bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Care Delivery Model for High-Need Older Adults in the Community
Authors: Hsu Hui-Fen , Chen Kuei-Min , Chen Yu-Ming , Chang Chiang-Ching , Chen Meng-Chin , Kuo Chuan-Feng 
Published: July 2019

Background
High-need older adults have multiple needs and require different types of care services. Care coordinators in community care centers in Taiwan, however, often experience difficulties in providing sufficient care services because of the inadequate capacity of case management.

Objective
The aim of this study was to develop a realistic care delivery model for the care coordinators to manage the care of high-need, community-dwelling older adults.

Methods
Focus-group interviews concerning elements and process for establishing a care delivery model were conducted with 12 care management experts in two groups: the practical work group (three registered nurses and three social workers) and the care management group (three care managers and three care management supervisors). The interviews were video-recorded and subjected to content analysis.

Results
A five-stage care delivery model was formulated: case screening, case assessment, care plan, care delivery, and follow-up evaluation. Six types of high-need older adults were identified: those living with disability, solitude, dementia, depression, elder abuse, and poverty. A list of categorized care services, including care resources, social welfare resources, and caregiver resources, was then used as a guide for case management and care delivery.

Discussion
The developed model—consisting a classification of services for different types of high-need older adults—serves as a guide for care coordinators in community care centers to make better decisions on service linkages, resource management, and care plan monitoring.
Pearls in the Wrong Pockets
Authors: Qureshi Pir Abdul Ahad Aziz , Yaseen Muhammad Talha , Bashir Humayun , Niazi Imran Khalid 
Published: July 2019

Abstract
Idiopathic scrotal calcinosis, also called dystrophic scrotal calcinosis, is a rare benign condition that causes superficial intradermal scrotal calcifications. We present one such case of a 40-year-old married man who underwent PET/CT scan for staging workup of lymphoma and revealed this rare entity incidentally without any other testicular pathology.
Adult Pancreatoblastoma With Liver Metastasis Diagnosed by 18F-FDG PET/CT and 2 Years’ Postoperative Follow-up
Authors: Liu En-Tao , Liu Chao , Wang Hui-Ling , Sun Tao-Tao , Wang Shu-Xia 
Published: July 2019

Abstract
Pancreatoblastoma is an extremely rare malignant tumor of the pancreas. Most patients are infants and children; however, a few cases have been reported in adults. Herein, we present the case of a 49-year-old man with pancreatoblastoma and liver metastasis who underwent preoperative multimodal imaging, in which 18F-FDG PET/CT showed a markedly increased 18F-FDG uptake in the metastatic lesion and a slightly increased uptake in the primary lesion. Subsequently, the patient underwent complete resection of the primary and metastatic lesions. No recurrences or metastases were found in 2 years of follow-up.
Use of 18F-Fluciclovine to Diagnose Recurrent Prostate Carcinoma in a Patient With Beta-Thalassemia
Authors: Schmitt Chelsea R. , Schmitt Christian T. , Hinds Peter R. , Sawyer Kevin J. 
Published: July 2019

Abstract
We present a case demonstrating increased diagnostic difficulty in interpretation of 18F-flucyclovine PET/CT in a patient with beta-thalassemia. 18F-flucyclovine PET/CT demonstrated diffuse increased marrow activity. Additional findings of extramedullary hematopoiesis including intrasplenic extramedullary hematopoiesis are presented. Despite the background marrow activity, an osseous metastatic lesion representing recurrent metastatic prostate carcinoma was identified. This case demonstrates a spectrum of findings of 18F-flucyclovine uptake in thalassemia, which increased the difficulty of identifying recurrent disease.
68Ga–Prostate-Specific Membrane Antigen Uptake in a Malignant Pleural Effusion From Metastatic Prostate Cancer After Pleurodesis
Authors: Sachpekidis Christos , Alberts Ian , Rominger Axel , Afshar-Oromieh Ali 
Published: July 2019

Abstract
A 76-year-old man with metastatic adenocarcinoma of the prostate presented with increasing dyspnea. After being treated initially with drainage and afterwards with pleurodesis, he was referred for 68Ga–prostate-specific membrane antigen 11 PET/CT imaging for restaging purposes. PET/CT demonstrated extensive 68Ga–prostate-specific membrane antigen 11 uptake in the right pleura. Histopathology confirmed the rare case of malignant pleural effusion from metastatic prostate cancer.
The Risk Factors for Facial Numbness After Microvascular Decompression in Patients With Trigeminal Neuralgia
Authors: Zhang Wen-Bo , Sun Qiu-Yang , Min Ling-Zhao , Tao Bang-Bao , Wang Xiao-Qiang 
Published: July 2019

Object:
Microvascular decompression (MVD) is the most popular surgical procedure for treating Trigeminal neuralgia (TN). In this article, the authors conducted a large case series in which patients underwent MVD for TN, and focus on surgical outcomes, intraoperative findings, complications and risk factors.

Methods:
From January 2017 to June 2017, a total of 84 patients with TN were treated with MVD in our department. The authors retrospectively analyzed the surgical outcomes and postoperative complications of these patients. Risk factors were analyzed by binary logistic regression analysis.

Results:
Of the 84 patients, 69 had complete postoperative symptom relief (BNI I-II). A total of 28 patients developed postoperative facial numbness (BNI III-IV) and 1 patient died intraoperatively. With binary logistic regression analysis, significant risk factors for postoperative Facial numbness (FN) were longer operation time (odds ratio [OR] 1.153, P <0.05) and longer hospital stay (OR 1.371, P <0.05). The patients’ age, the length of the disease, the gender, and the side of the disease did not affect the occurrence of postoperative FN.

Conclusions:
The study found that patients with TN treated with MVD had a good response rate after surgery. The incidence of FN after surgery is not low, and longer duration of surgery and longer hospital stay are risk factors for FN. In the case of ensuring the success rate of surgery, reducing unnecessary operations, reducing the operation time, will help to reduce the occurrence of FN.
Early Maladaptive Cardiovascular Responses are Associated with Mortality in a Porcine Model of Hemorrhagic Shock
Authors: Shaylor Ruth , Gavish Lilach , Yaniv Gal , Wagnert-Avraham Linn , Gertz Samuel David , Weissman Charles , Megreli Jacob , Shimon Gil , Simon Ben , Berman Asaf , Eisenkraft Arik 
Published: July 2019

ABSTRACT

Background:
Hemorrhage is a leading cause of death on the battlefield. Current methods for predicting hemodynamic deterioration during hemorrhage are of limited accuracy and practicality. During a study of the effects of remote ischemic preconditioning in pigs that underwent hemorrhage, we noticed arrhythmias among all pigs that died before the end of the experiment but not among surviving pigs. The present study was designed to identify and characterize the early maladaptive hemodynamic responses (tachycardia in the presence of hypotension without a corresponding increase in cardiac index or mean arterial blood pressure) and their predictive power for early mortality in this experimental model.

Methods:
Controlled hemorrhagic shock was induced in 16 pigs. Hemodynamic parameters were monitored continuously for 7 h following bleeding. Changes in cardiovascular and laboratory parameters were analyzed and compared between those that had arrhythmia and those that did not.

Results:
All animals had similar changes in parameters until the end of the bleeding phase. Six animals developed arrhythmias and died early, while 10 had no arrhythmias and survived longer than 6 h or until euthanasia. Unlike survivors, those that died did not compensate for cardiac output (CO), diastolic blood pressure (DBP), and stroke volume (SV). Oxygen delivery (DO2) and mixed venous saturation (SvO2) remained low in animals that had arrhythmia, while achieving certain measures of recuperation in animals that did not. Serum lactate increased earlier and continued to rise in all animals that developed arrhythmias. No significant differences in hemoglobin concentrations were observed between groups.

Conclusions:
Despite similar initial changes in variables, we found that low CO, DBP, SV, DO2, SvO2, and high lactate are predictive of death in this animal model. The results of this experimental study suggest that maladaptive responses across a range of cardiovascular parameters that begin early after hemorrhage may be predictive of impending death, particularly in situations where early resuscitative treatment may be delayed.
Twenty Years of Gut Transplantation for Chronic Intestinal Pseudo-obstruction
Authors: Sogawa Hiroshi , Costa Guilherme , Armanyous Sherif , Bond Geoffrey J. , Cruz Ruy J. , Humar Abhinav , Mazariegos George , Abu-Elmagd Kareem M. 
Published: July 2019

Objective:To define long-term outcome, predictors of survival, and risk of disease recurrence after gut transplantation (GT) in patients with chronic intestinal pseudo-obstruction (CIPO).Background:GT has been increasingly used to rescue patients with CIPO with end-stage disease and home parenteral nutrition (HPN)–associated complications. However, long-term outcome including quality of life and risk of disease recurrence has yet to be fully defined.Methods:Fifty-five patients with CIPO, 23 (42%) children and 32 (58%) adults, underwent GT and were prospectively studied. All patients suffered gut failure, received HPN, and experienced life-threatening complications. The 55 patients received 62 allografts; 43 (67%) liver-free and 19 (33%) liver-contained with 7 (13%) retransplants. Hindgut reconstruction was adopted in 1993 and preservation of native spleen was introduced in 1999. Immunosuppression was tacrolimus-based with antilymphocyte recipient pretreatment in 41 (75%).Results:Patient survival was 89% at 1 year and 69% at 5 years with respective graft survival of 87% and 56%. Retransplantation was successful in 86%. Adults experienced better patient (P= 0.23) and graft (P= 0.08) survival with lower incidence of post-transplant lymphoproliferative disorder (P= 0.09) and graft versus host disease (P= 0.002). Antilymphocyte pretreatment improved overall patient (P= 0.005) and graft (P= 0.069) survival. The initially restored nutritional autonomy was sustainable in 23 (70%) of 33 long-term survivors with improved quality of life. The remaining 10 recipients required reinstitution of HPN due to allograft enterectomy (n = 3) or gut dysfunction (n = 7). Disease recurrence was highly suspected in 4 (7%) recipients.Conclusions:GT is life-saving for patients with end-stage CIPO and HPN-associated complications. Long-term survival is achievable with better quality of life and low risk of disease recurrence.
Survival Outcomes Associated With Clinical and Pathological Response Following Neoadjuvant FOLFIRINOX or Gemcitabine/Nab-Paclitaxel Chemotherapy in Resected Pancreatic Cancer
Authors: Macedo Francis I. , Ryon Emily , Maithel Shishir K. , Lee Rachel M. , Kooby David A. , Fields Ryan C. , Hawkins William G. , Williams Greg , Maduekwe Ugwuji , Kim Hong J. , Ahmad Syed A. , Patel Sameer H. , Abbott Daniel E. , Schwartz Patrick , Weber Sharon M. , Scoggins Charles R. , Martin Robert C. G. , Dudeja Vikas , Franceschi Dido , Livingstone Alan S. , Merchant Nipun B. 
Published: July 2019

Objective:
To compare the survival outcomes associated with clinical and pathological response in pancreatic ductal adenocarcinoma (PDAC) patients receiving neoadjuvant chemotherapy (NAC) with FOLFIRINOX (FLX) or gemcitabine/nab-paclitaxel (GNP) followed by curative-intent pancreatectomy.

Background:
Newer multiagent NAC regimens have resulted in improved clinical and pathological responses in PDAC; however, the effects of these responses on survival outcomes remain unknown.

Methods:
Clinicopathological and survival data of PDAC patients treated at 7 academic medical centers were analyzed. Primary outcomes were overall survival (OS), local recurrence-free survival (L-RFS), and metastasis-free survival (MFS) associated with biochemical (CA 19–9 decrease ≥50% vs <50%) and pathological response (complete, pCR; partial, pPR or limited, pLR) following NAC.

Results:
Of 274 included patients, 46.4% were borderline resectable, 25.5% locally advanced, and 83.2% had pancreatic head/neck tumors. Vein resection was performed in 34.7% and 30-day mortality was 2.2%. R0 and pCR rates were 82.5% and 6%, respectively. Median, 3-year, and 5-year OS were 32 months, 46.3%, and 30.3%, respectively. OS, L-RFS, and MFS were superior in patients with marked biochemical response (CA 19–9 decrease ≥50% vs <50%; OS: 42.3 vs 24.3 months, P < 0.001; L-RFS-27.3 vs 14.1 months, P = 0.042; MFS-29.3 vs 13 months, P = 0.047) and pathological response [pCR vs pPR vs pLR: OS- not reached (NR) vs 40.3 vs 26.1 months, P < 0.001; L-RFS-NR vs 24.5 vs 21.4 months, P = 0.044; MFS-NR vs 23.7 vs 20.2 months, P = 0.017]. There was no difference in L-RFS, MFS, or OS between patients who received FLX or GNP.

Conclusion:
This large, multicenter study shows that improved biochemical, pathological, and clinical responses associated with NAC FLX or GNP result in improved OS, L-RFS, and MFS in PDAC. NAC with FLX or GNP has similar survival outcomes.
Missing expectations: Windlass tourniquet use without formal training yields poor results
Authors: Dennis Andrew , Bajani Francesco , Schlanser Victoria , Tatebe Leah C. , Impens Ann , Ivkovic Katarina , Li Anqi , Pickett Thomas , Butler Caroline , Kaminsky Matthew , Messer Thomas , Starr Frederic , Mis Justin , Bokhari Faran 
Published: July 2019

BACKGROUND
Despite significant attempts to educate civilians in hemorrhage control, the majority remain untrained. We sought to determine if laypersons can successfully apply one of three commercially available tourniquets; including those endorsed by the United States Military and the American College of Surgeons.

METHODS
Preclinical graduate health science students were randomly assigned a commercially available windless tourniquet: SAM XT, Combat Application Tourniquet (CAT), or Special Operation Forces Tactical Tourniquet (SOFT-T). Each was given up to 1 minute to read package instructions and asked to apply it to the HapMed Leg Tourniquet Trainer. Estimated blood loss was measured until successful hemostatic pressure was achieved or simulated death occurred from exsanguination. Simulation survival, time to read instructions and stop bleeding, tourniquet pressure, and blood loss were analyzed.

RESULTS
Of the 150 students recruited, 55, 46, and 49 were randomized to the SAM XT, CAT, SOFT-T, respectively. Mean overall simulation survival was less than 66% (65%, 72%, 61%; p = 0.55). Of survivors, all three tourniquets performed similarly in median pressure applied (319, 315, and 329 mm Hg; p = 0.54) and median time to stop bleeding (91, 70, 77 seconds; p = 0.28). There was a statistical difference in median blood loss volume favoring SOFT-T (SAM XT, 686 mL; CAT, 624 mL; SOFT-T, 433 mL; p = 0.03). All 16 participants with previous experience were able to successfully place the tourniquet compared with 81 (62%) of 131 first-time users (p = 0.008).

CONCLUSION
No one should die of extremity hemorrhage, and civilians are our first line of defense. We demonstrate that when an untrained layperson is handed a commonly accepted tourniquet, failure is unacceptably high. Current devices are not intuitive and require training beyond the enclosed instructions. Plans to further evaluate this cohort after formal “Stop the Bleed” training are underway.
Post-Li batteries: promises and challenges
Authors: Ponrouch Alexandre , Palacín M. Rosa 
Published: July 2019

Current societal challenges in terms of energy storage have prompted an intensification in the research aiming at unravelling new high energy density battery technologies. These would have the potential of having disruptive effects in the world transition towards a less carbon-dependent energy economy through transport, both by electrification and renewable energy integration. Aside from controversial debates on lithium supply, the development of new sustainable battery chemistries based on abundant elements is appealing, especially for large-scale stationary applications. Interesting alternatives are to use sodium, magnesium or calcium instead of lithium. While for the Na-ion case, fast progresses are expected as a result of chemical similarities with lithium and the cumulated Li-ion battery know-how over the years, for Ca and Mg the situation is radically different. On the one hand, the possibility to use Ca or Mg metal anodes would bring a breakthrough in terms of energy density; on the other, development of suitable electrolytes and cathodes with efficient multivalent ion migration are bottlenecks to overcome.
This article is part of a discussion meeting issue ‘Energy materials for a low carbon future’.
Assembly, charge-transfer and solar cell performance with porphyrin-C
60
on NiO for p-type dye-sensitized solar cells
Authors: Benazzi Elisabetta , Summers Gareth H. , Black Fiona A. , Sazanovich Igor V. , Clark Ian P. , Gibson Elizabeth A. 
Published: July 2019

A series of zinc tetraphenylporphyrin photosensitizers furnished with three different anchoring groups, benzoic acid, phenylphosphonate and coumarin-3-carboxylic acid, were prepared using ‘click’ methodology. All three gave modest performances in liquid junction devices with I
3
–
/I
–
as the electrolyte. The distinct spectroscopic properties of the porphyrins allowed a detailed investigation of the adsorption behaviour and kinetics for charge transfer at the NiO|porphyrin interface. The adsorption behaviour was modelled using the Langmuir isotherm model and the phosphonate anchoring group was found to have the highest affinity for NiO (6.65 × 10
4
M
−1
) and the fastest rate of adsorption (2.46 × 10
7
cm
2
mol
−1
min
−1
). The photocurrent of the p-type dye-sensitized solar cells increased with increasing dye loading and corresponding light harvesting efficiency of the electrodes. Coordinating the zinc to a pyridyl-functionalized fullerene (

C
60
PPy

) extended the charge-separated state lifetime from
ca
200 ps to 4 ns and a positive improvement in the absorbed photon to current conversion efficiency was observed. Finally, we confirmed the viability of electron transfer from the appended

C
60
PPy

to phenyl-C61-butyric acid methyl ester, a typical electron transporting layer in organic photovoltaics. This has implications for assembling efficient solid-state tandem solar cells in the future.

This article is part of a discussion meeting issue ‘Energy materials for a low carbon future’.
The effect of space-charge formation on the grain-boundary energy of an ionic solid
Authors: De Souza R. A. , Dickey E. C. 
Published: July 2019

Taking the model system of an oxide containing acceptor dopant cations and charge-compensating oxygen vacancies, we calculate at the continuum level the change in the excess grain-boundary energy of an ionic solid upon space-charge formation. Two different cases are considered for the space-charge layers: (i) only vacancies attain electrochemical equilibrium and (ii) both dopants and vacancies attain electrochemical equilibrium. The changes calculated for a specific set of grain boundaries indicate that, depending on dopant concentration, space-charge formation can decrease the excess free energy by up to 15% in the first case and by up to 45% in the second case. The possibility of the excess grain-boundary energy going to zero and the possible effects of an external electric field on the excess grain-boundary energy are also discussed.
This article is part of a discussion meeting issue ‘Energy materials for a low carbon future’.
Thermoelectric power generation: from new materials to devices
Authors: Tan Gangjian , Ohta Michihiro , Kanatzidis Mercouri G. 
Published: July 2019

Thermoelectric technology offers the opportunity of direct conversion between heat and electricity, and new and exciting materials that can enable this technology to deliver higher efficiencies have been developed in recent years. This mini-review covers the most promising advances in thermoelectric materials as they pertain to their potential in being implemented in devices and modules with an emphasis on thermoelectric power generation. Classified into three groups in terms of their operating temperature, the thermoelectric materials that are most likely to be used in future devices are briefly discussed. We summarize the state-of-the-art thermoelectric modules/devices, among which nanostructured PbTe modules are particularly highlighted. At the end, key issues and the possible strategies that can help thermoelectric power generation technology move forward are considered.
This article is part of a discussion meeting issue ‘Energy materials for a low carbon future’.
Public knowledge and attitude towards epilepsy and its associated factors in Debre Berhan, North Shoa, Amhara Region, Ethiopia, 2018/19. Community-based cross-sectional study
Authors: Dargie Abate , Alemnew Nigus , Admasu Elyas 
Published: July 2019

AbstractIntroductionEpilepsy is chronic brain disorder characterized by recurrent derangement of the nervous system due to the sudden excessive disorderly discharge of the cerebral neurons. People living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions, and misunderstandings that have persisted for many years. Therefore, this study aimed to assess the community general knowledge and attitude towards epilepsy.MethodsCommunity-based cross-sectional study was conducted to assess public general knowledge and attitude towards epilepsy and its associated factors using structured pretested questionnaire. Data were entered into Epi data version 3.1 and transported to SPSS version 21 further analysis. Both Bivariable and Multivariable Logistic Regression was done to identify associated factors. Odds Ratios and their 95% Confidence interval were computed and variables with p-value less than 0.05 was considered significantly associated factors.Results596 study participants participated in a response rate of 98%. Among the study participants, 43.6 (95% CI: 39.6, 47.5) had poor knowledge and 41.3 (95% CI: 37.4, 45.1) had an unfavorable attitude. Being secondary education, marital status, witnessed a seizure and heard the term epilepsy were showed statistically significant association with poor knowledge about epilepsy. Level of education, low average monthly income, not witnessed a seizure, not heard the term epilepsy and distant from health facility showed statically significant association with the unfavorable attitude.ConclusionIn this study, Debre Berhan communities were found to have deficits in terms of general knowledge and attitude about epilepsy; and it should be given due attention.