bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of cross‐sectional geometrical properties and bone density of the proximal radius between Saint Bernard and other giant breed dogs
Authors: Mejia Sebastian , Iodence Ashley , Griffin Lynn , Withrow Stephen , Puttlitz Christian , Salman Mo , Seguin Bernard 
Published: June 2019

AbstractObjectiveTo compare the geometrical properties and bone mineral density (BMD) of the proximal radius between Saint Bernard and other giant breed dogs.Study designObservational, cross‐sectional, descriptive study.AnimalsThirteen client‐owned Saint Bernard dogs and 13 other client‐owned giant breed dogs.MethodsComputed tomography (CT) studies of Saint Bernard and other giant breed dogs were reviewed. Multiplanar reconstruction of the CT images was used to determine cross‐sectional variables at the proximal half of the radius, including mean cortical thickness (mCT) and moment of inertia (MOI). Cortical BMD was estimated from Hounsfield unit measurements at each cross‐section and averaged per bone. One‐way analysis of variance was used to detect differences between groups.ResultsProximal radii of Saint Bernard dogs had a lower cortical/medullary ratio (1.75 vs 2.2, P < .001), mCT (1.96 vs 2.64 mm, P < .001), and MOI in all planes (mediolateral [ML]: 2086.09 vs 2757.69 mm4, P < .001; craniocaudal [CrCd]: 3736.36 vs 4370.28 mm4, P = .025; and polar: 5852.45 vs 7127.97 mm4, P = .002) compared with bones of other breeds. Cross‐sectional BMD did not differ between groups of dogs, but the mean BMD of all cross‐sections was lower in Saint Bernard dogs (1214.27 vs 1289.80 mg/mm3, P = .029).ConclusionThe proximal radii of Saint Bernard dogs had thinner cortices and lower CrCd, ML, and polar MOI compared with corresponding bones in giant breed dogs.Clinical significanceThe structural properties of the proximal radius of the Saint Bernard differ from those in other giant breeds and could reduce the ability of this region to sustain biomechanical loads. These properties could predispose Saint Bernard dogs to complications after surgical limb‐sparing procedures.
Low prevalence of zoonotic multidrug‐resistant bacteria in veterinarians in a country with prudent use of antimicrobials in animals
Authors: Verkola Marie , Pietola Eeva , Järvinen Asko , Lindqvist Kristian , Kinnunen Paula M. , Heikinheimo Annamari 
Published: June 2019

AbstractThe occurrence of multidrug‐resistant zoonotic bacteria in animals has been increasing worldwide. Working in close contact with livestock increases the risk of carriage of these bacteria. We investigated the occurrence of extended‐spectrum beta‐lactamase (ESBL) and plasmidic AmpC beta‐lactamase producing Enterobacteriaceae (ESBL/pAmpC‐PE) and livestock‐associated methicillin‐resistant Staphylococcus aureus (LA‐MRSA) in Finnish veterinarians (n = 320). In addition to microbiological samples, background information was collected. Bacterial whole genome sequencing was performed to deduce sequence types (STs), spa types and resistance genes of the isolates. In total, 3.0% (9/297) of the veterinarians carried ESBL producing Escherichia coli, with one ESBL producing E. coli isolate producing also AmpC. Seven different STs, sequences of several different plasmid groups as well as several different blaESBL/pAmpC genes existed in different combinations. No carbapenemase or colistin resistance genes were detected. MRSA was detected in 0.3% (1/320) of the samples. The strain belonged to LA‐MRSA clonal complex (CC) 398 (ST398, spa type 011, lacking Panton‐Valentine leukocidin genes). In conclusion, this study shows low carriage of multidrug‐resistant zoonotic bacteria in Finnish veterinarians. However, finding LA‐MRSA for the first time in a sample from a veterinarian in a country with prudent use of animal antimicrobials and regarding the recent rise of LA‐MRSA on Finnish pig farms, a strong recommendation to protect people working in close contact with animals carrying LA‐MRSA CC398 is given. Further studies are needed to explain why the prevalence of LA‐MRSA in veterinarians is lower in Finland than in other European countries.
An inhomogeneous Dirichlet theorem via shrinking targets
Authors: Kleinbock Dmitry , Wadleigh Nick 
Published: June 2019

We give an integrability criterion on a real-valued non-increasing function $\unicode[STIX]{x1D713}$ guaranteeing that for almost all (or almost no) pairs $(A,\mathbf{b})$, where $A$ is a real $m\times n$ matrix and $\mathbf{b}\in \mathbb{R}^{m}$, the system $$\begin{eqnarray}\Vert A\mathbf{q}+\mathbf{b}-\mathbf{p}\Vert ^{m}<\unicode[STIX]{x1D713}(T),\quad \Vert \mathbf{q}\Vert ^{n}<T,\end{eqnarray}$$ is solvable in $\mathbf{p}\in \mathbb{Z}^{m}$, $\mathbf{q}\in \mathbb{Z}^{n}$ for all sufficiently large $T$. The proof consists of a reduction to a shrinking target problem on the space of grids in $\mathbb{R}^{m+n}$. We also comment on the homogeneous counterpart to this problem, whose $m=n=1$ case was recently solved, but whose general case remains open.
Strength–Duration Curves of Radial Nerve in Patients With Lateral Elbow Pain
Authors: de la Cruz Torres Blanca 
Published: June 2019

Context:Lateral epicondylalgia (LE) refers to a painful condition at or around the lateral epicondyle of the humerus. LE is one of the most common injuries of the elbow; however, the cause of the pathology is not clear. Patients often experience symptoms consistent with a radial nerve injury; however, data on the involvement of the radial nerve are needed.Objective:To analyze the relationship between electrophysiologic excitability and morphology of the radial nerve in patients with unilateral chronic LE.Design:Cross-sectional study.Setting:Department of Physiotherapy, University of Seville.Patients:A total of 56 elbows (28 right, 28 left) in 28 patients (12 females, 16 males; age 49 [7.37] y) were recruited by convenience sampling.Main Outcome Measures:Strength–duration curves (chronaxia and accommodation index) and cross-sectional area (CSA) of the radial nerve were made in all participants. All parameters were compared between both limbs. Also, pain with palpation in the lateral epicondyle and functional pain of involved extremities was assessed using visual analog scale and the Patient-Rated Tennis Elbow Evaluation, respectively.Results:Symptomatic limb showed higher CSA values of the radial nerve when compared with the asymptomatic limb (P < .001). On the symptomatic limb, duration of symptoms was positively correlated with CSA values. Chronaxia values were all normal and similar between both limbs (P = .35). Regarding accommodation index, 14 (54%) patients showed accommodation indices that suggested pathological radial nerve on the right limb, 4 (14%) on the left limb, 5 (18%) on both limbs, and 4 (14%) had none of the affected nerves. Eight-six percent of patients showed accommodation indices that suggested pathological radial nerve, independently of symptomatic limb. In these cases, affected nerves had higher CSA than the unaffected nerve (P = .01). On the affected nerves, duration of symptoms was positively correlated with accommodation indices.Conclusions:These findings suggest that patients with unilateral chronic LE show a decreased excitability in any radial nerve, independently of the symptomatic limb, and that pathological nerves have higher CSA than the nonpathological nerves.
Can Myofascial Interventions Have a Remote Effect on ROM? A Systematic Review and Meta-Analysis
Authors: Burk Connor , Perry Jesse , Lis Sam , Dischiavi Steve , Bleakley Chris 
Published: June 2019

Context:Anatomical and in vivo studies suggest that muscles function synergistically as part of a myofascial chain. A related theory is that certain myofascial techniques have a remote and clinically important effect on range of motion (ROM).Objective:To determine if remote myofascial techniques can effectively increase the range of motion at a distant body segment.Evidence Acquisition:In November 2018, the authors searched 3 electronic databases (CENTRAL, MEDLINE, and PEDro) and hand-searched journals and conference proceedings. Inclusion criteria were randomized controlled trials comparing remote myofascial techniques with passive intervention (rest/sham) or local treatment intervention. The primary outcome of interest was ROM. Quality assessment was performed using the PEDro Scale. Three authors independently evaluated study quality and extracted data. RevMan software was used to pool data using a fixed-effect model.Evidence Synthesis:Eight randomized controlled trials, comprising N = 354 participants were included (mean age range 22–36 y; 50% female). Study quality was low with PEDro scores ranging from 2 to 7 (median scores 4.5/10). None of the studies incorporated adequate allocation concealment and just 2 used blinded assessment of outcomes. In all studies, treatments and outcomes were developed around the same myofascial chain (superficial back line). Five studies included comparisons between remote interventions to sham or inactive controls; pooled results for ROM showed trends in favor of remote interventions (standard mean difference 0.23; 95% confidence intervals; −0.09 to 0.55; 4 studies) at immediate follow-ups. Effects sizes were small, corresponding to mean differences of 9% or 5° in cervical spine ROM, and 1 to 3 cm in sit and reach distance. Four studies compared remote interventions to local treatments, but there were few differences between groups.Conclusions:Remote exercise interventions may increase ROM at distant body segments. However, effect sizes are small and the current evidence base is limited by selection and measurement bias.
National retrospective cohort study to identify age-specific fatality risks of comorbidities among hospitalised patients with influenza-like illness in Taiwan
Authors: Weng Ting-Chia , Chiu Han-Yi Robert , Chen Shey-Ying , Shih Fuh-Yuan , King Chwan-Chuen , Fang Cheng-Chung 
Published: June 2019

ObjectivesThis study aimed to examine comprehensively the prognostic impact of underlying comorbidities among hospitalised patients with influenza-like illness (ILI) in different age groups and provide recommendations targeting the vulnerable patients.Setting and participantsA retrospective cohort of 83 227 hospitalised cases with ILI were identified from Taiwan’s National Health Insurance Research Database from January 2005 to December 2010. Cases were stratified into three different age groups: paediatric (0–17 years), adult (18–64 years) and elderly (≧65 years), and their age, sex, comorbidity and past healthcare utilisation were analysed for ILI-associated fatality.Main outcome measuresORs for ILI-related fatality in different age groups were performed using multivariable analyses with generalised estimating equation models and adjusted by age, sex and underlying comorbidities.ResultsHospitalised ILI-related fatality significantly increased with comorbidities of cancer with metastasis (adjusted OR (aOR)=3.49, 95% CI: 3.16 to 3.86), haematological malignancy (aOR=3.02, 95% CI: 2.43 to 3.74), cancer without metastasis (aOR=1.72, 95% CI: 1.54 to 1.91), cerebrovascular (aOR=1.24, 95% CI: 1.15 to 1.33) and heart diseases (aOR=1.19, 95% CI: 1.11 to 1.27) for all age groups. Adult patients with AIDS; adult and elderly patients with chronic kidney disease, tuberculosis and diabetes were significantly associated with elevated risk of death. Severe liver diseases and hypothyroidism among elderly, and dementia/epilepsy among elderly and paediatrics were distinctively associated with likelihood of ILI-related fatality.ConclusionsDifferent age-specific comorbidities were associated with increasing risk of death among hospitalised ILI patients. These findings may help update guidelines for influenza vaccination and other prevention strategies in high-risk groups for minimising worldwide ILI-related deaths.
Patient experiences using a novel tool to improve care transitions in patients with heart failure: a qualitative analysis
Authors: Schofield Toni , Bhatia R Sacha , Yin Cindy , Hahn-Goldberg Shoshana , Okrainec Karen 
Published: June 2019

ObjectiveTo evaluate the utility of a novel discharge tool adapted for heart failure (HF) on patient experience.DesignSemistructured interviews assessed the utility of a novel discharge tool adapted for HF; patient-oriented discharge summary (PODS-HF) at 72 hours and 30 days after leaving hospital. Interviews were recorded and transcribed verbatim. Three investigators used directed content analysis to determine themes and subthemes from the narrative data.SettingThe cardiology ward of an urban academic institution in Canada.Participants13 patients and caregivers completed 24 interviews. Eligible patients were >18 years and admitted with a diagnosis of HF.ResultsAnalysis revealed six interconnected themes: (1) Utility of discharge instructions: how patients perceive and use written and verbal instructions. Patients receiving PODS-HF identified value in the patient-centred summarised content. (2) Adherence: strategies used by patients to enhance adherence to medications, diet and lifestyle changes. PODS-HF provides a strong visual reminder, particularly early postdischarge. (3) Adaptation: how patients incorporate changes into ‘new norms’. This was more evident by 30 days, and those using PODS-HF had less unscheduled visits and readmissions. (4) Relationships with healthcare providers: patients’ perceptions of the roles of family physicians and specialists in follow-up care. (5) Role of family and caregivers: the pivotal role of caregivers in supporting adherence and adaptation. (6) Follow-up phone calls: the utility of follow-up calls, particularly early after discharge as a means of providing clarification, reassurance and education.ConclusionPODS-HF is a useful tool that increases patients’ confidence to self-manage and facilitates adherence by providing relevant written information to reference after discharge.
Healthcare processes of laboratory tests for the prediction of mortality in the intensive care unit: a retrospective study based on electronic healthcare records in the USA
Authors: Zhang Zhongheng , Goyal Hemant , Lange Theis , Hong Yucai 
Published: June 2019

ObjectivesHealthcare process carries important prognostic information for patients, but the healthcare processes of laboratory tests have not yet been investigated for patients in the intensive care unit (ICU). The study aimed to investigate the effect of healthcare processes of laboratory tests on hospital mortality, with the hypothesis that the addition of healthcare processes could improve the discrimination for mortality outcome.DesignThe study included 12 laboratory tests. There were two dimensions for each laboratory test. One was the pathophysiology value; and the other was the healthcare process variables including the clock hour, the number of measurements and the measurement time from ICU admission. Generalised additive model was employed to investigate the effect of continuous variables on mortality. Generalised linear models with and without healthcare process variables were compared for their discrimination power.SettingICUs in an US-based hospital.ParticipantsAdult patients included in the critical care big data Medical Information Mart for Intensive Care.Primary and secondary outcome measuresThe hospital mortality was the primary outcome.ResultsA total of 52 963 adult patients with complete ICU stay information were included for analysis. The mortality rate was 12.3%. Lower number of tests such as 1–3 times were associated with the lowest mortality for most laboratory tests. However, the hematocrit, glucose and potassium required 6–10 measurements for the first 24 hours to reach the lowest mortality rate. In n of the 12 prediction models involving laboratory tests, the addition of healthcare process variables was associated with significantly increased area under receiver operating characteristics.ConclusionsThe study showed that healthcare processes of laboratory tests were independently associated with hospital mortality. The addition of healthcare processes to the pathophysiology value could increase the discrimination for mortality outcome.
Effects of exposure to direct and secondhand hookah and e-cigarette aerosols on ambient air quality and cardiopulmonary health in adults and children: protocol for a panel study
Authors: Shearston Jenni , Lee Lily , Eazor James , Meherally Saher , Park Su Hyun , Vilcassim MJ Ruzmyn , Weitzman Michael , Gordon Terry 
Published: June 2019

IntroductionUse of alternative nicotine delivery systems, such as electronic cigarettes and hookahs, has increased dramatically in the USA, but limited research has been conducted on the secondhand effects of these products, especially in children. The objective of this study is to assess the cardiopulmonary effects of e-cigarette and hookah use in vaping and smoking adults, and in non-smoking/non-vaping adults and children exposed to secondhand particles and gases.Methods and analysisThis study uses a pre/post design, with four groups: two control groups (non-smoking/non-vaping and cigarette smoking) and two test groups (hookah smoking and e-cigarette vaping). Participants will be recruited by household, so that each home includes one smoking or vaping adult and one non-smoking/non-vaping adult and/or child (5–18 years). Non-smoking/non-vaping homes include an adult and child who do not smoke or vape and do not live with individuals who do. Air quality measures will be completed during a household smoking or vaping session (ambient air for non-smoking/non-vaping group), while cardiopulmonary measures and biological samples will be taken directly before and after the smoking/vaping session, and again 24 hours later, for all participants. Air quality measures include carbon monoxide, black carbon, particulate matter, trace elements, nicotine and carbonyls; cardiopulmonary measures include heart rate variability, blood pressure, pulmonary function and exhaled carbon monoxide; biological samples will assess cotinine, inflammatory cytokines and biomarkers in urine, saliva and nasal mucosa.Ethics and disseminationThis study was approved by the Institutional Review Board at New York University School of Medicine (s16-02226 and s17-01143). Special attention was given to the inclusion of children, who are likely significantly impacted by the use of these products at home, and thus should be included in research. Results of the study will be distributed at conferences, in peer-reviewed journals and to relevant public health authorities for use in developing policy.
Detection and characterisation of optic nerve and retinal changes in primary congenital glaucoma using hand-held optical coherence tomography
Authors: Pilat Anastasia V , Shah Sonal , Sheth Viral , Purohit Ravi , Proudlock Frank A , Abbott Joseph , Gottlob Irene 
Published: June 2019

ObjectiveTo investigate (1) the feasibility of scanning the optic nerve (ON) and central retina with hand-held optical coherence tomography (HH-OCT) without sedation or anaesthesia in primary congenital glaucoma (PCG), (2) the characteristics of ON changes in comparison with adult primary open-angle glaucoma (POAG) in comparison with matched controls, (3) the sensitivity and specificity of ON parameters for diagnosis, and (4) changes of foveal morphology.Methods and analysisHH-OCT (Envisu 2300; Leica Microsystems) was used to investigate ON and foveal morphology of 20 children with PCG (mean age 4.64±2.79) and 10 adult patients with POAG (mean age 66.8±6.94), and compared with age-matched, gender-matched and ethnicity-matched healthy controls without sedation or anaesthesia.ResultsHH-OCT yielded useful data in 20 out of 24 young children with PCG. Patients with PCG had significantly deeper cup changes than patients with POAG (vs respective age-matched controls, p=0.014). ON changes in PCG are characterised by significant increase in cup depth (165%), increased cup diameter (159%) and reduction in rim area (36.4%) as compared with controls with high sensitivity (81.5, 74.1% and 88.9%, respectively) and specificity (85.0, 80.0% and 75.0%, respectively). Patients with PCG have a significantly smaller width of the macula pit (p<0.001) with non-detectable external limiting membrane.ConclusionHH-OCT has the potential to be a useful tool in glaucoma management for young children. We have demonstrated the use of HH-OCT in confirming a diagnosis of glaucoma within the studied cohort and found changes in disc morphology which characterise differently in PCG from POAG.
The validity of three malnutrition screening markers among older patients with cancer
Authors: Zhang Xiaotao , Pang Linda , Sharma Shreela V , Li Ruosha , Nyitray Alan G , Edwards Beatrice J 
Published: June 2019

BackgroundMalnutrition is common in older adults with cancer and is associated with adverse clinical outcomes. We assessed and compared the validity of three tools commonly used to screen for malnutrition: The Mini Nutritional Assessment (MNA), weight loss and body mass index (BMI).MethodsIn this retrospective study, we reviewed patients over age 65 with a diagnosis of cancer who were treated at the MD Anderson Cancer Center between 1 January 2013 and 31 March 2017. All patients in this study were evaluated by a trained geriatrician as part of a comprehensive geriatric assessment (CGA). Malnutrition was diagnosed by both CGA and clinical examination. The sensitivity, specificity and Cohen’s κ of each tool was also compared with the clinical diagnosis.ResultsA total of 454 older patients with cancer who had malnutrition information available were included in the analyses. The median age was 78%, and 42% (n=190) were clinically diagnosed with malnutrition at baseline. When the MNA was performed, 105 out of 352 patients (30%) were malnourished, and 122 (35%) at risk of malnutrition. Weight loss >3 kg was seen in 183 out of 359 (51%) patients, and BMI <20 kg/m2was found in 30 of the 454 (7%) patients. MNA had the highest validity (area under curve (AUC)=0.83) and reliability (κ=0.67), weight loss had moderate validity (AUC=0.73) and reliability (κ=0.46), while BMI had the lowest validity (AUC=0.55) and reliability (κ=0.55).ConclusionsFor clinical practice, MNA should be incorporated for standard assessment/screening for these older patients with cancer.