bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of Inadequate Sleep on Blood Pressure and Endothelial Inflammation in Women: Findings From the American Heart Association Go Red for Women Strategically Focused Research Network
Authors: Aggarwal Brooke , Makarem Nour , Shah Riddhi , Emin Memet , Wei Ying , St‐Onge Marie‐Pierre , Jelic Sanja 
Published: June 2018

Background
Insufficient sleep increases blood pressure. However, the effects of milder, highly prevalent but frequently neglected sleep disturbances, including poor sleep quality and insomnia, on vascular health in women are unclear. We investigated whether poor sleep patterns are associated with blood pressure and endothelial inflammation in a diverse sample of women.

Methods and Results

Women who participated in the ongoing American Heart Association Go Red for Women Strategically Focused Research Network were studied (n=323, 57% minority, mean age=39±17 years, range=20–79 years). Sleep duration, sleep quality, and time to sleep onset were assessed using the Pittsburgh Sleep Quality Index (score ≥5=poor sleep quality). Risk for obstructive sleep apnea was evaluated using the Berlin questionnaire, and insomnia was assessed using the Insomnia Severity Index. In a subset of women who participated in the basic study (n=26), sleep duration was assessed objectively using actigraphy, and endothelial inflammation was assessed directly in harvested endothelial cells by measuring nuclear translocation of nuclear factor kappa B. Vascular reactivity was measured by brachial artery flow‐mediated dilation (n=26). Systolic and diastolic blood pressure were measured by trained personnel (n=323). Multivariable linear regressions were used to evaluate associations between sleep patterns and blood pressure, nuclear factor kappa B, and flow‐mediated dilation. Mean sleep duration was 6.8±1.3 hours/night in the population study and 7.5±1.1 hour/night in the basic study. In the population study sample, 50% had poor sleep quality versus 23% in the basic study, and 37% had some level of insomnia versus 15% in the basic study. Systolic blood pressure was associated directly with poor sleep quality, and diastolic blood pressure was of borderline significance with obstructive sleep apnea risk after adjusting for confounders (
P
=0.04 and
P
=0.08, respectively). Poor sleep quality was associated with endothelial nuclear factor kappa B activation (β=30.6;
P
=0.03). Insomnia and longer sleep onset latency were also associated with endothelial nuclear factor kappa B activation (β=27.6;
P
=0.002 and β=8.26;
P
=0.02, respectively). No evidence was found for an association between sleep and flow‐mediated dilation.

Conclusions
These findings provide direct evidence that common but frequently neglected sleep disturbances such as poor sleep quality and insomnia are associated with increased blood pressure and vascular inflammation even in the absence of inadequate sleep duration in women.

Clinical Trial Registration

URL
:
https://www.clinicaltrials.gov
. Unique identifier:
NCT
02835261.
Inverse Association Between Serum Non–High‐Density Lipoprotein Cholesterol Levels and Mortality in Patients Undergoing Incident Hemodialysis
Authors: Chang Tae Ik , Streja Elani , Ko Gang Jee , Naderi Neda , Rhee Connie M. , Kovesdy Csaba P. , Kashyap Moti L. , Vaziri Nosratola D. , Kalantar‐Zadeh Kamyar , Moradi Hamid 
Published: June 2018

Background

There is accumulating evidence that serum levels of non–high‐density lipoprotein cholesterol (non–
HDL
‐C) are a more accurate predictor of cardiovascular outcomes when compared with low‐density lipoprotein cholesterol. However, we recently found that higher serum concentrations of triglycerides are associated with better outcomes in patients undergoing hemodialysis. Therefore, we hypothesized that the association of serum levels of non–
HDL
‐C (which includes triglyceride‐rich lipoproteins) with outcomes may also be different in patients undergoing hemodialysis when compared with other patient populations.

Methods and Results

We studied the association of baseline and time‐dependent serum levels of non–
HDL
‐C with all‐cause and cardiovascular mortality using Cox proportional hazard regression models in a nationally representative cohort of 50 118 patients undergoing incident hemodialysis from January 1, 2007, to December 31, 2011. In time‐dependent models adjusted for case mix and surrogates of malnutrition and inflammation, a graded inverse association between non–
HDL
‐C level and mortality was demonstrated with hazard ratios (95% confidence intervals) of the lowest (<60 mg/dL) and highest (≥160 mg/dL) categories: 1.88 (1.72–2.06) and 0.73 (0.64–0.83) for all‐cause mortality and 2.07 (1.78–2.41) and 0.75 (0.60–0.93) for cardiovascular mortality, respectively (reference, 100–115 mg/dL). In analyses using baseline values, non–
HDL
‐C levels <100 mg/dL were also associated with significantly higher mortality risk across all levels of adjustment. Similar associations were found when evaluating non‐
HDL
/
HDL
cholesterol ratio and mortality, with the highest all‐cause and cardiovascular mortality being observed in patients with decreased non‐
HDL
/
HDL‐C
ratio (<2.5).

Conclusions

Contrary to the general population, decrements in non–
HDL
‐C and non‐
HDL
/
HDL
cholesterol ratio were paradoxically associated with increased all‐cause and cardiovascular mortality in patients undergoing incident hemodialysis. The underlying mechanisms responsible for these associations await further investigation.
Ventricular Arrhythmias in Young Competitive Athletes: Prevalence, Determinants, and Underlying Substrate
Authors: Zorzi Alessandro , De Lazzari Manuel , Mastella Giulio , Niero Alice , Trovato Domenico , Cipriani Alberto , Peruzza Francesco , Portolan Leonardo , Berton Giampaolo , Sciacca Federco , Tollot Saverio , Palermo Chiara , Bellu Roberto , D'ascenzi Flavio , Muraru Denisa , Badano Luigi Paolo , Iliceto Sabino , Schiavon Maurizio , Perazzolo Marra Martina , Corrado Domenico 
Published: June 2018

Background

Whether ventricular arrhythmias (
VAs
) represent a feature of the adaptive changes of the athlete's heart remains elusive. We aimed to assess the prevalence, determinants, and underlying substrates of
VAs
in young competitive athletes.

Method and Results

We studied 288 competitive athletes (age range, 16–35 years; median age, 21 years) and 144 sedentary individuals matched for age and sex who underwent 12‐lead 24‐hour ambulatory electrocardiographic monitoring.
VAs
were evaluated in terms of number, complexity (ie, couplet, triplet, or nonsustained ventricular tachycardia), exercise inducibility, and morphologic features. Twenty‐eight athletes (10%) and 13 sedentary individuals (11%) showed >10 isolated premature ventricular beats (
PVB
s) or ≥1 complex
VA
(
P
=0.81). Athletes with >10 isolated
PVB
s or ≥1 complex
VA
were older (median age, 26 versus 20 years;
P
=0.008) but did not differ with regard to type of sport, hours of training, and years of activity compared with the remaining athletes. All athletes with >10 isolated
PVB
s or ≥1 complex
VA
had a normal echocardiographic examination; 17 of them showing >500 isolated
PVB
s, exercise‐induced
PVB
s, and/or complex
VA
underwent additional cardiac magnetic resonance, which demonstrated nonischemic left ventricular late gadolinium enhancement in 3 athletes with right bundle branch block
PVB
s morphologic features.

Conclusions

The prevalence of >10 isolated
PVB
s or ≥1 complex
VA
at 24‐hour ambulatory electrocardiographic monitoring did not differ between young competitive athletes and sedentary individuals and was unrelated to type, intensity, and years of sports practice. An underlying myocardial substrate was uncommon and distinctively associated with right bundle branch block
VA
morphologic features.
Splenic artery embolisation in trauma: A five-year single-centre experience at a UK major trauma centre
Authors: Davies James , Wells David 
Published: June 2018

Introduction Since the introduction of major trauma centres and regional trauma networks in 2012, management of splenic injury has shifted, with non-operative management now favoured. For those requiring intervention, splenic artery embolisation is well established as a first-line treatment in all but the most severely injured. Follow-up is variable, with few guidelines, highlighting the paucity of data addressing the need for further imaging and antimicrobial prophylaxis. This review was undertaken to assess practice and outcomes at our centre in the context of the contemporary literature. Methods This retrospective study captured splenic embolisations over five years (January 2012–December 2016). CRIS interventional radiology codes were used to retrieve embolisation cases and Trauma Audit and Research Network and hospital event statistics data were used to identify all cases of traumatic splenic injury and to identify splenectomy and non-operative management patients. Outcomes were compared with available standards from different sources. Results Over the study period 176 splenic injuries were identified, of which 122 underwent non-operative management, 28 were laparotomy first, and 26 undergoing embolisation with an increased trend to an ‘embolisation-first’ approach over this time. In the embolisation group, the age range was 16–79 yr (mean 41), 18 were male and the median time to intervention was 2 h 9 min (range 1.1–171 h), with eight following failed non-operative management. The proportion of proximal versus selective embolisation versus both was 10:14:1 and the predominant mechanism was coiling. One patient was not embolised due to absence of contrast extravasation on initial angiogram and two proceeded to splenectomy due to failure of splenic artery embolisation. There were complications in six patients: five ongoing left upper quadrant pain, one infected haematoma requiring drainage, two chest infections with pleural effusions, one of which required drainage. There were two deaths from other injuries. Fifteen of the 25 patients who underwent splenic artery embolisation had follow-up imaging, seven did not and three were excluded due to splenectomy and/or death; five patients were vaccinated according to the hospital splenectomy protocol, and six received prophylactic antibiotics. Conclusion Our data show that non-operative management is the mainstay of treatment for the majority of splenic injury patients. Serious complications are not common but variation does exist in follow-up. The changing management trends are in line with national data. These findings will help to further implement and develop local protocols but more work is required to address splenic function after embolisation and the requirement for antimicrobial prophylaxis.
Comparison of psychosocial and medical characteristics of patients with dementia and their primary informal caregivers between inpatient and day clinic treatment
Authors: Linnemann Alexandra , Hilsenbek Magdalena M , Lelieveld Irene , Geschke Katharina , Wolf Dominik , Fellgiebel Andreas 
Published: June 2018

BackgroundCaregiver burden is one of the most common reasons for hospitalization of patients with dementia. However, changes of location are not recommended for patients with dementia and associated with negative outcomes for patients with dementia. As there is yet a lack of outpatient treatment options, this study explores psychiatric day clinic treatment as option for patients with dementia by comparing characteristics of voluntarily treated patients with dementia and their respective informal caregivers between an inpatient and day clinic setting.MethodsA total of 92 patients with dementia (56 inpatient, 36 day clinic) and their informal caregiver provided information on psychosocial and clinical characteristics (Mini-Mental-Status-Test, Neuropsychiatric Inventory, Bayer Activities of Daily Living, Barthel Index, Geriatric Depression Scale-30, Beck’s Depression Inventory-II, caregiver burden, Short Form Health Survey-36) at the beginning of treatment and at follow-up (n = 48 patient caregiver dyads) six months after discharge.ResultsPatients with dementia did not differ in disease severity, neuropsychiatric symptoms, and depression depending on treatment setting. However, the higher the Bayer activities of daily living score, the more likely treatment in day clinic was. Caregivers from patients with dementia in the inpatient setting were younger and reported more financial burden, whereas caregivers from patients with dementia in the day clinic reported lower physical health and more burden due to practical caring responsibilities. Longitudinal data indicated no differences in characteristics of patients with dementia and caregivers depending on treatment setting, despite caregivers from patients in the day clinic reporting more depressive symptoms after six months.ConclusionDay clinic treatment for voluntarily treated patients with dementia might be an alternative to inpatient settings. Patients with dementia do not substantially differ depending on treatment setting, rather characteristics of the caregivers were associated with placement in inpatient or day clinic setting. The needs of caregivers deserve special attention when considering treatment for patients with dementia.
Is it time to change? Portable echocardiography demonstrates high prevalence of abnormalities in self-presenting members of a rural community in Kyrgyzstan
Authors: James Barron Anthony , Aijigitov Turgunbai , Baltabaeva Aigul 
Published: June 2018

Objectives Cardiovascular disease accounts for 42% of male and 51% of female mortality within Europe. Kyrgyzstan, population of almost 6 million, has amongst the highest rates within Europe, second only to Uzbekistan for female cardiovascular disease mortality (588 per 100,000). We attempted to identify established cardiovascular disease prevalence within a rural community in Kyrgyzstan using portable echocardiography. Design Free open access echocardiography (VIVID-I, GE, USA) was offered to all adults in Batken district. Routine echocardiographic views were obtained and analysis performed using EchoPac Clinical Workstation (GE, USA). Mild valvular regurgitation, mild LV hypertrophy, patent foramen ovales and mild atrial enlargement were considered mild abnormalities; compensated ischaemic or valvular heart disease – moderate abnormalities, and decompensated congenital, ischaemic or valvular disease – severe abnormalities. Results One hundred and twenty five adults (48 male, 77 female), mean age 53 ± 16 years, underwent echocardiography. Only 16% of participants had no significant abnormality, 46% had mild disease, 25% moderate, compensated disease and 13% had severe disease. Nine percent had congenital heart disease including one tetralogy of Fallot and one Ebstein’s anomaly. Average LV function was normal, however, 19 participants had EF < 50%. Forty percent of participants had a new diagnosis warranting formal follow-up, 12% a new diagnosis of heart failure. Conclusion Using portable echocardiography, we identify a higher than reported prevalence of cardiovascular disease in rural Kyrgyzstan. Absence of portable tools and specialists for early diagnosis might lead to presentation in an advanced stage of disease when little can be done to improve mortality. Embracing remote access diagnostics is essential for disease identification within rural communities.
Nella Larsen's Etiquette Lesson: Small Talk, Racial Passing, and the Novel of Manners
Authors: Krumholtz Matthew 
Published: June 2018

AbstractThis essay explores how novelists of the Harlem Renaissance deploy small talk to disrupt racial identification. Nella Larsen's Passing (1929) serves as a case study showing that small talk magnifies a strange intimacy between passing narratives and etiquette manuals in the early twentieth century. While critics have tended to view small talk under the rubric of gossip, writers of the Harlem Renaissance call attention to the way that small talk enables racial passing by keeping dialogue on neutral and impersonal grounds. Nella Larsen makes peculiarly pronounced use of small talk, which emerges in her fiction as a self-accenting style of racial embodiment and a bold revision to the American novel of manners and to early twentieth-century etiquette manuals. Drawing on sociolinguistics and microsociology, this essay argues that Larsen unsettles the cultural tendency to equate passing with self-denial, converting small talk to an equivocal medium for passing that, paradoxically, makes audible a protest against racial segregation and social regulation.
Modernist Low Vision: Visual Impairment and Weak Narrative in Conrad and Joyce
Authors: Volpicelli Robert 
Published: June 2018

AbstractJoseph Conrad and James Joyce share an interest in the aesthetic qualities of bad eyesight. Drawing on recent disability theory, this essay shows how Conrad and Joyce make use of disabled or “low” vision to initiate what I call weak narration, the tendency to prioritize the sensory-rich experiences of diminished perception over the normative demands of narrative resolution. Relying on low vision for their hazy, impressionist atmosphere, Conrad's novels specifically form a response to fin de siècle degeneration theory, which links proper perception to a larger narrative of human development. Though Heart of Darkness follows such a formula by using the failure of sight to mark narrative decline, Conrad's later texts, especially The End of the Tether, disrupt any deterministic relationship between sight and progress. Joyce takes up a similar line in Portrait of the Artist as a Young Man, where Stephen Dedalus's low vision draws his attention to sensations that repeatedly distract from his bildungsroman plot. The low-vision characters of Ulysses then offer a conclusion to this strategy in the way they altogether abandon progress to make a narrative of wandering sensations, revealing in the process the centrality of disability to the antidevelopment plot as well as to modernist aesthetics more generally.
Street-Level Multiculturalism: Cultural Integration and Identity Politics of African Migrants in Hong Kong
Authors: Shum Terence Chun Tat , 俊达 岑 
Published: June 2018

AbstractMulticulturalism is about co-existence of diverse cultures. Current literature on multiculturalism mostly uses a top-down approach to examine how the governments adopt different policies to manage cultural diversity. However, how the migrants use their own culture including music to enhance integration is often neglected. This paper uses the experience of African migrants in Hong Kong to reveal an alternative account of multiculturalism. Based on in-depth interviews and participant observation with African drummers, this paper examines the role of African drum as a means of cultural integration. It raises the concept of “street-level multiculturalism” for analysing how African migrants experience and negotiate cultural difference on the ground. It argues that African drum music promotes intercultural contact by arousing curiosity and creating friendly atmosphere. Africans’ engagement in identity politics is based on their marginal status. Their ability to negotiate their African culture and their Hong Kong experience is a politically conscious process.
Vanishing Selves under Hong Kong’s Unified Screening Mechanism
Authors: Lau Pui Yan Flora , Gheorghiu Iulia , 佩欣 刘 , 乔治乌 尤莉亚· 
Published: June 2018

Abstract
Drawing on Erving Goffman’s analysis of total institutions and his concept of mortification of the self, the present article deals with the process of identity construction and identity loss among refugees and asylum seekers in Hong Kong. We argue that the slow pace of processing of political asylum applications as well as the harsh restrictions imposed on rights to work and the minimal welfare provisions for refugees and asylum seekers in Hong Kong operate as means of isolating them from the broader society. Another consequence of these restrictive conditions becomes manifest in the loss of identity experienced by those who have been stuck in Hong Kong for many years waiting for their applications to be processed. Being unable to preserve the sense of identity they had in their countries of origin, they find themselves deprived of the social and institutional resorts necessary to forge a new one.
The Group Theory of Parties: Identity Politics, Party Stereotypes, and Polarization in the 21st Century
Authors: Ahler Douglas J. 
Published: June 2018

AbstractAn emerging narrative contends that 2016 was significant for bridging identity politics and American party conflict. This narrative misses a fundamental truth: for ordinary Americans, partisan identity has always been grounded in their orientations toward groups in society. Thegroup theory of partiesholds that citizens evaluate political parties according to their social stereotypes of Democrats and Republicans, ultimately identifying (or not) with a party that jives with their own self-image. In this essay, I review existing research and summarize several original studies suggesting that citizens’ beliefs about party composition affect their feelings toward Democrats and Republicans. Americans tend to hold shockingly erroneous beliefs about the degree to which stereotypical groups compose the parties – for example, that 38% of Republicans belong to the economic “1%” – and correcting social stereotypes about the out-party reduces polarization between rank-and-file party supporters. Most studies discussed in this essay were conducted before Donald Trump became a candidate, suggesting that 2016 was not the year that identity politics hijacked the parties, but rather the year in which the implicit group basis for mass partisanship became baldly explicit.
Partisanship as Social Identity; Implications for the Study of Party Polarization
Authors: Iyengar Shanto , Krupenkin Masha 
Published: June 2018

Abstract
Partisanship continues to divide Americans. Using data from the American National Election Study, as well as implicit attitude tests, we argue that Americans’ partisan identity has become highly salient. Partisans have become more negative towards the opposing party on both explicit and implicit measures, and these biases spill over into their everyday decisions. Partisanship has become one of Americans’ most salient social identities.
Who is Ideological? Measuring Ideological Consistency in the American Public
Authors: Barber Michael , Pope Jeremy C. 
Published: June 2018

Abstract
Political constraint and issue consistency are key variables in the study of public opinion, but the existing literature contains many parallel but contradictory accounts of the sources and predictors of ideological constraint. Some posit that constraint is essentially a function of a person’s partisan commitment, others suggest it is rooted in participation in politics, while others see a wide range of correlates summarized as “sophistication.” Still others deny that constraint exists in the mass public altogether. Contrary to these accounts, we argue that issue consistency exists within the American public and is best predicted by political knowledge, which should be thought of as separate from those other predictors. In fact, after accounting for political knowledge, other variables like partisanship, participation, and demographic variables have little independent relationship to ideological constraint. The data show that political knowledge is about as strong a predictor of issue consistency as is one’s self-placed ideology – a widely used proxy for constraint. These results help us understand how citizens think about politics and which groups of people most closely resemble elites in the structure of their opinions. Our findings show that previously hypothesized predictors of constraint – particularly partisanship and participation – are mainly related to ideological constraint through a person’s level of political knowledge.