carotid Artery Stenting and Intracranial Thrombectomy for Tandem Cervical and Intracranial Artery Occlusions
Authors: Kim Byungjun , Kim Byung Moon , Bang Oh Young , Baek Jang-Hyun , Heo Ji Hoe , Nam Hyo Suk , Kim Young Dae , Yoo Joonsang , Kim Dong Joon , Jeon Pyoung , Baik Seung Kug , Suh Sang Hyun , Lee Kyung-Yul , Kwak Hyo Sung , Roh Hong Gee , Lee Young-Jun , Kim Sang Heum , Ryu Chang Woo , Ihn Yon-Kwon , Jeon Hong-Jun , Kim Jin Woo , Byun Jun Soo , Suh Sangil , Park Jeong Jin , Lee Woong Jae , Roh Jieun , Shin Byoung-soo 
Published: January 2019

Abstract

BACKGROUND
It remains controversial whether carotid artery stenting (CAS) is needed in cases of tandem cervical internal carotid artery occlusion (cICAO) and intracranial large vessel occlusion (LVO).

OBJECTIVE
To investigate the efficacy and safety of CAS in combination with endovascular thrombectomy (CAS-EVT) in cICAO-LVO patients and to compare its outcomes with those of EVT without CAS (EVT-alone).

METHODS
We identified all patients who underwent EVT for tandem cICAO-LVO from the prospectively maintained registries of 17 stroke centers. Patients were classified into 2 groups: CAS-EVT and EVT-alone. Clinical characteristics and procedural and clinical outcomes were compared between 2 groups. We tested whether CAS-EVT strategy was independently associated with recanalization success.

RESULTS
Of the 955 patients who underwent EVT, 75 patients (7.9%) had cICAO-LVO. Fifty-six patients underwent CAS-EVT (74.6%), and the remaining 19 patients underwent EVT-alone (25.4%). The recanalization (94.6% vs 63.2%, P = .002) and good outcome rates (64.3% vs 26.3%, P = .007) were significantly higher in the CAS-EVT than in the EVT-alone. Mortality was significantly lower in the CAS-EVT (7.1% vs 21.6%, P = .014). There was no significant difference in the rate of symptomatic intracranial hemorrhage between 2 groups (10.7 vs 15.8%; P = .684) and according to the use of glycoprotein IIb/IIIa inhibitor (10.0% vs 12.3%; P = .999) or antiplatelet medications (10.2% vs 18.8%; P = .392). CAS-EVT strategy remained independently associated with recanalization success (odds ratio: 24.844; 95% confidence interval: 1.445-427.187).

CONCLUSION
CAS-EVT strategy seemed to be effective and safe in cases of tandem cICAO-LVO. CAS-EVT strategy was associated with recanalization success, resulting in better clinical outcome.
Factors Impacting Practice of Home Kangaroo Mother Care with Low Birth Weight Infants Following Hospital Discharge
Authors: Dawar Rebecca , Nangia Sushma , Thukral Anu , Chopra Sapna , Khanna Rajesh 
Published: January 2019

Abstract

Objective
To identify enablers and barriers related to home Kangaroo Mother Care (KMC) adoption after hospital discharge.

Study design
An exploratory study, using a mixed methods evaluation, followed 60 mother–infant dyads from the hospital ward to 4 weeks post-hospital discharge.

Results
Fifty-three of the mothers (88.3%) completed all study visits. The majority of mothers were breastfeeding and practicing skin-to-skin contact 4 weeks post-discharge. Seven mothers (13.2%) discontinued skin-to-skin contact at 4 weeks. KMC was practiced on average 3.3 h/day and 5.1 days/week. The top two enablers reported were significantly related to the amount of time skin-to-skin was practiced, with support for household responsibilities being most significant (U = 195, p = 0.008). Lack of privacy (p = 0.002) and lack of motivation (p = 0.034) were negatively correlated to duration of skin-to-skin contact.

Conclusion
Future programs may increase dissemination and adoption of home KMC by specifically addressing enablers and barriers correlated to duration of skin-to-skin contact.
A CASE OF CAT SCRATCH DISEASE DIAGNOSED BY INDIRECT FLUORESCENT ANTIBODY ASSAY OF IgM SPECIFIC FOR A JAPANESE STRAIN OF Bartonella henselae
Authors: Uchi Sho-Hei , Yanai Ryoji , Tsuneoka Hidehiro , Otsuyama Ken-ichiro , Sonoda Koh-Hei , Kimura Kazuhiro 
Published: January 2019

Purpose:
To report a case of cat scratch disease–associated retinitis diagnosed with an indirect fluorescent antibody (IFA) assay for immunoglobulin M (IgM) specific for a strain (YH-01) of Bartonella henselae recently identified in Japan.

Methods:
Case report of a 24-year-old pregnant woman presented with general fever, fatigue, as well as blurred vision, and a central visual field deficiency in her right eye and was suspected as cat scratch disease because she had started to feed a feral dog a month ago.

Results:
The patient's serum tested negative, however, with an IFA assay for IgG or IgM specific for the Houston-1, common strain of B. henselae. Further testing with an IFA assay for IgM specific for the YH-01 strain yielded a positive result. On the basis of the clinical findings and the IFA results, we were thus able to make a definitive diagnosis of cat scratch disease.

Conclusion:
An IFA assay based on the YH-01 or combination of both YH-01 and Houston-1 strains of B. henselae may show increased sensitivity for the diagnosis of cat scratch disease in Japan.
Tolerability and Functionality of a Wireless 24-Hour Ocular Telemetry Sensor in African American Glaucoma Patients
Authors: Marando Catherine M. , Mansouri Kaweh , Kahook Malik Y. , Seibold Leonard K. 
Published: January 2019

Purpose:
The purpose of the study was to evaluate the tolerability and functionality of a wireless ocular telemetry sensor in African American patients with glaucoma.

Materials and Methods:
In this prospective, observational cohort study, 20 African American patients with primary open angle glaucoma (POAG) were evaluated at the University of Colorado Eye Center. Before lens placement, patients recorded ocular comfort and underwent a baseline eye exam. Following the exam, patients were fitted with a SENSIMED Triggerfish contact lens sensor and data recording device. Patients were sent home and instructed to record their activities in a journal and return in 24 hours. Repeat exams were performed at various time points in clinic before and after lens removal.

Results:
All 20 patients retained the lens for the 24-hour study period. The patient reported comfort was excellent, with a nadir of mean recorded comfort of 7.05/10. Significant clinical changes were noted in lid/conjunctival erythema, BCVA, refraction, and pachymetry over the course of lens wear. The majority of these changes were improved or resolved by 1 hour after lens removal. Voltage output was significantly greater nocturnally than diurnally (184.79 mV and 71.48 mV, respectively; P<0.0001). There was no significant change in signal variability or slope over the entire duration of the sleep/wake period based on sleep.

Conclusions:
The wireless ocular sensor is well tolerated over a 24-hour period in African American patients with POAG despite transient changes in visual acuity and conjunctival erythema. Clinically usable 24-hour profiles were generated for all patients, with voltage output increasing significantly during periods of sleep.