bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of propranolol treatment in infantile hepatic haemangioma
Authors: Yang Kaiying , Peng Suhua , Chen Linwen , Chen Siyuan , Ji Yi 
Published: January 2019

AimThe aim of this study was to assess the efficacy of propranolol treatment in multifocal and diffuse infantile hepatic haemangioma (IHH).MethodsA retrospective study of symptomatic or potentially symptomatic IHH was performed in our hospital between 2011 and 2016.ResultsThirteen patients were identified: 2 patients had diffuse lesions, and 11 patients had multifocal lesions, including 2 patients who had combined lesions that shared features of both multifocal and diffuse lesion patterns. Eleven (84.6%) patients had cutaneous infantile haemangioma. Hepatomegaly was the predominant clinical presentation. Hypothyroidism was identified in three patients, including one patient who had documented congestive heart failure (CHF). The median age at diagnosis and the median duration of treatment were 2.0 months (range 1.2–26.0) and 24.0 months (range 4.0–30.0). The median duration of follow‐up was 30.0 months (range 3.0–48.0). For patients with hypothyroidism, the thyroid hormone level was normal after 4 weeks of propranolol and levothyroxine treatment. All but one patient responded well to propranolol treatment. The patient who failed to respond to treatment died of CHF and abdominal compartment syndrome induced by hepatomegaly. No significant side effects of propranolol were observed during follow‐up.ConclusionsMost multifocal and diffuse IHH respond well to propranolol. However, progressive cases may be fatal despite aggressive treatments. Our data suggest that propranolol may be considered the first‐line treatment for multifocal and diffuse IHH due to its efficacy.
Multifocal contact lenses: towards customisation?
Authors: Faria‐Ribeiro Miguel , González‐Méijome José M 
Published: January 2019

AbstractPurposeFirstly, to determine if eyes with spherical aberration (SA) that deviates significantly from the average level underperform when fitted with a simultaneous‐imaging contact lens (CL) with a power profile calculated for an ‘average eye’. Secondly, to determine if CL customisation can improve image quality in these eyes after fitting with a bifocal CL.MethodsA statistical model of the wavefront aberration function of normal eyes was used to generate a vector of Zernike fourth‐order SA coefficients from 100 synthetic eyes. Four bifocal power profiles were modelled: centre‐near (CN) or centre‐distance (CD), and two‐zone or four‐zone. All designs had 0.1‐mm‐wide transition zones. Different levels of distance and add powers were modelled, using well‐established computational wave‐optics methods. Zone widths were optimised to obtain maximal multifocal efficiency (MFE), a metric based on the visual Strehl that synthesises the through‐focus curve in one number. The MFE was calculated for each synthetic eye coupled with each bifocal power profile.ResultsFor an ‘average eye’, the mean MFE values were 0.33 vs 0.25 and 0.32 vs 0.29, for CN vs CD and two vs four zone designs, respectively. When the four power profiles were assessed in eyes with non‐average levels of ocular SA, the MFE decreased with higher levels of SA (eye and CL combined) for all designs. Some of this reduction in MFE could be prevented by adjusting the nominal distance and add power of the bifocal profiles to compensate for the increased or decreased level of combined SA. The four‐zone CN profile showed better tolerance for different levels of ocular SA than the two‐zone designs, but this was not true for the four‐zone CD design.ConclusionEyes with SA levels differing significantly from the average level underperform when fitted with simultaneous‐imaging CLs with power profiles calculated for average eyes. Our findings suggest that visual performance at distance and near when wearing bifocal CLs can be improved by using a semi‐customised approach.
Comparison of defect depths for sinusoidal and circular perimetric stimuli in patients with glaucoma
Authors: Swanson William H , King Brett J 
Published: January 2019

AbstractPurposeClinical use of perimetric testing in patients with glaucoma typically assumes that perimetric defects will be less deep for larger than smaller stimuli. However, studies have shown that very large sinusoidal stimuli can yield similar defects as small circular stimuli. In order to provide guidelines for new perimetric stimuli, we tested patients with glaucoma using five different stimuli and compared defects to their patterns of retinal nerve fibre layer (RNFL) damage.MethodsTwenty subjects with glaucoma were imaged with optical coherence tomography (OCT) volume scans to allow for en face RNFL images and were also tested on a custom perimetry station with five stimuli: Goldmann sizes III and V, a two‐dimensional Gaussian blob (standard deviation 0.5°) and a 0.5 cycle degree−1 sinusoidal grating presented two ways: flickered at 5 Hz, and pulsed for 200 ms instead of flickered. En face RNFL images were reviewed with the visual field locations overlaid, and each location was labelled for a patient as either no visible RNFL defect or as wedge, slit, edge, or diffuse defect. Nineteen age‐similar controls were tested with the same stimuli to define depth of defect as difference from mean normal. Bland‐Altman analysis was used to test three predictions of neural modelling by making five comparisons.ResultsBland‐Altman analysis confirmed the three predictions. The flickered sinusoid gave deeper defects in damaged areas than the pulsed sinusoid (r = 0.25, p < 0.0001). When comparing data for sizes III and V there was increased spread of the data in deeper defects in the direction of size III having deeper defect (r = 0.35, p < 0.0001). The size V stimulus yielded shallower defects than a stimulus of similar size but with blurred edges (r = 0.20, p = 0.0004).ConclusionsOn average, all stimuli produced similar results comparing across type of RNFL damage. However, there were systematic patterns consistent with predictions of neural modelling: in damaged areas, depth of defect tended to be greater for the flickered sinusoid than the pulsed sinusoid, greater for the size III stimulus than the size V stimulus, and greater for the Gaussian blob than for the size V stimulus.
Oral surgery and the critical care department
Authors: McCormick R.S. , Greenwood M. , Francis N. 
Published: January 2019

AbstractThe majority of oral surgery patients do not require the input of a critical care department (CCD). However, oral surgeons working in secondary care may be involved in the management of such patients. This may be due to surgical complications or sequelae (predicted or otherwise) or for medical reasons. Oral Surgery trainees working within Oral and Maxillofacial Surgery departments are likely to be involved in managing patients whose presenting condition necessitates care within a CCD. This article gives an overview of the reasons for use of a CCD and some of its functions.
Impact of ventricular assist device implantation on the nutritional status of children awaiting heart transplantation
Authors: Hollander Seth A. , Schultz Lisa M. , Dennis Katelin , Hollander Amanda M. , Rizzuto Sandra , Murray Jenna M. , Rosenthal David N. , Almond Christopher S. 
Published: January 2019

AbstractBackgroundMalnutrition is common in pediatric heart failure and is associated with mortality. The effect of VAD support on malnutrition in children is unknown. We sought to compare the prevalence and severity of malnutrition at HT in children on VAD support vs OMT to inform decisions regarding support strategies.MethodsRetrospective chart review involving all patients <18 years who underwent HT at Stanford between 1/1/2011 and 3/1/2018. Malnutrition diagnosis and severity were defined by ASPEN guidelines using the lowest age‐adjusted z‐score for weight (WAZ), height (HAZ), and BMI (BMIZ) when the patient was euvolemic. Changes in z‐scores from baseline to HT and across groups were analyzed.ResultsA total of 104 patients (52 in each group) were included. Among all patients, WAZ (−0.9 vs 0.3, P < 0.001) and BMIZ (0 vs 0.6, P < 0.001) improved while HAZ (−0.9 vs −0.9, P = 0.4) did not. Compared to children on OMT, children on VAD experienced greater increases in WAZ (0.8 vs 0.3, P < 0.001) and BMIZ (0.7 vs 0.2, P < 0.003) at HT. The prevalence of moderate‐to‐severe malnutrition decreased in VAD patients (40% to 19%, P < 0.001) and increased in OMT patients (37% to 46%, P < 0.001), leading to a lower prevalence of moderate‐to‐severe malnutrition at HT (19% vs 46%, P = 0.003).ConclusionsMalnutrition is common in pediatric HT candidates. Compared to children on OMT, children on VAD support had greater improvement in nutritional status while awaiting HT, and a lower prevalence of malnutrition at HT.
Experiences from using eHealth in contact with health care among older adults with cognitive impairment
Authors: Jakobsson Elin , Nygård Louise , Kottorp Anders , Malinowsky Camilla 
Published: January 2019

RationaleSince health care is facing challenges, with fewer caregivers providing care to more clients, eHealth plays a crucial role. Through eHealth, people are expected to be more involved in their own care. On the part of health care users, eHealth requires use of everyday technology such as telephones and computers, and services through the Internet which might be challenging for older adults with cognitive impairment.AimTo investigate experiences of using eHealth in contact with health care among older adults with cognitive impairment.MethodIndividual, semi‐structured interviews were conducted with nine participants, aged 65–84 years, with cognitive impairments of varying origins. A constructivist Grounded Theory approach was used. Data collection and analysis were performed simultaneously using a constant comparative method.Ethical issuesEthical approval (Dnr: 2014/906‐32) was obtained from the regional ethical committee, Stockholm.ResultsThe core category, the eHealth staircase supported by habits, is presented as a model that visualises the result. The model includes three steps showing different ways of being in contact with health care through the use of technological devices and services that mirrors different levels of complexity of eHealth use as follows: (i) Analogue use, (ii) One‐way‐use and (iii) Interactive use. The participants’ location on the eHealth staircase was affected by several aspects described in three categories united by habits; A stable relationship with technology: a prerequisite for use; The importance of interpersonal relationships within health care and Being supported by significant others: a prerequisite in contact with health care.ConclusionsOlder adults with cognitive impairments seemed to prefer common and less complex eHealth when contacting health care. Therefore, it is necessary that health care providers offer different possibilities for patients to contact them, that is, both through the Internet and by personal telephone service.
Spatial Linkages in FDI Location: Evidence from the Spanish Regions
Authors: Gutiérrez‐Portilla Paula , Maza Adolfo , Villaverde José 
Published: January 2019

AbstractThis paper examines the main factors behind the regional location of foreign direct investment (FDI) in Spain, at both the aggregate and sectoral levels, over the 1996‐2013 period. To do so, a panel spatial Durbin model, which allows us to unveil patterns of substitution or complementarity in FDI across regions, is estimated. Our findings reveal that inward FDI in one region is complementary to that in neighbouring regions, a conclusion that is consistent with a complex vertical FDI strategy. Besides, they tend to confirm the hypotheses that FDI exhibits some inertia and is attracted by regions with: (i) large market size; (ii) large surrounding‐market potential; and (iii) high levels of human capital and wages. However, the results cast some doubts on the role played by infrastructure, R&D and regional differences in taxes as key elements in attracting FDI.
Sex differences in the sympathoexcitatory response to insulin in obese rats: role of neuropeptide Y
Authors: Shi Zhigang , Cassaglia Priscila A. , Pelletier Nicole E. , Brooks Virginia L. 
Published: January 2019

Key points
Intracerebroventricular insulin increased sympathetic nerve activity (SNA) and baroreflex control of SNA and heart rate more dramatically in obese male rats; in obese females, the responses were abolished.
In obese males, the enhanced lumbar SNA (LSNA) responses were associated with reduced tonic inhibition of LSNA by neuropeptide Y (NPY) in the PVN. However, PVN NPY injection decreased LSNA similarly in obesity prone/obesity resistant/control rats. Collectively, these results suggest that NPY inputs were decreased. In obese females, NPY inhibition in the PVN was maintained. Moreover, NPY neurons in the arcuate nucleus became resistant to the inhibitory effects of insulin.
A high‐fat diet did not alter arcuate NPY neuronal InsR expression in males or females.
Obesity‐induced ‘selective sensitization’ of the brain to the sympathoexcitatory effects of insulin and leptin may contribute to elevated basal SNA, and therefore hypertension development, in males with obesity.
These data may explain in part why obesity increases SNA less in women compared to men.
AbstractObesity increases sympathetic nerve activity (SNA) in men but not women; however, the mechanisms are unknown. We investigated whether intracerebroventricular insulin infusion increases SNA more in obese male than female rats and if sex differences are mediated by changes in tonic inhibition of SNA by neuropeptide Y (NPY) in the paraventricular nucleus (PVN). When consuming a high‐fat diet, obesity prone (OP) rats accrued excess fat, whereas obesity resistant (OR) rats maintained adiposity as in rats eating a control (CON) diet. Insulin increased lumbar SNA (LSNA) similarly in CON/OR males and females under urethane anaesthesia. The LSNA response was magnified in OP males but abolished in OP females. In males, blockade of PVN NPY Y1 receptors with BIBO3304 increased LSNA in CON/OR rats but not OP rats. Yet, PVN nanoinjections of NPY decreased LSNA similarly between groups. Thus, tonic PVN NPY inhibition of LSNA may be lost in obese males as a result of a decrease in NPY inputs. By contrast, in females, PVN BIBO3304 increased LSNA similarly in OP, OR and CON rats. After insulin, PVN BIBO3304 failed to increase LSNA in CON/OR females but increased LSNA in OP females, suggesting that with obesity NPY neurons become resistant to the inhibitory effects of insulin. These sex differences were not associated with changes in arcuate NPY neuronal insulin receptor expression. Collectively, these data reveal a marked sex difference in the impact of obesity on the sympathoexcitatory actions of insulin and implicate sexually dimorphic changes in NPY inhibition of SNA in the PVN as one mechanism.
Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases
Authors: Vinogradova Yana , Coupland Carol , Hippisley-Cox Julia 
Published: January 2019

AbstractObjectiveTo assess the association between risk of venous thromboembolism and use of different types of hormone replacement therapy.DesignTwo nested case-control studies.SettingUK general practices contributing to the QResearch or Clinical Practice Research Datalink (CPRD) databases, and linked to hospital, mortality, and social deprivation data.Participants80 396 women aged 40-79 with a primary diagnosis of venous thromboembolism between 1998 and 2017, matched by age, general practice, and index date to 391 494 female controls.Main outcome measuresVenous thromboembolism recorded on general practice, mortality, or hospital records. Odds ratios were adjusted for demographics, smoking status, alcohol consumption, comorbidities, recent medical events, and other prescribed drugs.ResultsOverall, 5795 (7.2%) women who had venous thromboembolism and 21 670 (5.5%) controls had been exposed to hormone replacement therapy within 90 days before the index date. Of these two groups, 4915 (85%)and 16 938 (78%) women used oral therapy, respectively, which was associated with a significantly increased risk of venous thromboembolism compared with no exposure (adjusted odds ratio 1.58, 95% confidence interval 1.52 to 1.64), for both oestrogen only preparations (1.40, 1.32 to 1.48) and combined preparations (1.73, 1.65 to 1.81). Estradiolhad a lower risk than conjugated equine oestrogen for oestrogen only preparations (0.85, 0.76 to 0.95) and combined preparations (0.83, 0.76 to 0.91). Compared with no exposure, conjugated equine oestrogen with medroxyprogesterone acetate had the highest risk (2.10, 1.92 to 2.31), and estradiol with dydrogesterone had the lowest risk (1.18, 0.98 to 1.42). Transdermal preparations were not associated with risk of venous thromboembolism, which was consistent for different regimens (overall adjusted odds ratio 0.93, 95% confidence interval 0.87 to 1.01).ConclusionsIn the present study, transdermal treatment was the safest type of hormone replacement therapy when risk of venous thromboembolism was assessed. Transdermal treatment appears to be underused, with the overwhelming preference still for oral preparations.
A pilot randomised controlled trial of metacognitive therapy for prolonged grief
Authors: Wenn Jenine Anne , O’Connor Moira , Kane Robert T , Rees Clare Samantha , Breen Lauren J 
Published: January 2019

ObjectivesProlonged grief disorder is associated with significant distress and impairment and thus efforts to improve treatments are essential. The present pilot study tested the efficacy and feasibility of group Metacognitive Grief Therapy (MCGT) designed specifically for prolonged grief symptomatology to reduce the psychological distress and impaired function resulting from bereavement.Design/participantsTwenty-two bereaved adult participants with prolonged grief symptomatology were randomised to a wait-list control (n=10) or an intervention condition (n=12) with a 3-month and 6-month follow-up. The wait-list control group was offered treatment after the post-test assessment.InterventionParticipants attended six group MCGT sessions that ran for 2 hours per week.Outcome measuresA primary outcome measure of prolonged grief symptomatology and secondary outcome measures of depression, anxiety, rumination, metacognitive beliefs and quality of life were taken pretreatment and post-treatment for both groups and at the 3-month and 6-month follow-up for the intervention group. A Generalised Linear Mixed Model was used to assess treatment efficacy.ResultsPost-treatment intent-to-treat analyses showed MCGT reduced prolonged grief symptomatology (Cohen’s d=1.7), depression (d=1.3), anxiety (d=0.8), stress (d=1.0), rumination (d=0.9) and increased quality of life (d=0.6), and these effects were maintained at the 3-month and 6-month follow-ups. No prepost between-group differences were found in metacognitive beliefs. However, a large significant effect was identified at the 3-month and 6-month follow-ups (d=1.0).ConclusionThe results show promise for the utility of group MCGT for reducing psychological distress and promoting quality of life. Additionally, the results underscore the need for a full randomised controlled trial of group MCGT, which may be an important addition to the treatment armamentarium available to support people with prolonged grief.Trial registration numberACTRN12613001270707; Results.Original protocolBMJ Open2015;5:e007221. doi:10.1136/bmjopen-2014-007221
Non-Invasive Positive airway Pressure thErapy to Reduce Postoperative Lung complications following Upper abdominal Surgery (NIPPER PLUS): protocol for a single-centre, pilot, randomised controlled trial
Authors: Lockstone Jane , Boden Ianthe , Robertson Iain K , Story David , Denehy Linda , Parry Selina M 
Published: January 2019

IntroductionPostoperative pulmonary complications (PPCs) are a common serious complication following upper abdominal surgery leading to significant consequences including increased mortality, hospital costs and prolonged hospitalisation. The primary objective of this study is to detect whether there is a possible signal towards PPC reduction with the use of additional intermittent non-invasive ventilation (NIV) compared with continuous high-flow nasal oxygen therapy alone following high-risk elective upper abdominal surgery. Secondary objectives are to measure feasibility of: (1) trial conduct and design and (2) physiotherapy-led NIV and a high-flow nasal oxygen therapy protocol, safety of NIV and to provide preliminary costs of care information of NIV and high-flow nasal oxygen therapy.Methods and analysisThis is a single-centre, parallel group, assessor blinded, pilot, randomised trial, with 130 high-risk upper abdominal surgery patients randomly assigned via concealed allocation to either (1) usual care of continuous high-flow nasal oxygen therapy for 48 hours following extubation or (2) usual care plus five additional 30 min physiotherapy-led NIV sessions within the first two postoperative days. Both groups receive standardised preoperative physiotherapy and postoperative early ambulation. No additional respiratory physiotherapy is provided to either group. Outcome measures will assess incidence of PPC within the first 14 postoperative days, recruitment ability, physiotherapy-led NIV and high-flow nasal oxygen therapy protocol adherence, adverse events relating to NIV delivery and costs of providing a physiotherapy-led NIV and a high-flow nasal oxygen therapy service following upper abdominal surgery.Ethics and disseminationEthics approval has been obtained from the relevant institution and results will be published to inform future multicentre trials.Trial registration numberACTRN12617000269336; Pre-results.
Values-based and acceptance-based intervention to promote adoption and maintenance of habitual physical activity among inactive adults with overweight/obesity: a study protocol for an open trial
Authors: Lillis Jason , Bond Dale S 
Published: January 2019

IntroductionDespite the importance of regular moderate-intensity to vigorous-intensity physical activity (MVPA) for health benefits and long-term weight management, current comprehensive lifestyle interventions have focused on providing MVPA prescriptions and goals but with only minimal and intermittent focus on psychosocial theoretical constructs and novel strategies, perhaps explaining the often modest impact on adoption and maintenance of higher levels of MVPA. An intervention based on acceptance and commitment therapy (ACT) targeting the increase of values-based autonomous motivation could improve the adoption and maintenance of habitual MVPA among insufficiently active overweight or obese adults in a brief intervention format.Methods and analysisThe overall aim of this study is to develop and test the feasibility, acceptability and preliminary efficacy of an ACT-based brief workshop intervention for increasing bouted MVPA for inactive adults with overweight/obesity using a single-arm design. A total of 48 inactive adults with overweight/obesity will be recruited and attend a 4-hour, ACT-based workshop followed by weekly emails and monthly phone calls for 3 months. The workshop will teach values clarification and acceptance-based skills to increase values-based autonomous motivation and bouted MVPA. Participants will self-monitor minutes of MVPA and personal values and report on progress via weekly emails and monthly phone calls. Assessments will be conducted at baseline and at 3 and 6 months.Ethics and disseminationStudy procedures have been approved by the Institutional Review Board. Consent is given in writing and in person. Data collection and storage separates study data from personally identifying information. Two safety officers who are not connected to the study monitor study progress and participant safety.Trial registration numberNCT03565731; Pre-results.