bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlates of Self-Care Behaviors in Adults With Type 2 Diabetes and Comorbid Heart Failure
Authors: Aga Fekadu B. , Dunbar Sandra B. , Kebede Tedla , Higgins Melinda Kay , Gary Rebecca A. 
Published: June 2019

Purpose The purpose of this study was to describe sociodemographic, clinical, and psychosocial correlates of diabetes self-care behaviors in adults with type 2 diabetes mellitus (T2D) and comorbid heart failure (HF). Method Baseline data of 180 participants from a clinical trial that tested a 6-month integrated self-care intervention for persons with comorbid HF and T2D were analyzed. Correlational bivariate and multiple logistic regression analyses were performed to examine correlates of diabetes self-care behaviors. Result Participants had a mean age of 58 ± 11years; the majority were male (n = 118, 66%) and African American (n = 119, 66%). Number of comorbidities >2 ( P < .001), having more than a high school education ( P < .05), and African American ethnicity ( P < .05) predicted better exercise, self-monitoring blood glucose (SMBG), and foot care behaviors, respectively. The use of an aldosterone inhibitor ( P < .05) predicted worse exercise performance, higher Charlson Comorbidity Index scores ( P < .01) predicted worse SMBG, and treatment with diet plus medication ( P < .05) and dyslipidemia ( P < .001) predicted worse foot care. Conclusion Findings from this study provide new insights into the complex self-care requirements for T2D patients with comorbid HF. Integrated self-care interventions are clearly warranted in persons living with multiple chronic conditions for optimal health outcomes and the prevention of complications. Our sample of predominately African American men showed they had better T2D self-care behaviors than whites than previously reported. Additional research is needed to determine racial and gender differences on health outcomes in persons with T2D and comorbid HF.
Moving Just Enough Deep Sequencing Data to Get the Job Done
Authors: Mills Nicholas , Bensman Ethan M , Poehlman William L , Ligon Walter B , Feltus F Alex 
Published: June 2019

Motivation: As the size of high-throughput DNA sequence datasets continues to grow, the cost of transferring and storing the datasets may prevent their processing in all but the largest data centers or commercial cloud providers. To lower this cost, it should be possible to process only a subset of the original data while still preserving the biological information of interest. Results: Using 4 high-throughput DNA sequence datasets of differing sequencing depth from 2 species as use cases, we demonstrate the effect of processing partial datasets on the number of detected RNA transcripts using an RNA-Seq workflow. We used transcript detection to decide on a cutoff point. We then physically transferred the minimal partial dataset and compared with the transfer of the full dataset, which showed a reduction of approximately 25% in the total transfer time. These results suggest that as sequencing datasets get larger, one way to speed up analysis is to simply transfer the minimal amount of data that still sufficiently detects biological signal. Availability: All results were generated using public datasets from NCBI and publicly available open source software.
Predicting Neonatal Skin Injury: The First Step to Reducing Skin Injuries in Neonates
Authors: Broom Margaret , Dunk Ann Marie , E Mohamed Abdel-Latif 
Published: June 2019

Background: Skin injuries remain common in neonates admitted to neonatal intensive care units. While predicting neonates at risk of skin injury may assist in reducing the incidence of injury, currently there is limited evidence on which tool may be superior. Methods: A prospective study was completed during November-December 2016 to evaluate the predictive value of the Skin Risk Assessment and Management Tool (SRAMT). Comparisons were made between SRAMT and Neonatal/Infant Braden-Q Scale (BQS) as well as staff’s capacity to predict a neonate’s risk of skin injury. Data collected included gestation, weight, day of assessment, injury types, causation, medical devices in situ and risk scores. Results: In total, 248 assessments were completed with 38% (93) recorded skin injuries. Median (interquartile range) gestation and weight at assessment were 36.7 (26.86-56.86) weeks and 2.44 (0.99-4.06) kg, respectively. Receiver operating characteristic curve analysis showed the SRAMT had AUC ( SE) of 0.94 (0.02) compared with 0.82 (0.03) for BQS (0.011, P < .001). The SRAMT and BQS had sensitivity of [(90.0 (80.5-95.9), 72.86 (60.9-82.8)] and specificity [(88.46 (81.7-93.4), 79.23 (71.2-85.8)], respectively. Conclusion: In this study, the SRAMT’s capacity to predict neonates at risk of injury was higher than the Neonatal BQS and staff. Predicting injuries remains complex and often multifactorial.
Contamination assessment of orthodontic bands after different pre-cleaning methods at a tertiary care hospital
Authors: Irfan Sarah , Irfan Seema , Fida Mubassar , Ahmad Israr 
Published: June 2019

Introduction: Infection control in dentistry is a major concern due to risk of transmission of communicable diseases. The aim of this study is to evaluate and compare the efficacy of various pre-cleaning methods for the tried-in orthodontic bands. Material and methods: An in-vitro experimental study was conducted at the Central Sterilization Services Department (Dental Clinic) and the Microbiology lab at our university hospital. A total of 130 bands were included in our study which comprised 10 controls and the rest were equally divided into three groups according to the pre-cleaning methods, i.e. manual scrubbing, enzymatic solution and a combination of both. The orthodontic bands were incubated in the brain heart infusion broth at 37 °C for five days after pre-cleaning and sterilisation in a steam autoclave and were assessed for any bacterial growth. The chi-square test was applied to determine any significant association between the various pre-cleaning methods and the frequency of bands that showed growth. Effect size was calculated using the phi coefficient. Results: The enzyme method revealed 5% of the sample to exhibit bacterial growth, whereas manual scrubbing and the combination of both showed no growth. There was no statistically significant difference among the three methods ( P = 0.131). Further investigations showed the presence of Staphylococcus non-aureus bacterial species in contaminated bands from group II. Conclusions: All pre-cleaning methods were found to be equally effective in the decontamination of bands. Hence, the tried-in bands can be safely reused after pre-cleaning and sterilisation.
Cost awareness in urology: A nationwide survey
Authors: Phan Yih Chyn , Hadjipavlou Marios , Abdalla Omer , Sriprasad Seshadri , Rane Abhay 
Published: June 2019

Introduction: In the current economic climate with continuous expenditure reviews and financial constraints, clinicians should remain conscious of making cost-effective choices on consumables and medications. In this survey, we evaluated the cost awareness amongst UK urologists. This is an observational study in which urology clinicians were asked to estimate the cost of 10 commonly used medications and consumables in urology by completing a questionnaire. Methodology: The survey was primarily conducted at the BAUS Annual Meeting 2017 with subsequent responders at local hospitals and urological courses. The costs of consumables and medications were verified with the relevant companies and the 73rd edition of the British National Formulary. Result: There were 139 responders from across the UK (46 consultants, 64 training registrars, 13 trust grades doctors and 16 senior house officers (SHOs)). In total, 16 and 60% of all estimates were within ± 25% and ± 100% of the true cost of the items respectively. Approximately 97.1, 95.7 and 97.1% overestimated the cost of a 14Ch urethral catheter, Ciprofloxacin and Sildenafil, respectively; while 78.4 and 84.9% of responders underestimated the cost of a JJ ureteric stent and Solifenacin, respectively. On multivariate analysis, SHOs significantly overestimated the cost of urethral catheters, suprapubic catheterization kits and JJ ureteric stents compared to other clinician grades. Conclusion: Cost awareness among UK urologists is poor. Expensive items (e.g. JJ ureteric stent, Solifenacin) tend to be underestimated while inexpensive items (e.g. catheter, Ciprofloxacin, Sildenafil) tend to be overestimated. This lack of appreciation of value may have an impact on drug and consumable expenditure. Level of Evidence: Level 3
Oral contraceptive use and its association with symptomatology in migraine patients
Authors: Peng Kuan-Po , May Arne 
Published: June 2019

Background: Hormonal changes in natural menstrual cycles are known to modulate and even worsen headache symptoms in migraineurs; however, the impact of oral contraceptive pills (OCP), including combined oral contraceptive (COC) and progestogen-only pills on migraine symptomatology, is little investigated. Method: In this retrospective cohort study of 1758 migraine patients, data from 1032 female patients aged 15–45 years were accessed and their contraceptive methods, if any, were analyzed. Further comparisons were conducted between patients with OCP use and those without OCP use regarding the demographics, headache symptoms, and associated symptoms. Most OCP users in this study were assumed to have used COC, but information of individual hormone content of OCP was not collected. Patients with nonoral hormonal contraceptives were excluded for further comparison. Results: The use of OCP was common (47.8%) among the study cohort. Compared to those without OCP use ( n = 410), patients with OCP use ( n = 493) were younger (27.4 ± 7.0 vs. 32.8 ± 7.9, p < 0.001), had lower headache frequency (days per month, 11.1 ± 7.5 vs. 12.3 ± 8.8, p = 0.03), were less likely to have osmophobia (47.3 vs. 54.4%, p = 0.033) or cranial autonomic symptoms (44.8 vs. 53.2%, p = 0.013), and more commonly reported menstrually-related worsening of headache (52.3 vs. 42.4%, p = 0.012). The proportion of migraine with aura or other headache characteristics including severity, unilaterality, and pulsatile characteristic showed no differences between groups. Conclusion: Our data provide real-life information about contraceptive use among patients with migraine. The use of OCP is associated with differences in migraine symptomatology. Further studies are needed to determine whether this relationship is causal and any possible underlying mechanism.
Clozapine: why wait to start a laxative?
Authors: Attard Azizah , Iles Andrew , Attard Stephen , Atkinson Nathan , Patel Anita 
Published: June 2019

SUMMARYClozapine, the antipsychotic of choice for treatment-resistant schizophrenia, has a number of side-effects, some of which are potentially life-threatening. Historically viewed as a relatively minor side-effect, there is increasing awareness of the potentially severe sequalae of constipation secondary to clozapine-induced gastrointestinal hypomotility (CIGH). These include ileus, intestinal obstruction, bowel ischaemia, gastrointestinal necrosis, toxic megacolon and death. CIGH is significantly more common than clozapine-induced blood dyscrasias and has a higher mortality rate. Although strict criteria must be followed to assertively monitor, detect and treat blood dyscrasias in patients taking clozapine, no such framework exists for CIGH. We recommend that prescribing guidelines, regulatory agencies and information from manufacturers should more clearly highlight the risks identified in the literature. Furthermore, we recommend that, in people taking clozapine, constipation should be prevented by prophylactic treatment with laxatives rather than treated only when clinically identified.LEARNING OBJECTIVES:After reading this article you will be able to:
•understand the mechanism of gastrointestinal hypomotility in those taking clozapine•improve the monitoring of clozapine-induced constipation•understand prophylactic laxative treatment and the use of less commonly prescribed laxatives in patients who experience clozapine-induced constipation.
The challenge of cost-effectiveness research on first-episode psychosis
Authors: Rosenheck Robert 
Published: June 2019

SummaryEarly intervention in psychosis has generated hope. Cost-effectiveness studies, to determine whether benefits exceed costs, thus far conclude only that early intervention ‘might be’ worth its costs. It is a testament to the importance of the question: even in the absence of conclusive data, a synthesis should be attempted.Declaration of interestNone.
The Trump Effect: Postinauguration Changes in Marketplace Enrollment
Authors: Anderson David , Shafer Paul 
Published: June 2019

Abstract
Context: On January 20, 2017, President Donald Trump penned his first executive order, which aimed to “minimiz[e] the economic burden” of the Affordable Care Act, signaling his intent to make good on promises to repeal and replace the law. This executive order, along with concurrent changes in political messaging associated with the transition in power and reductions in HealthCare.gov advertising, lowered Health Insurance Marketplace enrollment at the end of the 2017 open enrollment period.
Methods: The authors used difference-in-differences and event-study models with weekly county-level Marketplace application data from 1,476 counties in 37 states to estimate the incremental enrollment loss in the postinauguration period.
Findings: Estimates indicate a population-weighted decline of over 700 applications per county-week during the final 2 weeks of the 2017 open enrollment period relative to 2016, corresponding to a nearly 30% decline in applications submitted. A more flexible event-study approach that better accounts for time shifting of enrollment across open enrollment periods found a similar decline of approximately 660 applications per county-week associated with the postinauguration period (−24%).
Conclusions: The lack of political support for the law by the incoming administration seemingly had an immediate and significant downward effect on Marketplace enrollment nationwide.
A cellular atlas of Pitx2-dependent cardiac development
Authors: Hill Matthew C. , Kadow Zachary A. , Li Lele , Tran Tien T. , Wythe Joshua D. , Martin James F. 
Published: June 2019

ABSTRACT
The Pitx2 gene encodes a homeobox transcription factor that is required for mammalian development. Disruption of PITX2 expression in humans causes congenital heart diseases and is associated with atrial fibrillation; however, the cellular and molecular processes dictated by Pitx2 during cardiac ontogeny remain unclear. To characterize the role of Pitx2 during murine heart development we sequenced over 75,000 single cardiac cell transcriptomes between two key developmental timepoints in control and Pitx2 null embryos. We found that cardiac cell composition was dramatically altered in mutants at both E10.5 and E13.5. Interestingly, the differentiation dynamics of both anterior and posterior second heart field-derived progenitor cells were disrupted in Pitx2 mutants. We also uncovered evidence for defects in left-right asymmetry within atrial cardiomyocyte populations. Furthermore, we were able to detail defects in cardiac outflow tract and valve development associated with Pitx2. Our findings offer insight into Pitx2 function and provide a compilation of gene expression signatures for further detailing the complexities of heart development that will serve as the foundation for future studies of cardiac morphogenesis, congenital heart disease and arrhythmogenesis.
Mitochondrial NCKX5 regulates melanosomal biogenesis and pigment production
Authors: Zhang Zhao , Gong Juanjuan , Sviderskaya Elena V. , Wei Aihua , Li Wei 
Published: June 2019

ABSTRACT
Oculocutaneous albinism (OCA) is a heterogeneous and autosomal recessive hypopigmentation disorder, which is caused by mutations of genes involved in pigment biosynthesis or melanosome biogenesis. We have previously identified NCKX5 (also known as SLC24A5) as a causative gene for OCA type 6 (OCA6). However, the pathogenesis of OCA6 is unknown. We found that NCKX5 is localized to mitochondria, not to melanosomes. Pharmacological inhibition of mitochondrial function or NCKX exchanger activity reduced pigment production. Loss of NCKX5 attenuated Ca2+ enrichment in melanosomes, which compromised PMEL fibril formation, melanosome maturation and pigment production. Thus, we have defined a new class of hypopigmentation attributable to dysfunctional mitochondria and an impairment of mitochondrial Ca2+ transfer into melanosomes. Thus, it is possible that mitochondrial function could have a role in the graying of hair in older people and formation of hypopigmented lesions in vitiligo patients.
Switching of Fluorescence Wavelength Caused by Phase Separation of Pyrene in Poly(N-isopropylacrylamide) Gel
Authors: Hamasaki Atom , Sato Naoya , Kubo Kei , Katsuki Akio , Ozeki Sumio 
Published: June 2019

Abstract
Pyrene (Py) contained in poly(N-isopropylacrylamide) gel (NIPA gel) that is swollen by water emits excimer-like derived fluorescence. However, as dehydration proceeded with increasing temperature, the luminescence changed to the monomer-derived one. Changes of it occurred continuously and reversibly around the lower critical solution temperature of NIPA gel. Because the gel interior becomes a hydrophobic environment in the shrunken state, the Py molecules can diffuse. However, it gathers like an oil droplet in the swollen gel by water. Reversible change of fluorescence wavelength with phase separation of Py according to hydration of NIPA gel represents an unprecedented type of chromism.
Deep learning-based muscle segmentation and quantification at abdominal CT: application to a longitudinal adult screening cohort for sarcopenia assessment
Authors: Graffy Peter M. , Liu Jiamin , Pickhardt Perry J. , Burns Joseph E. , Yao Jianhua , Summers Ronald M. 
Published: June 2019

Objective:
To investigate a fully automated abdominal CT-based muscle tool in a large adult screening population.

Methods:
A fully automated validated muscle segmentation algorithm was applied to 9310 non-contrast CT scans, including a primary screening cohort of 8037 consecutive asymptomatic adults (mean age, 57.1±7.8 years; 3555M/4482F). Sequential follow-up scans were available in a subset of 1171 individuals (mean interval, 5.1 years). Muscle tissue cross-sectional area and attenuation (Hounsfield unit, HU) at the L3 level were assessed, including change over time.

Results:
Mean values were significantly higher in males for both muscle area (190.6±33.6 vs 133.3±24.1 cm2, p&lt;0.001) and density (34.3±11.1 HU vs 27.3±11.7 HU, p&lt;0.001). Age-related losses were observed, with mean muscle area reduction of -1.5 cm2/year and attenuation reduction of -1.5 HU/year. Overall age-related muscle density (attenuation) loss was steeper than for muscle area for both sexes up to the age of 70 years. Between ages 50 and 70, relative muscle attenuation decreased significantly more in females (-30.6% vs -18.0%, p&lt;0.001), whereas relative rates of muscle area loss were similar (-8%). Between ages 70 and 90, males lost more density (-22.4% vs -7.5%) and area (-13.4% vs -6.9%, p&lt;0.001). Of the 1171 patients with longitudinal follow-up, 1013 (86.5%) showed a decrease in muscle attenuation, 739 (63.1%) showed a decrease in area, and 1119 (95.6%) showed a decrease in at least one of these measures.

Conclusion:
This fully automated CT muscle tool allows for both individualized and population-based assessment. Such data could be automatically derived at abdominal CT regardless of study indication, allowing for opportunistic sarcopenia detection.

Advances in knowledge:
This fully automated tool can be applied to routine abdominal CT scans for prospective or retrospective opportunistic sarcopenia assessment, regardless of the original clinical indication. Mean values were significantly higher in males for both muscle area and muscle density. Overall age-related muscle density (attenuation) loss was steeper than for muscle area for both sexes, and therefore may be a more valuable predictor of adverse outcomes.
Complete denture series part 2: tips on how to correct 10 avoidable errors
Authors: Jayachandran Sivakumar , Leyssen Wouter , Walmsley A Damien 
Published: June 2019

The first article of this series identified the common reasons for referral for complete denture patients to secondary care. With this background, this article provides general dental practitioners (GDPs) with clinical tips to avoid the common errors whilst making complete dentures. CPD/Clinical Relevance: The use of the clinical tips may help GDPs to improve their clinical success in treating complete denture patients and, in turn, aim to avoid improper referrals to secondary care.
Treatment options for deciduous molar hypomineralization: a report of three cases
Authors: Quintero Yasmy , Restrepo Manuel , Saldarriaga Jenny Angélica , Saldarriaga Alexandra , Santos-Pinto Lourdes 
Published: June 2019

Deciduous molar hypomineralization (DMH) is an enamel defect of systemic and multifactorial origin that affects the second deciduous molar. Currently, its treatment is based on guidelines for Molar Incisor Hypomineralization (MIH), a disturbance that affects permanent molars and may or may not be associated with permanent incisors. To date, there are no guidelines for DMH. Therefore, three different therapeutic approaches are presented to treat DMH, emphasizing the relevance of early diagnosis, differential diagnosis and treatment options, and tailored to take into account each patient's and parents' specific needs, as well as the involved tooth, severity of DMH, patients' symptoms and behaviour. CPD/Clinical Relevance: To understand the clinical implications of DMH since the diagnosis and delayed treatment of this enamel alteration could have important complications in both the primary and permanent dentition.
Non dental incidental findings on dental panoramic radiographs: identification and management
Authors: Ahsan-Mohammed Aisha , Clarkson Rosalyn J , Carmichael Fiona A 
Published: June 2019

All relevant ‘dental’ radiographic anomalies require a report, be they related to the teeth, mandible, maxillary sinuses, temporomandibular joints or soft tissues. However, non-dental incidental findings are often present on dental radiographs, some of which may be due to systemic disease: these should also be assessed. We compare the confidence at diagnosing, and subsequent management of, three such incidental findings between specialist dental and maxillofacial radiologists and recently qualified dentists. The imaging features and clinical implications of dense bone islands, carotid artery calcification and osteoporosis are described. CPD/Clinical Relevance: Dental panoramic radiographs cover structures not confined to the tooth-bearing areas and incidental findings in these regions should be recognized and appropriately reported, in line with IR(ME)R legislation.
A Novel Framework to Measure Executive Function in Down Syndrome With Applications for Early Clinical Diagnosis of Dementia
Authors: Smith Elizabeth , Hedge Craig , Jarrold Christopher 
Published: June 2019

Abstract
Executive function (EF) decline is a consistent early sign of Alzheimer's disease (AD) among adults with Down syndrome (DS), which means that baseline measures of EF for individuals with DS are vital to allow detection of meaningful decline. We developed a framework to extract measures of three core components of EF (memory updating, inhibitory, and temporal components) within one task. Increases in memory load, inhibitory load, and temporal demands led to significant increases in reaction times and significant decreases in accuracy among 18 adults with DS and 18 typically developing matched individuals; thus, the expected effects of all three manipulations were detected. Good test-retest reliability indicated that this framework has the potential to provide a simple, baseline EF measure for individuals with DS.