bluuebunny/crossref_metadata_2025_split huggingface dataset:
Green space associations with mental health and cognitive function
Authors: Hystad Perry , Payette Yves , Noisel Nolwenn , Boileau Catherine 
Published: February 2019

Background:
Urban green space may be important to mental health, but the association between long-term green space exposures and depression, anxiety, and cognitive function in adults remains unknown.

Methods:
We examined 8,144 adults enrolled in the CARTaGENE cohort in Quebec Canada. Average green space and change in green space with residential mobility were assessed using satellite-derived normalized difference vegetation index from 5-year residential address histories. Outcomes included depression and anxiety determined through medical record linkages, self-reported doctor diagnosis of depression, and the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7scales. Cognitive function was available for 6,658 individuals from computerized tests of reaction time, working memory, and executive function. We used linear and logistic multivariate models to assess associations between green space and each mental health and cognitive function measure.

Results:
In fully adjusted analyses, a 0.1 increase in residential normalized difference vegetation index within 500 m was associated with an odds ratio of 0.85 (95% CI: 0.76, 0.95) for a self-reported doctor diagnosis of depression and 0.81 (95% CI: 0.70, 0.93) for moderate anxiety assessed using the Generalized Anxiety Disorder 7 scale. Other models showed protective effects of urban green space on depression and anxiety but were not statistically significant, and the magnitude of association varied by green space exposure and mental health outcome assessment method. We did not observe any evidence of associations between green space and cognitive function.

Conclusions:
We observed some evidence to support the hypothesis that urban green space is associated with decreased depression and anxiety but not cognitive function.
Facilitators and barriers to the novice nurse practitioner workforce transition in primary care
Authors: Faraz Asefeh 
Published: February 2019

ABSTRACT

Background and purpose:
Little is known about the facilitators and barriers to the workforce transition of novice nurse practitioners (NPs) in primary care. This research aimed to identify factors contributing and detracting from a successful initial workforce transition for novice NPs in the primary care setting.

Methods:
A descriptive, cross-sectional study was conducted via online survey administered to a national sample of 177 NPs who graduated from an accredited NP program and were practicing in a primary care setting for 3–12 months. Open-ended responses were analyzed using the Krippendorff content analysis method.

Conclusions:
This study demonstrated that facilitators of the novice NP transition are the presence of mentorship and social support, finding meaning in their work, job satisfaction, and work–life balance. Barriers to the novice NP transition are lack of support and respect, role ambiguity, and workload.

Implications for practice:
More mentorship, support, role clarity, and respect are needed to facilitate the novice NP workforce transition. More research is needed on interventions that can be implemented by health care organizations to improve the facilitators of role transition identified in this study.
Effects of thoracic epidural anesthesia/analgesia on the stress response, pain relief, hospital stay, and treatment costs of patients with esophageal carcinoma undergoing thoracic surgery
Authors: Li Yan , Dong Hongquan , Tan Shanbai , Qian Yanning , Jin Wenjie 
Published: February 2019

Abstract

Background:
Appropriate postoperative pain management can improve outcomes in patients with esophageal cancer (EC).

Objective:
To compare different combinations of anesthesia and analgesia techniques in patients with EC undergoing open thoracotomy.

Methods:
This randomized, controlled, open-label trial enrolled 100 patients with EC (aged 40–65 years; American Society of Anesthesiologists [ASA] grade I/II) receiving elective surgery at Jiangsu Province Hospital (China) between July 2016 and December 2017. Patients were randomized to 4 groups (n = 25 per group): total intravenous general anesthesia plus patient-controlled intravenous analgesia (TIVA/PCIA); TIVA plus patient-controlled epidural analgesia (TIVA/PCEA); thoracic epidural anesthesia with intravenous general anesthesia plus PCIA (TEA-IVA/PCIA); and TEA-IVA/PCEA (TEA-IVA plus PCEA). Primary outcomes were plasma cortisol level (measured at baseline, 2 h after skin incision, surgery completion, and 24 and 48 h post-surgery) and pain (assessed at 24, 48, and 72 hours post-surgery using a visual analog scale). Secondary outcomes included time to first flatus, hospital stay and treatment costs. Postoperative adverse events (AEs) were analyzed.

Results:
Baseline and operative characteristics were similar between the 4 groups. Plasma cortisol level increased (P <.05 vs baseline) earlier in the TIVA groups (2 h after skin incision) than in the TEA-IVA groups (24 h after surgery). At 48 hours after surgery, plasma cortisol had returned to baseline levels in the PCEA groups but not in the PCIA groups. VAS pain scores at rest and during coughing were lower in the PCEA groups than in the PCIA groups (P <.05). Compared with the PCIA groups, the PCEA groups had shorter time to first flatus and shorter hospital stay, while use of TEA-IVA lowered the costs of intraoperative anesthesia (P <.05). However, the PCEA groups had a higher incidence of nausea, vomiting, and pruritus.

Conclusion:
Thoracic epidural anesthesia/analgesia can reduce the stress response, improve postoperative recovery and reduce hospital stay and costs for patients with EC.
Perioperative holistic care more significantly reduces levels of anxiety and depression of pituitary tumor patients versus conventional care
Authors: Xie Yu-Huan , Xie Hai-Tong , Wang Tian-Shu , Shu Yi-Ping , Dai Xing-Liang 
Published: February 2019

Abstract
To compare the effect of perioperative holistic care versus conventional care on the levels of anxiety and depression of pituitary tumor patients at a single tertiary care center in China.
We enrolled 100 patients who underwent transnaso-sphenoidal microsurgical resection of pituitary tumor at our institution between January 2017 and December 2017. The patients were assigned to the conventional care group (n = 50) and the holistic care group by the order of admission. Patients were evaluated by staff nurses at admission and upon discharge from the hospital using the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS). QoL was assessed using EORTC QLQ-C30.
The 2 groups were comparable in the demographic and baseline variables including baseline SDS and SAS scores (P > .05). A significantly greater reduction in SAS score was observed in the holistic care group versus the conventional care group (−19.14% vs −11.60%; P < .05). Moreover, we observed a significantly greater reduction in SDS score in the holistic care group versus the conventional care group (−40.4% vs -18.79%, P < .05). The QoL functional domain scores at discharge were significantly higher in the holistic care group than the conventional care group (P < .05).
Perioperative holistic care significantly alleviates the levels of anxiety and depression and improves QoL of pituitary adenoma patients.
Local recurrence of sinonasal renal cell-like adenocarcinoma
Authors: Wu Jian , Fang Qin , He Yu-Jie , Chen Wei-Xiang , Qi Yu-Kai , Ding Jun 
Published: February 2019

Abstract

Rationale:
Sinonasal renal cell-like adenocarcinoma (SNRCLA) is a very rare sino-nasal carcinoma. Because SNRCLA has the same morphological features as other clear cell carcinomas, and some of them also occurred in sinonasal part, it is necessary to differentiate SNRCLA from these tumors.

Patient concerns:
A 42-year-old man presented with complaints of epistaxis for 1 day. The patient had undergone endoscopic resection of a neoplasm in the right nasal passage at another hospital 35 months before and was diagnosed with SNRCLA at that time, and did not receive any other adjuvant therapy.

Diagnoses:
The postoperative histopathological examination revealed a diagnosis of recurrent SNRCLA.

Interventions:
The tumor was removed under nasal endoscopy.

Outcomes:
The patient was followed up for 2 months and recovered well without any complications.

Lessons:
NSRCLA is a very rare tumor, and should be differentiated from other clear cell tumors including some salivary tumors and metastatic tumors of renal and thyroid.
A novel inflammation-based prognostic index for patients with esophageal squamous cell carcinoma
Authors: Lv Yajuan , Zhang Jiandong , Liu Zhen , Tian Yuan , Liu Fengjun 
Published: February 2019

Abstract
NLR/Alb (neutrophil lymphocyte ratio/albumin ratio), is a prognostic index for esophageal cancer has been confirmed. Prealbumin (PA) is more sensitive to malnutrition than albumin. A new prognostic index, named neutrophil lymphocyte ratio/prealbumin ratio (NLR/PA), for predicting the survival time in patients with esophageal squamous cell carcinoma (ESCC) was proposed.
A retrospective study of 315 cases with ESCC was enrolled. The optimal cut-off values were evaluated by ROC curve (the receiver operating characteristics curve). Pearson correlation analyses were used to calculate the correlations among NLR, Alb, NLR/Alb and NLR/PA. The overall survival (OS) was calculated by Kaplan-Meier method. Cox regression analyses were performed to evaluate the prognostic factors.
The optimal cut-off value was 0.01 for NLR/PA according to ROC curve. According to multivariate analyses, TNM stage, NLR, NLR/Alb, NLR/PA were prognostic factors for OS. The AUC area (the area under the receiver operating characteristics curves) of the NLR/PA was higher than the areas of NLR and NLR/Alb for all the patients. The index of NLR/ PA had a higher AUC area than that of the index of NLR or NLR/Alb for patients in stage I-II. But in stage III-IVA, the index of NLR had a higher AUC area than that of the index of NLR/PA or NLR/Alb.
The index of NLR/PA is superior to the index of NLR as a prognostic indicator for patients with early stage (stage I-II) ESCC.
Surveillance of non-muscle invasive bladder cancer using fluorescence in situ hybridization
Authors: Lin Tianhai , Jin Hongyu , Gong Lina , Yu Ruichao , Sun Sheng , Yang Lu , Zhang Peng , Han Ping , Cheng Jingqiu , Liu Liangren , Wei Qiang 
Published: February 2019

Abstract

Background:
To evaluate the diagnostic effectiveness and predictive value of fluorescence in situ hybridization (FISH) in the surveillance of non-muscle invasive bladder cancer (NMIBC).

Methods:
PubMed/Medline, EMBASE, Web of Science, Ovid, Web of Knowledge, and Cochrane Library will be searched for studies related to the topic. The identification, inclusion, and exclusion flowcharts will be conducted according to preferred reporting items for systematic reviews and meta-analysis guidelines. The identified reports will be critically appraised according to the Newcastle–Ottawa scale, quality assessment of diagnostic accuracy studies-2 and standards for reporting of diagnostic accuracy 2015. Forest plots will be generated to display hazard ratios, sensitivities, and specificities. Pooled estimates with their 95% confidence intervals will be calculated using the bivariate model, the hierarchical summary receiver operating characteristic model and a fixed- or random-effects model.

Results:
This study will provide evidence and data to form a comprehensive understanding of the value of FISH in the surveillance of NMIBC.

Conclusion:
The diagnostic efficacy of FISH will be affected by post-therapy factors. However, FISH still could facilitate the surveillance of NMIBC owing to its non-invasive feature. This study will improve the clinical decision-making and enlighten the future research of NMIBC.
IL-1 inhibition improves insulin resistance and adipokines in rheumatoid arthritis patients with comorbid type 2 diabetes
Authors: Ruscitti Piero , Ursini Francesco , Cipriani Paola , Greco Marta , Alvaro Saverio , Vasiliki Liakouli , Di Benedetto Paola , Carubbi Francesco , Berardicurti Onorina , Gulletta Elio , De Sarro Giovambattista , Giacomelli Roberto 
Published: February 2019

Abstract
Recently, it has been shown that some well-known pathogenic mediators in rheumatoid arthritis (RA), such as interleukin-1β (IL-1β) and tumor necrosis factor (TNF), could play a pathogenic role in insulin resistance and (IR) and type 2 diabetes (T2D).
In this 6-month longitudinal study, we aimed at investigating if the inhibition of IL-1 or TNF is associated with an improvement of IR in RA patients with comorbid T2D and the possible effects on selected serum adipokines. RA patients with comorbid T2D were recruited among those undergoing treatment with anakinra (ANA) or with TNF inhibitor (TNFi). The 1998-updated version of the Homeostasis Model Assessment (HOMA2) was used to calculate surrogate indexes of IR (HOMA2-IR) and steady-state beta cell function (%B) from fasting values of glucose and C-peptide. Glucagon, adiponectin, adipsin, leptin, and resistin were also measured. All these parameters were collected at baseline, after 3 and 6 months of treatment.
ANA-treated patients showed a significant improvement in HOMA2-%β, HOMA2-IR, and glucagon. In TNFi-treated patients, no significant difference was observed analyzing these metabolic parameters. Adipsin and resistin decreased after 6 months in ANA-treated patients whereas, no difference was recognized analyzing adiponectin and leptin. In TNFi-treated patients, leptin and resistin significantly increased, whereas no difference was found analyzing adiponectin and adipsin, during the follow-up.
Our data may suggest a beneficial effect of IL-1 inhibition on measures of metabolic derangement in RA-associated T2D. If further confirmed by larger studies, IL-1 targeting therapies may represent a tailored approach in these patients.
Fetal cardiac examination can affect patients’ preference on invasive tests
Authors: Ekmekci Emre , Gencdal Servet , Demirel Emine , Kelekci Sefa 
Published: February 2019

Abstract

Background:
Prenatal screening for aneuploidies has seen great changes over the last 2 decades. But there is still no non-invasive diagnostic test. Therefore, prenatal invasive procedures are still being routinely performed due to maternal anxiety. The association of cardiac anomalies and abnormal findings with aneuploidies has been known for a long time. This prospective study was done to evaluate abnormal fetal cardiac examination (FCE) findings on patients undergoing diagnostic invasive procedures due to maternal anxiety and to assess the predictive value of abnormal cardiac findings on abnormal karyotype.

Materials and methods:
Patients who underwent prenatal diagnostic invasive tests due to maternal anxiety indication between March 2013 and September 2016 were included in this study. FCE was performed in the study group immediately prior to invasive tests. Findings of fetal cardiac examination are classified as normal, major–minor cardiac anomalies and soft markers. Fetal karyotypes were compared among groups depending on cardiac findings.

Results:
One hundred eighty-two invasive procedures were performed because of maternal anxiety during this period. There were 29 abnormal findings detected on FCE. A total of 7 abnormal karyotypes were detected. FCE was abnormal in 5 of the abnormal karyotypes (71.4%). The presence of a major cardiac anomaly was most predictive for abnormal karyotype (LR+: 96,67, LR-: 0,34). No association was detected between the presence of minor cardiac anomalies and abnormal karyotype. Normal FCE appeared to be a good predictive factor for normal karyotype (LR-: 0.20).

Conclusions:
This is the first study evaluating the power of early fetal cardiac examination findings on fetal aneuploidies. This study suggested that the application of fetal cardiac examination findings to genetic counseling for screening aneuploidies may be efficient on patients’ preference about invasive tests. Due to the small number of abnormal findings and karyotypes detected (not the large study group), further studies on large study groups are needed to confirm these results.
Diagnostic value of using epicardial fat measurement on screening low-dose chest CT for the prediction of metabolic syndrome
Authors: Kim Hyun Ji , Lee Heon , Lee Bora , Lee Jae Wook , Shin Kyung Eun , Suh Jon , Park Hyun Woo , Kim Jeong A. 
Published: February 2019

Abstract
There has been a marked increase in the use of low-dose computed tomography (LDCT) for lung cancer screening. However, the potential of LDCT to predict metabolic syndrome (MetS) has not been well-documented in this risk-sharing population. We assessed the reliability of epicardial fat volume (EFV) and epicardial fat area (EFA) measurements on chest LDCT for prediction of MetS.
A total of 130 (mean age, 50.2 ± 10.77 years) asymptomatic male who underwent nonelectrocardiography (ECG)-gated LDCT were divided into 2 groups for the main analysis (n = 75) and validation (n = 55). Each group was further divided into subgroups with or without MetS. EFV and EFA were calculated semiautomatically using commercially available software with manual assistance. The area under the curve (AUC) on receiver operating characteristic (ROC) analysis and cutoff values to predict MetS on LDCT were then calculated and validated. Female data were not available for analysis due to small sample size in this self-referred lung cancer screening program.
In the analysis group, the mean EFV was 123.12 ± 42.29 and 67.30 ± 20.68 cm3 for the MetS and non-MetS subgroups, respectively (P < .001), and the mean EFA was 7.95 ± 3.10 and 4.04 ± 1.73 cm2, respectively (P < .001). Using 93.65 and 4.94 as the cutoffs for EFV and EFA, respectively, the sensitivity, specificity, positive and negative predictive values, and accuracy for predicting MetS were 84.2% and 84.2%, and 92.9% and 64.3% (P < .001); 80% and 44.4% (P = .01); 94.5% and 92.3%; and 90.7% and 69.3% (P < .001), respectively. The AUC for EFV and EFA for predicting MetS was 0.909 and 0.808 (95% confidence interval, 0.819–1.000 and 0.702–0.914, respectively) (P = .02). Using the same cutoff values in the analysis group, there was no significant difference in diagnostic performance using EFV and EFA between the analysis and validation sets.
Although quantification of both EFA and EFV is feasible on non-ECG-gated LDCT, EFV may be used to reliably predict MetS with fairly high and better diagnostic performance in selected population.
Effect of Home Medication Titration on Blood Pressure Control in Patients With Hypertension
Authors: Chen Ting-Yu , Kao Chi-Wen , Cheng Shu-Meng , Chang Yue-Cune 
Published: February 2019

Background:
Medication titration has been used in home blood pressure (BP) control, with the expectation of enabling patients with hypertension to better manage their BP.

Objective:
The study goal was to estimate the effects of medication titration intervention in lowering the systolic blood pressure and diastolic blood pressure of patients with hypertension.

Methods:
The meta-analysis included randomized controlled trials on adults diagnosed with hypertension and BP≧130/80 mm Hg, having a medication-titration intervention, and using a home BP measurement. We systematically searched PubMed, CINAHL, Ovid-Medline, and the Cochrane Library, for studies published from 1997 to 2017. The quality of the studies was evaluated by the Modified Jadad scale. Statistical heterogeneity among the trials was evaluated using Q statistics and I
2. Publication bias was assessed with the funnel plot and Rosenthal’s fail-safe N.

Results:
The meta-analysis included 4 studies randomizing 1335 participants. Medication-titration intervention significantly assisted hypertensive patients to improve BP control; systolic blood pressure was reduced by 6.86 mm Hg [95% confidence interval (CI), 4.80-8.93, P<0.0001] and diastolic blood pressure by 3.03 mm Hg (95% CI, 2.07-3.99, P<0.0001), did not significantly affect EQ-5D scores (mean difference, 0.02; 95% CI, −0.01 to 0.04, P=0.13).

Conclusions:
Our findings suggest home medication titration of antihypertensive medication for hypertensive patients significantly improved home BP control. However, the strategy did not enhance quality of life in patients with hypertension.
Continuation and stability of rotating waves in the magnetized spherical Couette system: secondary transitions and multistability
Authors: Garcia Ferran , Stefani Frank 
Published: February 2019

Rotating waves (RW) bifurcating from the axisymmetric basic magnetized spherical Couette (MSC) flow are computed by means of Newton–Krylov continuation techniques for periodic orbits. In addition, their stability is analysed in the framework of Floquet theory. The inner sphere rotates while the outer is kept at rest and the fluid is subjected to an axial magnetic field. For a moderate Reynolds number
Re
= 10
3
(measuring inner rotation), the effect of increasing the magnetic field strength (measured by the Hartmann number
Ha
) is addressed in the range
Ha
∈(0, 80) corresponding to the working conditions of the HEDGEHOG experiment at Helmholtz-Zentrum Dresden-Rossendorf. The study reveals several regions of multistability of waves with azimuthal wavenumber
m
= 2, 3, 4, and several transitions to quasi-periodic flows, i.e modulated rotating waves. These nonlinear flows can be classified as the three different instabilities of the radial jet, the return flow and the shear layer, as found in the previous studies. These two flows are continuously linked, and part of the same branch, as the magnetic forcing is increased. Midway between the two instabilities, at a certain critical
Ha
, the non-axisymmetric component of the flow is maximum.
The double tubular contractile structure of the type VI secretion system displays striking flexibility and elasticity
Authors: Stietz Maria Silvina , Liang Xiaoye , Wong Megan , Hersch Steven , Dong Tao G. 
Published: February 2019

AbstractThe double tubular structure of the type VI secretion system (T6SS) is considered as one of the longest straight and rigid intracellular structures in bacterial cells. Contraction of the T6SS outer sheath occurs almost instantly and releases sufficient power to inject the inner needle-like Hcp tube and its associated effectors into target bacterial cells through piercing the stiff cell envelope. The molecular mechanism triggering T6SS contraction remains elusive. Here we report that the double tubular T6SS structure is strikingly flexible and elastic, forming U-, circular-, or S-shapes while maintaining functional for contraction and substrate delivery. We show that physical contact with cytoplasmic membrane induced a range of T6SS structure deformation, but the resultant mechanical pressing force on the T6SS baseplate did not trigger contraction. Our results also reveal a stalling intermediate stage of sheath-tube extension following which the structure contracts or resumes to extend. These observations suggest that the recruitment equilibrium of sheath-tube precursors to the extending structure is key to stability/contraction and lead us to propose a model of T6SS contraction, termed ESCAPE (extension-stall-contraction and precursor equilibrium). Our data highlight the remarkable flexibility of the double tubular T6SS structure and its length control mechanism distinct from the other evolutionarily related contractile cell-puncturing systems.