bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does AGN fraction depend on redshift or luminosity? An extinction-free test by 18-band near- to mid-infrared SED fitting in the AKARI NEP wide field
Authors: Chiang Chia-Ying , Goto Tomotsugu , Hashimoto Tetsuya , Kim Seong Jin , Matsuhara Hideo , Oi Nagisa 
Published: February 2019

Abstract
Revealing what fraction of galaxies harbor active galactic nuclei (AGNs) is central to understanding the black hole accretion history of the universe. However, optical and soft X-ray surveys miss the most highly obscured AGNs. Infrared (IR), instead, is more robust against absorption. Previous IR photometric surveys, however, only had four or five filters in mid-IR. Our AKARI North Ecliptic Pole wide field sample has 18 filters in mid-IR (nine from AKARI, four from WISE, and five from Spitzer), for the first time allowing a sophisticated mid-IR spectral energy distribution (SED) fitting diagnosis for a statistical number of sources (89178 over 5.4 deg2). By using an SED fitting technique, we investigated the evolution of AGN fraction as a function of redshift and IR (8–1000 μm) luminosity in an extinction-free way. We found that the AGN fraction (FAGN) shows no sign of strong redshift evolution. Instead, FAGN increases with increasing IR luminosity in all redshift bins (0 &lt; $z$ &lt; 2).
Body dysmorphic disorder
Authors: Perkins Amanda 
Published: February 2019

Abstract:
Body dysmorphic disorder (BDD) is an obsessive-compulsive and related disorder that pushes people toward perfection, affecting 5 to 7.5 million people in the US. Individuals with BDD spend a great deal of time focusing on perceived flaws and ways in which to hide these flaws. The time spent on these negative thoughts can interfere with quality of life and the ability to carry out daily tasks. This article discusses BDD, including symptoms, diagnosis, treatment, complications, and the nurse's role.
Severe asthma in children: therapeutic considerations
Authors: Selby Louise , Saglani Sejal 
Published: February 2019

Purpose of review
Children with poor asthma control despite maximal maintenance therapy have problematic severe asthma (PSA). A step-wise approach including objective adherence monitoring and a detailed multidisciplinary team assessment to identify modifiable factors contributing to poor control is needed prior to considering therapy escalation. Pathophysiological phenotyping in those with true severe therapy-resistant asthma (STRA) and the current array of add-on therapies will be discussed.

Recent findings
Adherence monitoring using electronic devices has shown that only 20–30% of children with PSA have STRA and need additional therapies. Omalizumab and mepolizumab are licensed for children with STRA aged 6 years and older. Although robust safety and efficacy data, with reduced exacerbations, are available for omalizumab, biomarkers predicting response to treatment are lacking. Paediatric safety data are available for mepolizumab, but efficacy data are unknown for those aged 6–11 years and minimal for those 12 years and older. A sub-group of children with STRA have neutrophilia, but the clinical significance and contribution to disease severity remains uncertain.

Summary
Most children with PSA have steroid sensitive disease which improves with adherence to maintenance inhaled corticosteroids. Add-on therapies are only needed for the minority with STRA. Paediatric efficacy data of novel biologics and biomarkers that identify the optimal add-on for each child are lacking. If we are to progress toward individualized therapy for STRA, pragmatic clinical trials of biologics in accurately phenotyped children are needed.
Boyer and Beyond: An Interview Study of Health Professions Education Scholarship Units in the United States and a Synthetic Framework for Scholarship at the Unit Level
Authors: O’Brien Bridget C. , Irby David M. , Durning Steven J. , Hamstra Stanley J. , Hu Wendy C.Y. , Gruppen Larry D. , Varpio Lara 
Published: February 2019

Purpose
Health professions education scholarship units (HPESUs) in the United States are large in number and diverse in purpose, activities, and contributions. Although each of these units shares a commitment to scholarship, there is no synthetic framework to accurately represent and evaluate their activities and contributions. This study aimed to provide such a framework.

Method
The authors examined data collected from 11 U.S. HPESU directors. Interviews occurred between April 2015 and February 2016. The research team used a combination of deductive and inductive qualitative techniques to analyze the interview transcripts. The deductive portion drew on Boyer’s four-part framework of scholarship; the inductive portion produced a new conceptualization of scholarship at the HPESU level.

Results
The scholarly activities of HPESUs generally align with Boyer’s four types of scholarship—discovery, integration, application, and teaching. However, this categorization fails to capture the interconnectedness and variety of purposes served by these activities. Both are important when considering how best to represent the scholarly contributions made by HPESUs. From their analysis of interviews, the authors developed a three-part framework characterizing HPESU scholarly activities: supporting a scholarly approach to education, supporting educational scholarship within the institution, and supporting HPESU members’ scholarship.

Conclusions
The authors contend that the three-part, unit-level framework for scholarship constructed in this study brings clarity and understanding to the purpose, activities, and contributions made by HPESUs in the United States. The proposed framework may allow unit directors to better justify and advocate for the resources needed to further promote the work of HPESUs.
Acidity of Enteral Feeding Tube Aspirate in Neonates
Authors: Kemper Carol , Haney Barb , Oschman Alexandra , Lee Brian R. , Lyman Beth , Parker Leslie , Brandon Debra 
Published: February 2019

Background:
Enteral feeding tubes (EFTs) are commonly used in neonatal practice, but complications from tube misplacement remain a concern. Measuring the pH of EFT aspirate is a recommended method to evaluate EFT placement. A pH value of ≤5.5 is considered predictive of gastric placement. Using this method in infants has been questioned. It is unclear whether infants can produce adequate gastric acid to achieve a pH 5 or less and whether feedings and medications influence pH.

Purpose:
To report EFT aspirate pH values in infants and to evaluate factors potentially influencing pH values.

Methods:
A retrospective descriptive study was conducted with 1024 infants with 6979 pH values. Demographic and clinical data were collected including type of EFT, pH of gastric aspirate, feeding method, time of last feeding, and administration of acid suppression medications. The frequency of measured pH values of 5 or less was calculated for each covariate.

Findings/Results:
The majority (97.51%) of pH values were 5 or less. Orogastric tubes, continuous feeding, a 4-hour or more feeding interval, exposure to medications (proton pump inhibitor, histamine-2 receptor antagonist, or multiple medications) were associated with an increased likelihood of pH values of more than 5. However, with each study variable the majority of pH values were 5 or less.

Implications for Practice:
These findings suggest EFT pH, a recommended method to evaluate the likelihood of gastric placement, can be successfully used in the neonatal population.

Implications for Research:
Future research should prospectively evaluate EFT pH in infants when compared with clinically indicated radiographs. Other factors that might influence pH should be explored including severity of illness, feeding type, and other medications.
Is Anteromedial Drilling Safe in Transphyseal Anterior Cruciate Ligament Reconstruction in Adolescents with Growth Remaining?
Authors: Mathew Stephen , Ellis Henry B. , Wyatt Charles W. , Sabatino Meagan J. , Zynda Aaron J. , Dennis Garrett , Wilson Philip L. 
Published: February 2019

Background:
Previous reports of transphyseal drilling in anterior cruciate ligament (ACL) reconstruction have demonstrated good clinical outcomes without subjective changes in further skeletal development. The purpose of this study is to evaluate radiographic changes during continued growth following a transphyseal ACL reconstruction using an anteromedial femoral (AM) drilling technique in patients with >18 months of growth remaining.

Methods:
A review of consecutive adolescents who underwent a soft tissue transphyseal ACL reconstruction using an AM drilling technique was performed. Inclusion criteria was 18 months of growth remaining based on radiographic bone age and standing radiographs at least one year from the index procedure. Demographic, preoperative, and postoperative data, and follow-up three-foot standing lower extremity radiographs were reviewed. Radiographic data included femoral length, tibial length, total lower extremity length, mechanical axis deviation (MAD), lateral distal femoral angle (LDFA), and medial proximal tibial angle (MPTA).

Results:
In total 12 adolescent patients with a mean age of 13.4 years (range, 12.3 to 14.4) and bone age of 13.4 years (11.5 to 14) at the time of surgery were included. At an average of 2.27-year follow-up (412 to 1058 d), there was no difference in the total growth of the operative and nonoperative limb (48.5 mm vs. 47 mm; P=0.36). In addition, the average increases in femoral length (23.4 mm) and tibial length (25.8 mm) were not statistically different between the operative and the nonoperative limb (P=0.12; P=0.75). There was no statistical difference in mechanical axis deviation, LDFA, or MPTA between preoperative and postoperative radiographs. Mean differences in operative and nonoperative coronal angular changes were all <1.5 degrees.

Conclusions:
With at least 2 years of growth remaining, transphyseal ACL reconstruction with anteromedial drilling did not significantly affect the physis or residual growth compared with the contralateral extremity. Although this technique may create a larger defect in the physis, standing radiographs demonstrate there is no change in limb length or angulation in growing adolescents approximately 2 years after surgery.

Level of Evidence:
This is a case series; Level IV evidence.
Does Metabolic Syndrome Increase the Risk of Postoperative Complications in Patients Undergoing Colorectal Cancer Surgery?
Authors: Shariq Omair A. , Hanson Kristine T. , McKenna Nicholas P. , Kelley Scott R. , Dozois Eric J. , Lightner Amy L. , Mathis Kellie L. , Habermann Elizabeth B. 
Published: February 2019

BACKGROUND:
Metabolic syndrome is associated with poorer postoperative outcomes after various abdominal operations. However, the impact of metabolic syndrome on outcomes after colorectal cancer surgery remains poorly described.

OBJECTIVE:
The purpose of this study was to determine the association between metabolic syndrome and short-term postoperative outcomes in patients undergoing elective colorectal cancer surgery.

DESIGN:
This was a retrospective cohort study.

SETTINGS:
This study used a national multicenter database.

PATIENTS:
Adult patients who underwent elective colectomy for colorectal cancer from 2010 to 2016 were identified in the American College of Surgeons National Surgical Quality Improvement Program database.

MAIN OUTCOME MEASURES:
Thirty-day postoperative mortality and morbidity, unplanned reoperation, unplanned readmission, operative time, and length of stay were measured.

RESULTS:
A total of 91,566 patients were analyzed; 7603 (8.3%) had metabolic syndrome. On unadjusted analysis, metabolic syndrome was associated with an increased risk of 30-day overall morbidity, pulmonary complications, renal complications, septic complications, cardiac complications, wound complications, blood transfusion, longer length of stay, and unplanned readmissions. On multivariable analysis, metabolic syndrome remained significantly associated with renal complications (OR = 1.44 (95% CI, 1.29–1.60)), superficial surgical site infection (OR = 1.46 (95% CI, 1.32–1.60)), deep surgical site infection (OR = 1.40 (95% CI, 1.15–1.70)), wound dehiscence (OR = 1.47 (95% CI, 1.20–1.80)), and unplanned readmissions (HR = 1.24 (95% CI, 1.15–1.34)). The risks of overall morbidity, cardiac and septic complications, and prolonged length of stay for laparoscopic procedures were significantly associated with diabetes mellitus rather than metabolic syndrome as a composite entity.

LIMITATIONS:
This study was limited by its retrospective design and inability to analyze outcomes beyond 30 days.

CONCLUSIONS:
Patients with metabolic syndrome undergoing elective surgery for colorectal cancer have an increased risk of 30-day postoperative renal complications, wound complications, and unplanned hospital readmissions. A multidisciplinary approach involving lifestyle modifications and pharmacologic interventions to improve the components of metabolic syndrome should be implemented preoperatively for these patients. See Video Abstract at http://links.lww.com/DCR/A909.
Association of Depression and Unhealthy Lifestyle Behaviors in Chinese Patients With Acute Coronary Syndromes
Authors: Zhu Yidan , Yu Xin , Wu Yangfeng , Shi Chuan , Zhang Aihua , Jiang Ronghuan , Li Shenshen , Guo Guifang , Gao Runlin , Blumenthal James A. 
Published: February 2019

Purpose:
This study sought to examine associations between depression and unhealthy lifestyle behaviors in Chinese patients with acute coronary syndromes (ACS).

Methods:
This cross-sectional study included 4043 ACS patients from 16 hospitals across China who participated in the I-Care (Integrating Depression Care in Acute Coronary Syndromes Patients) trial. Patients were enrolled between November 2014 and January 2017. Depression was assessed with the Patient Health Questionnaire-9 (PHQ-9). Five lifestyle behaviors were assessed: smoking, drinking, body mass index (BMI), physical activity, and sleep quality.

Results:
A total of 135 patients (3.3%) were considered clinically depressed (PHQ-9 ≥10). After adjusting for covariates, physical activity and sleep quality were inversely related to PHQ-9 scores. Adjusted logistic models showed that depressed patients were 1.7 times likely to be physically inactive (OR = 1.74; 95% CI, 1.15-2.64) and 4.6 times likely to have poor sleep quality (OR = 4.60; 95% CI, 3.07-6.88) compared with nondepressed patients. The association of depression with smoking, unhealthy drinking, and unhealthy BMI was not significant after adjustment for demographic characteristics. Higher depression scores were found to be associated with a greater number of unhealthy lifestyle behaviors (P for trend < .001).

Conclusions:
The association of depression and unhealthy lifestyles in post-ACS patients suggests that reducing depressive symptoms and improving healthy lifestyle behaviors could potentially improve clinical outcomes in this vulnerable patient population.
Stressful Life Events Are Associated With Health-Related Quality of Life During Cardiac Rehabilitation and at 2-yr Follow-up in Patients With Heart Failure
Authors: Kažukauskienė Nijolė , Burkauskas Julius , Macijauskienė Jūratė , Mickuvienė Narseta , Brožaitienė Julija 
Published: February 2019

Purpose:
According to recent literature, stressful life events might represent an important risk factor of health-related quality of life (HRQoL) in patients with heart failure. The aim of this study was to evaluate the association between stressful life events and HRQoL in patients with heart failure after acute coronary syndrome, both during cardiac rehabilitation and during 2 yr of follow-up.

Methods:
Patients with heart failure (n = 481; 75% male; mean age: 58 ± 9 yr) were evaluated for sociodemographic, clinical, and mental distress factors including stressful life events, anxiety and depression symptoms, perceived social support, and type D personality. Health-related quality of life was evaluated at baseline and at follow-up by telephone interview. Patients were also tested for exercise capacity at baseline.

Results:
Stressful life events were associated with impaired HRQoL independently of sociodemographic characteristics, clinical factors, mental distress, social support, and type D personality.

Conclusion:
Stress level due to experiencing stressful life events should be specifically assessed during cardiac rehabilitation, as it is associated with patients HRQoL.
Feasibility and Outcomes of an Exercise Intervention for Chemotherapy-Induced Heart Failure
Authors: Tsai Edward , Mouhayar Elie , Lenihan Daniel , Song Jaejoon , Durand Jean-Bernard , Fadol Anecita , Massey Mona , Harrison Carol , Basen-Engquist Karen 
Published: February 2019

Purpose:
Cancer treatment–related heart failure (HF) is an emerging health concern, as the number of survivors is increasing rapidly, and cardiac health issues are a leading cause of mortality in this population. While there is general evidence for the efficacy of exercise rehabilitation interventions, more research is needed on exercise rehabilitation interventions for patients specifically with treatment-induced HF and whether such interventions are safe and well-accepted. This study provides feasibility and health outcomes of a pilot exercise intervention for cancer survivors with chemotherapy-induced HF.

Methods:
Twenty-five participants were randomized to a clinic-based exercise intervention or a wait-list control group or, alternatively, allowed to enroll in a home-based exercise intervention if they declined the randomized study. For purposes of analysis, both types of exercise programs were combined into a single intervention group. Repeated-measures analysis of variance was conducted to assess for significant time and treatment group main effects separately and time × treatment group interaction effects.

Results:
Significant improvements in maximum oxygen uptake (

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2max) were observed in the intervention group. Intervention satisfaction and adherence were high for both clinic- and home-based interventions, with no reported serious adverse events. Enrollment was initially low for the clinic-based intervention, necessitating the addition of the home-based program as an intervention alternative.

Conclusions:
Results suggest that exercise rehabilitation interventions are feasible in terms of safety, retention, and satisfaction and have the potential to improve

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2max. To maximize adherence and benefits while minimizing participant burden, an ideal intervention may incorporate elements of both clinic-based supervised exercise sessions and a home-based program.
Medical and Psychosocial Factors Associated With Low Physical Activity and Increasing Exercise Level After a Coronary Event
Authors: Peersen Kari , Otterstad Jan Erik , Sverre Elise , Perk Joep , Gullestad Lars , Moum Torbjorn , Dammen Toril , Munkhaugen John 
Published: February 2019

Purpose:
The reasons why many coronary patients are inactive or have a low level of physical activity (PA) are not completely understood. We identified medical and psychosocial factors associated with PA status and increasing exercise level after a coronary event.

Methods:
A cross-sectional study investigated the factors associated with PA in 1101 patients hospitalized with myocardial infarction (MI) and/or a revascularization procedure. Data were collected from hospital records, a self-report questionnaire, and a clinical examination. PA was categorized as inactivity, low activity, and adequate activity (≥ moderate intensity of 30 min ≥2-3 times/wk), an overall summary PA-index was measured as a continuous variable, and self-reported PA increase since the index event was measured on a 0- to 10-point Likert Scale.

Results:
In all, 18% reported inactivity, 42% low, and 40% adequate activity at follow-up after median 16 mo. In multiadjusted linear regression analyses, low PA-index was significantly associated with smoking, obesity, unhealthy diet, depression, female, low education, MI as index diagnosis, and ≥1 previous coronary event. Motivation, risk and illness perceptions, and low reported need of help to increase PA were significantly associated with self-reported increasing PA level in adjusted continuous analyses.

Conclusions:
Daily smoking, obesity, unhealthy diet, and depression were the major potentially modifiable factors associated with insufficient PA, whereas high motivation and risk and illness perceptions were associated with increasing PA level. Further research on the effect of interventions tailored to the reported significant factors of failure is needed to improve PA level in CHD patients.
Reduction of Operator Hand Exposure in Interventional Radiology With a Novel Finger Sack Using Tungsten-containing Rubber
Authors: Kosaka Hiroyuki , Monzen Hajime , Matsumoto Kenji , Tamura Mikoto , Nishimura Yasumasa 
Published: February 2019

Abstract
The purpose of this study was to evaluate the x-ray shielding ability of a novel tungsten-particle-containing rubber-based finger sack for use in interventional radiology. Shielding rates for the air kerma (mGy m−1) were measured using a semiconductor dosimeter with and without the finger sack and commercial lead gloves, at a 20 cm distance from the field of view. A C-arm digital angiography system was used with x-ray tube voltages of 60, 80, 100, and 120 kVp. In addition, the 70 μm dose equivalent to the operator’s finger was measured using fluorescent glass dosimeters with and without the finger sack during interventional radiology examinations. The x-ray shielding rates for 60, 80, 100, and 120 kV x rays were 98.0 ± 0.03%, 94.8 ± 0.05%, 92.3 ± 0.12%, and 90.1 ± 0.03%, respectively, with the finger sack and 69.8 ± 0.39%, 61.0 ± 0.53%, 52.3 ± 0.52%, and 47.0 ± 0.69% with the lead gloves. The x-ray shielding rates for the fluoroscopy and cine mode with the finger sack were 91.3 ± 0.21% and 56.5 ± 0.58%, respectively, while with the lead gloves they were 96.5 ± 0.04% and 67.6 ± 0.33%. The 70 μm dose equivalent for the operator’s finger exposure dose was reduced by approximately 39.4% using the finger sack. The finger shields were more user friendly, had excellent radiation shielding ability against x rays, and should reduce finger exposure in interventional radiology.
UNUSUAL EARLY-ONSET VITELLIFORM DYSTROPHY POSSIBLY LINKED TO THE INTERPHOTORECEPTOR MATRIX PROTEOGLYCAN-1 P.LEU154PRO MUTATION
Authors: Gupta Mrinali P. , Brodie Scott E. , Freund K. Bailey 
Published: February 2019

Purpose:
To describe a case of symptomatic outer retinal disruption in a patient heterozygous for the p.Leu154Pro interphotoreceptor matrix proteoglycan-1 (IMPG1) mutation implicated in adult-onset foveomacular vitelliform dystrophy.

Methods:
Observational case report.

Results:
We describe a case of a 25-year-old female patient with symptomatic scotoma and vision decrease who exhibited bilateral small foveal yellow spots. Optical coherence tomography revealed disorganization and decreased reflectance of the foveal ellipsoid and interdigitation zones in the left eye more than in the right eye. Fundus autofluorescence imaging showed minimal findings, and dye angiography was unrevealing. Multifocal electroretinogram revealed slightly decreased retinal sensitivity in the central retina of the left eye. Genetic testing identified a heterozygous p.Leu154Pro mutation in the IMPG1 gene.

Conclusion:
The p.Leu154Pro IMPG1 mutation may cause symptomatic outer retinal disturbance in the heterozygous state. Further studies are necessary.