bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feeling like a burden to others and the wish to hasten death in patients with advanced illness: A systematic review
Authors: Rodríguez‐Prat Andrea , Balaguer Albert , Crespo Iris , Monforte‐Royo Cristina 
Published: April 2019

AbstractStudies that have explored the wish to hasten death (WTHD) in patients with advanced illness have found that the feeling of being a burden may trigger WTHD. Research suggests that both the feeling and the wish are indicators of multidimensional suffering whose meaning may depend on the patient's biographical background. Therefore, we carried out a systematic review and meta‐ethnography. Fourteen qualitative studies, reported in 16 articles, met the inclusion criteria. The analysis identified two themes: the personal and social dimensions that could help to explain the feeling of being a burden in these patients. These dimensions reveal how this feeling is linked to physical, psychological/emotional, existential and social factors. The feeling of being a burden cannot be understood without considering patients’ personal interpretation of their dependency or care needs, and hence it is also necessary to understand their biographical background. Such an understanding is crucial to inform clinical policies based on the moral duty to provide all patients with humane care.
Patient and public involvement: Two sides of the same coin or different coins altogether?
Authors: McCoy Matthew S. , Warsh Jonathan , Rand Leah , Parker Michael , Sheehan Mark 
Published: April 2019

AbstractPatient and public involvement (PPI) has gained widespread support in health research and health policy circles, but there is little consensus on the precise meaning or justifications of PPI. We argue that an important step towards clarifying the meaning and justification for PPI is to split apart the familiar acronym and draw a distinction between patient and public involvement. Specifically, we argue that patient involvement should refer to the practice of involving individuals in health research or policy on the basis of their experience with a particular condition, while public involvement should refer to the practice of involving individuals in health policy or research based on their status as members of a relevant population. Analyzing cases from the UK, Australia, and the USA, we show how our proposed distinction can deliver much needed clarity to conversations on PPI, while guiding the development and evaluation of future PPI‐based policies.
Pathophysiology of atopic dermatitis
Authors: Grobe William , Bieber Thomas , Novak Natalija 
Published: April 2019

SummaryOnly few diseases have been studied as extensively and on as many different levels in recent years as atopic dermatitis (AD). One of the reasons why AD is the focus of interest is that it is one of the most common chronic inflammatory skin diseases, affecting up to 30 % of children and 1–10 % of adults. Numerous complex alterations both on the genetic level as well as on the level of innate and adaptive immunity have been identified and form the basis for the characterization of different patient groups and the development of novel diagnostic and therapeutic approaches. Despite the complex pathophysiological and immunological differences, which are closely related to disease stage and severity, as well as the heterogeneity of individual trigger factors, treatment of AD – in particular that of moderate‐to‐severe AD – was long limited to merely symptomatic and relatively nonspecific immunosuppressive approaches. Since the approval of the first biologic for the treatment of moderate‐to‐severe adult AD (commercially available in Germany since late 2017), there has been some movement in the field of AD management.The present review highlights recent pathophysiologic insights. Advances in research allow for better characterization of certain patient subgroups and different disease manifestations. In addition, they form the basis of current and future developments in the field of precision medicine in AD.
Morphometric MRI findings challenge the concept of the “unaffected” hemisphere in Rasmussen encephalitis
Authors: David Bastian , Prillwitz Conrad C. , Hoppe Christian , Sassen Robert , Hörsch Sophia , Weber Bernd , Hattingen Elke , Elger Christian E. , Rüber Theodor 
Published: April 2019

SummaryRasmussen encephalitis (RE) is an immune‐mediated brain disease with progressive unihemispheric atrophy. Although it is regarded as a strictly one‐sided pathology, volumetric magnetic resonance imaging (MRI) studies have revealed atrophy in the so‐called unaffected hemisphere. In contrast to previous studies, we hypothesized that the contralesional hemisphere would show increased gray matter volume in response to the ipsilesional atrophy. We assessed the gray matter volume differences among 21 patients with chronic, late‐stage RE and 89 age‐ and gender‐matched healthy controls using voxel‐based morphometry. In addition, 11 patients with more than one scan were tested longitudinally. Compared to controls, the contralesional hemisphere of the patients revealed a higher cortical volume but a lower subcortical gray matter volume (all P < 0.001, unpaired t test). Progressive gray matter volume losses in bilateral subcortical gray matter structures were observed (P < 0.05, paired t test). The comparatively higher cortical volume in the contralesional hemisphere can be interpreted as a result of compensatory structural remodeling in response to atrophy of the ipsilesional hemisphere. Contralesional subcortical gray matter volume loss may be due to the pathology or its treatment. Because MRI provides the best marker for determining the progression of RE, an accurate description of its MRI features is clinically relevant.
Association of bioimpedance phase angle and prospective falls in older adults
Authors: Uemura Kazuki , Yamada Minoru , Okamoto Hiroshi 
Published: April 2019

AimBioelectrical impedance analysis‐derived phase angle has been shown to reflect multiple health conditions, including sarcopenia and malnutrition. We aimed to investigate the prospective association between phase angle and incident falls in older adults.MethodsCommunity‐dwelling adults aged ≥65 years (n = 205) participated in this study. Phase angle was examined using a multifrequency bioelectrical impedance analysis at baseline. Participants in the first tertile (T1), which had the lowest phase angle, were compared with those in the second and third tertiles (T2/3). Potential confounding factors, such as demographics, sarcopenia status and medications, were also assessed. Falls were recorded prospectively using falls diaries.ResultsOver a median follow‐up period of 181 days, a total of 11.7% of the sample (n = 24) experienced falls, with an overall incidence rate of 250.4 per 1000 person‐years. Univariate Cox regression analysis showed that T1 had a significant relationship to incident falls compared with T2/3 (hazard ratio 2.51, 95% confidence interval 1.13–5.60). Multivariate Cox regression analysis with stepwise selection identified the phase angle (hazard ratio 2.32, 95% CI 1.03–5.21) and the number of medications (hazard ratio 1.21, 95% CI 1.003–1.45) as significant risk factors for incident falls.ConclusionsOlder adults with lower phase angles are more likely to experience prospective falls compared with those with normal‐high phase angles. Bioelectrical impedance analysis‐derived phase angle can be used as a valuable prognostic tool to predict future falls and the resulting negative consequences in older adults. Geriatr Gerontol Int 2019; 19: 503–507.
The influence of colony traits on the collective behaviour ofMyrmica scabrinodisants
Authors: Maák István , Camera Jessica , Casacci Luca Pietro , Barbero Francesca , Trigos‐Peral Gema , Ślipiński Piotr , Bonelli Simona , Zaccagno Michele , Witek Magdalena 
Published: April 2019

AbstractEusocial insects exhibit different kinds of collective behaviours which are the outcomes of interactions among several individuals without central control. Ant societies are ideal models to study group behaviours performed by cooperative individuals at caste or at the colony level. In addition to the ecological constraints, such as the costs of maintaining patterns of interactions, the social structure might also affect the collective behaviour in ants.We tested the effect ofMyrmica scabrinodiscolony traits (number of queens, colony size, and colony age structure) on four major collective behaviours (aggression against intruders, removal of nestmate corpses, foraging, and colony relocation).Our results showed that neither the number of queens nor the colony size affected the level of aggression against non‐nestmates while the efficiency of corpse removal was positively correlated with both traits. The age structure of the colony influenced both the aggressiveness towards non‐nestmates and the hygienic behaviours. Subcolonies containing a higher proportion of young individuals were more aggressive and less efficient in corpse removal. All studied traits affected foraging activity, as one of the most important behaviour in colony life.Some of the ant collective behaviours, like foraging, are determined by many traits and their interaction, while others are mostly determined by one or a few major colony characteristics. Overall, our results suggest that individual tasks which generate collective behaviours depend on different intrinsic traits of the ant colony that make a timely and appropriate behavioural response possible in every situation.
Current status of prognostic factors in patients with metastatic renal cell carcinoma
Authors: Teishima Jun , Inoue Shogo , Hayashi Tetsutaro , Matsubara Akio 
Published: April 2019

AbstractIn recent years, the induction of novel agents, including molecular‐targeted agents and immune checkpoint inhibitors, have dramatically changed therapeutic options and their outcomes for metastatic renal cell carcinoma. Several prognostic models based on the data of patients with metastatic renal cell carcinoma treated with targeted agents or cytokine therapy have been useful in real clinical practice. Serum or peripheral blood markers related to inflammatory response have been reported to be associated with their prognosis or therapeutic efficacy. In addition to them, investigation for novel predictive factors that represent the efficacy of agents, the risk of adverse events and the prognosis are required for the advance of therapeutic strategies. The present review discusses the conventional prognostic models and clinical factors, and recent advances of the identification of some of the most promising molecules as novel biomarkers for metastatic renal cell carcinoma.
Sudden infant death syndrome: current perspectives
Authors: Horne Rosemary S. C. 
Published: April 2019

AbstractDespite significant reductions in incidence since the introduction of safe infant sleeping recommendations, sudden infant death syndrome is still the major cause of neonatal death in western countries. In the United States, over 2500 infants die suddenly and unexpectedly each year with nearly 100 deaths annually in Australia. Health professionals play a critical role in advising parents how to sleep their infants safely to minimise the risk of sudden infant death syndrome and sleeping accidents. Infants should be placed supine to sleep in a cot with a firm well‐fitting mattress in the parental bedroom with no soft or loose bedding which could obstruct the airway. Exposure to smoking both before and after birth should be minimised. Breastfeeding should be encouraged, as should immunisation. Dummies can be recommended after breastfeeding has been established. This review outlines the evidence behind these recommendations.
A comparison of nurse shift workers’ and non‐shift workers’ psychological functioning and resilience
Authors: Tahghighi Mozhdeh , Brown Janie A. , Breen Lauren J. , Kane Robert , Hegney Desley , Rees Clare S. 
Published: April 2019

AbstractAimsTo investigate the impact of shift work on the psychological functioning and resilience of nurses by comparing nurses who work shifts and nurses who work regular hours.DesignA comparative descriptive design using an online self‐report questionnaire.MethodData were collected from employed Registered and Enrolled Nurses (N = 1,369) who were members of the Queensland Nurses and Midwives Union (QNMU) in 2013. The survey included standardized measures of resilience, depression, anxiety, compassion satisfaction, compassion fatigue, and intention to leave the profession.ResultsGeneralized Linear Mixed Model analysis revealed shift workers had significantly lower levels of compassion satisfaction. However, there were no significant differences between the groups on resilience, depression, anxiety, stress, compassion fatigue or intention to leave nursing.ConclusionThe findings suggest that shift work is not associated with worse psychological functioning or lower resilience in nurses. However, this study requires replication using a longitudinal design to confirm these findings.
Agency cost of debt overhang with optimal investment timing and size
Authors: Nishihara Michi , Sarkar Sudipto , Zhang Chuanqian 
Published: April 2019

AbstractThe concept of debt overhang (that is, an equity‐maximizing levered firm will under‐invest relative to a firm‐value‐maximizing firm) is well established in the literature. A number of papers have demonstrated it as delayed investment (when investment size is specified) or smaller investment (when investment time is specified). However, there is no work on the underinvestment effect when the firm chooses both size and timing of investment, as it usually does in real life. This is what our paper focuses on. When the firm has the flexibility to choose both size and time, the effect is complicated by the fact that delayed investment results in larger investment, which suggests that the underinvestment problem might be mitigated. We find, however, that the effect depends on how underinvestment is measured. When measured by the expected present value of investment, flexibility can mitigate or exacerbate the underinvestment problem, depending on the cost of installing capacity. But when measured by the agency cost, flexibility always exacerbates the underinvestment problem. It is shown numerically that, at the optimal leverage ratio, the agency cost with plausible parameter values can be economically significant. Thus, with the flexibility of choosing both time and size of investment, the debt overhang problem can be of significant practical relevance in corporate investment decisions.
Epicardial ganglionated plexi ablation increases the inducibility of ventricular tachyarrhythmias in a canine postmyocardial infarction model
Authors: Wu Bing , Xu Shanghua , Dai Ruozhu , Hong Meiman , Wu Haiyun , Lin Rong 
Published: April 2019

AbstractIntroductionPrevious studies have shown that epicardial ganglionated plexi ablation (EGPA) could increase the risk of ventricular arrhythmias induced by acute myocardial ischemia. However, the long‐term effect of EGPA in a canine postmyocardial infarction (MI) model is not well established.Materials and MethodsTwenty mongrel dogs were randomly divided into two groups: an MI group (n = 10) and an EGPA group (EGPA plus MI, n = 10). EGPA was achieved by ablation of four major ganglion plexi and the ligament of Marshall. The electrocardiograph (ECG) parameters, ventricular effective refractory period (ERP), inducibility of tachyarrhythmias, and ventricular fibrillation threshold (VFT) were measured at baseline and after 8 weeks. Tyrosine hydroxylase (TH) and nerve growth factor (NGF) expression levels in the peri‐infarcted zone were also determined by immunohistochemistry in both groups at the end of the study.ResultsNo significant differences were found in electrophysiological parameters at the baseline between the two groups. At the end of the 8‐week follow‐up, however, the EGPA group was associated with a longer QT interval, corrected QT (QTc) interval and ventricular ERP, larger dispersion of QT, QTc, and ERP, and higher inducibility of tachyarrhythmia and VFT when compared to the MI group. In addition, the density of TH and NGF in the peri‐infarcted zone was also significantly increased in the EGPA group in comparison to the MI group.ConclusionsAfter the 8‐week follow‐up, EGPA increased the ventricular arrhythmia inducibility in the canine post‐MI model, likely by increasing ventricular electrophysiological instability and promoting ventricular sympathetic remodeling.
EYA4 serves as a prognostic biomarker in hepatocellular carcinoma and suppresses tumour angiogenesis and metastasis
Authors: Gu Fangming , Yuan Shengxian , Liu Lei , Zhu Peng , Yang Yuan , Pan Zeya , Zhou Weiping 
Published: April 2019

AbstractEye absent homolog 4 (EYA4) has been demonstrated to be down‐regulated in hepatocellular carcinoma (HCC), but its biological function and the mechanism in HCC angiogenesis and metastasis remain largely unknown. Herein, we showed that EYA4 expression was frequently low in HCC tissue samples compared with matched adjacent non‐tumourous tissues. In the analysis of 302 HCC specimens, we revealed that decreased expression of EYA4 correlated with tumour differentiation status. Univariate and multivariate analyses identified EYA4 as an independent risk factor for recurrence‐free survival (RFS) and overall survival (OS) among the 302 patients. Functional assays showed that forced expression of EYA4 suppressed HCC cell migration, invasion and capillary tube formation of endothelial cells in vitro, as well as in vivo tumour angiogenesis and metastasis in a mouse model. Furthermore, mechanism study exhibited that EYA4 could inhibit HCC angiogenesis and metastasis by inhibiting c‐JUN/VEGFA pathway. Together, we provide proof that EYA4 is a novel tumour suppressor in HCC and a new prognostic biomarker and therapeutic target in HCC.
Multimorbidity Frameworks Impact Prevalence and Relationships with Patient‐Important Outcomes
Authors: Griffith Lauren E. , Gilsing Anne , Mangin Dee , Patterson Christopher , van den Heuvel Edwin , Sohel Nazmul , St. John Philip , van den Akker Marjan , Raina Parminder 
Published: April 2019

OBJECTIVESTo explore how different frameworks and categories of chronic conditions impact multimorbidity (defined as two or more chronic conditions) prevalence estimates and associations with patient‐important functional outcomes.DESIGNBaseline data from a population‐based cohort study.SETTINGNational sample of Canadians.PARTICIPANTSA total of 51 338 community‐living adults, aged 45 to 85 years.MAIN OUTCOME MEASURESChronic conditions from three commonly recognized frameworks were categorized as: (1) diseases, (2) risk factors, or (3) symptoms. Estimates of multimorbidity prevalence were compared among frameworks by age and sex. Separate weighted logistic regression models were used to explore the impact of the different frameworks and categories of chronic conditions on odds ratios (ORs) for multimorbidity for four patient‐important functional outcomes: disability, social participation restriction, and self‐rated physical and mental health.RESULTSOne framework included diseases and risk factors, and two frameworks included diseases, risk factors, and symptoms. The prevalence of multimorbidity differed among the frameworks, ranging from 33.5% to 60.6% having two or more chronic conditions. Including risk factors in frameworks increased prevalence estimates, while including symptoms increased prevalence estimates and associations with most patient‐important outcomes. The two frameworks that included symptoms had the largest ORs for associations with disability, social participation restriction, and self‐rated physical health but not self‐rated mental health. Similar results were found when we compared ORs for patient‐important outcome for multimorbidity based on three subframeworks: one including diseases only, one including diseases and risk factors, and one including diseases, risk factors, and symptoms.CONCLUSIONSIncluding risk factors appeared to increase only the prevalence of multimorbidity without significantly altering relationships to outcomes. The inclusion of symptoms increased prevalence and associations with patient‐important outcomes. These findings underscore the importance of considering not only the number, but also the category, of conditions included in multimorbidity frameworks, as simply counting the number of diagnoses may reduce sensitivity to outcomes that are important to individuals. J Am Geriatr Soc 67:1632–1640, 2019
Relationships of family history of disease and child weight status to child routines: Multi‐mediating effect of parental feeding practices and perception of child's weight
Authors: Park So Hyun , Park Hanjong 
Published: April 2019

AbstractThe present study is a secondary data analysis of a cross‐sectional survey conducted among 129 parents of preschoolers from northwest Florida, USA. It examined the multi‐mediating effect of parental feeding practices and parents' perception of child's weight in the relationships of family history of disease and child's weight to child routines. Children's height and weight were measured, and body mass index was calculated. Path analyses were performed to test the mediation model using AMOS 25.0. The mediating analysis revealed that restriction mediates the relationship between family history of disease and child routines. Restriction and monitoring were significant mediators between child's weight and routines. Given the critical impact of parents on childhood obesity, understanding the mediating roles of parental feeding practices is imperative, as such practices might be susceptible to intervention. Health‐care providers should assess parental feeding practices in their practice settings.
Bowel symptoms predate the diagnosis among many patients with multiple sclerosis: A 14‐year cohort study
Authors: Almeida Mariana N. , Silvernale Casey , Kuo Braden , Staller Kyle 
Published: April 2019

AbstractBackgroundMultiple sclerosis (MS) is an autoimmune, neurodegenerative disease frequently complicated by bowel symptoms. Multiple sclerosis typically first manifests with a demyelination event, also known as a clinically isolated syndrome (CIS). We sought to examine the prevalence of prodromal bowel symptoms predating a CIS in patients with MS as part of a recently characterized prodromal phase of disease.MethodsWe constructed a retrospective cohort of MS patients with bowel symptoms and an identifiable CIS at two tertiary care centers over 14 years using administrative and billing data. We determined the date of onset of reported bowel symptoms in comparison with the date of first CIS and determined the overall prevalence of prediagnosis bowel symptoms within 1, 2, 3, and >3 years from a CIS. We used multivariable modeling to determine demographic and clinical risk factors for prediagnosis bowel symptoms.Key ResultsAmong 385 MS patients with reported bowel symptoms, 122 (31.6%) reported bowel symptoms prior to CIS. The most common first bowel symptom was constipation (50.0%), followed by diarrhea (29.5%). The average lead time between a first bowel symptom and a CIS event was 3.7 ± 3.4 years. Pre‐CIS fatigue (OR 4.48, 95% CI: 2.68‐7.51, P < 0.001) and pre‐CIS sensory disturbances (OR 1.88, 95% CI: 1.15‐3.08, P < 0.05) were all associated with bowel symptoms prior to a CIS event.Conclusions and InferencesNearly a third of MS patients with bowel symptoms reported bowel symptoms prior to a demyelinating event/CIS. Characterization of a prodromal phase of disease may provide important insights into understanding disease progression.