bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advanced dementia: an integrated homecare programme
Authors: Hum Allyn , Tay Ri Yin , Wong Yoko Kin Yoke , Ali Noorhazlina Binte , Leong Ian Yi Onn , Wu Huei Yaw , Chin Jing Jih , Lee Angel Onn Kei , Koh Mervyn Yong Hwang 
Published: June 2019

ObjectivesWe established an integrated palliative homecare programme for advanced dementia. This study explores patients’ symptoms and quality-of-life and their association with enteral feeding, evaluates the impact of the programme on these parameters and examines familial caregiver burden.MethodsThis is a prospective cohort study. Patients at Functional Assessment Stage 7, with an albumin level <35 g/L, pneumonia or enteral feeding were recruited. At baseline and regular intervals, the multidisciplinary homecare team used the Pain Assessment in Advanced Dementia, Mini Nutritional Assessment and Neuropsychiatric Inventory Questionnaire (NPI-Q) to identify patients’ symptoms, and the Quality of Life in Late-Stage Dementia (QUALID) tool to assess quality-of-life as primary outcomes, stratified by feeding status. The Zarit Burden Interview (ZBI) investigated caregiver burden, stratified by living arrangement and availability of stay-in help. Mann-Whitney U and χ2tests compared continuous and categorical variables respectively between groups while Wilcoxon signed-rank test compared assessment scores at baseline and on review.ResultsAt baseline, 49.2% of the 254 patients had pain, 92.5% were malnourished and 85.0% experienced neuropsychiatric challenges. Patients on enteral feeding had lower NPI-Q score (median=3; IQR 1–6) than orally fed patients ((median=4; IQR 2–7), p=0.004) and higher QUALID score (median=25; IQR 21–30 vs median=21; IQR 17–25 for orally fed patients), p<0.0001, indicating a better quality-of-life for orally fed patients. Both symptoms and quality-of-life improved significantly for the 53 patients reviewed at the fifth month. Median ZBI score for caregivers was 26 (IQR 15–36). Having stay-in help reduced it from 39.5 (IQR 25–49) to 25 (IQR 15–35), p=0.001.ConclusionAn integrated multidisciplinary palliative homecare team with geriatric training that is accessible all-hours addressed the needs of home-dwelling patients with advanced dementia, improved their quality-of-life and supported families to care for them at home.
Association of maximal systolic blood pressure with poor outcome in patients with hyperattenuated lesions on immediate NCCT after mechanical thrombectomy
Authors: Ding Xinfa , Xu Chao , Zhong Wansi , Gong Xiaoxian , Zhou Ying , Chen Zhicai , Lou Min 
Published: June 2019

Background and purposeThis study aimed to investigate the relationship between blood pressure(BP) management and clinical outcome in patients with hyperattenuated lesions on non-contrast CT (NCCT) immediately after mechanical thrombectomy (MT).MethodsWe retrospectively reviewed our prospectively collected cohort for consecutive patients with acute ischemic stroke (AIS) who received MT between October 2013 and July 2018. Hourly systolic BP (SBP) and diastolic BP (DBP) values were recorded for 24 hours following MT, and then maximum SBP (SBPmax) and DBP (DBPmax) values were identified. Poor outcome was defined as 3-month modified Rankin score (mRS) 3–6 and parenchymal hemorrhage (PH) was defined according to the European Cooperative Acute Stroke Study (ECASS) II trial. Associations of BP parameters with poor outcome and PH were determined using binary logistic regression models. Receiver operating characteristics (ROC) curve analysis was used to determine the predictive value of BP.ResultsInitially 262 patients with AIS who received MT were reviewed and 148 patients with hyperattenuated lesions on immediate NCCT were enrolled in the final cohort for analysis. Binary logistic regression showed that every 10 mm Hg increase in SBPmaxwas independently associated with a poor outcome (OR 1.426; 95% CI 1.095 to 1.855; p=0.008) and PH (OR 1.025; 95% CI 1.005 to 1.480; p=0.044). SBP ≤140 mm Hg during the post-procedural 24-hour period was associated with lower odds of a poor outcome and PH compared with the other group.ConclusionsControl of maximal SBP within 24 hours might be related to a low rate of PH and poor outcome in patients with hyperattenuated lesions on immediate NCCT after intervention.
Efficacy of Nifekalant in Patients With Wolff‐Parkinson‐White Syndrome and Atrial Fibrillation: Electrophysiological and Clinical Findings
Authors: Hu Jinzhu , Yu Jianhua , Chen Qi , Hu Jianxin , Huang Qianghui , Xia Zhen , Xia Zirong , Ju Zhenzhen , Yuan Ping , Fan Siyang , Xiong Qinmei , Zhu Bo , Huang Lin , You Chunjiao , Bao Huihui , Wu Yanqing , Cheng Xiaoshu , Li Juxiang , Marian Ali J. , Hong Kui 
Published: June 2019

Background

The efficacy of nifekalant in preexcited atrial fibrillation (
AF
) has not been assessed.

Methods and Results

The study populations consisted of patients with sustained preexcited
AF
(n=51), paroxysmal supraventricular tachycardia (n=201), and persistent
AF
(n=87). Effects of intravenous infusion of nifekalant were assessed on electrophysiological and clinical parameters. Nifekalant prolonged the shortest preexcited R‐R, the average preexcited R‐R, and the average R‐R intervals from 290±35 to 333±44 ms, 353±49 to 443±64 ms, and 356±53 to 467±75 ms, respectively, in patients with preexcited
AF
(all
P
<0.001). Nifekalant also decreased the percentage of preexcited
QRS
complexes, heart rate, and increased systolic pressure (all
P
<0.001). Nifekalant terminated
AF
in 33 of 51 patients (65%). Similar effects were also observed in a subgroup of 12 patients with preexcited
AF
and impaired left ventricular function. In patients with paroxysmal supraventricular tachycardia, nifekalant significantly prolonged the effective refractory period, the block cycle length of the antegrade accessory pathway, and the atrial effective refractory period (all
P
<0.001). Nifekalant had no effect on the effective refractory period of the antegrade atrioventricular node. Finally, in patients with persistent
AF
without an accessory pathway, nifekalant did not significantly decrease the ventricular rate of
AF
. One patient developed Torsades de Pointes. No other adverse effects were observed.

Conclusions

Nifekalant prolongs the effective refractory period of the antegrade accessory pathway and atrium without blocking antegrade conduction through the atrioventricular node, leading to slowing and/or to termination of preexcited
AF
. Thus, nifekalant might be an effective and a relatively safe drug in patients with preexcited
AF
.
Carnosine Supplementation Mitigates the Deleterious Effects of Particulate Matter Exposure in Mice
Authors: Abplanalp Wesley , Haberzettl Petra , Bhatnagar Aruni , Conklin Daniel J. , O'Toole Timothy E. 
Published: June 2019

Background

Exposure to fine airborne particulate matter (
PM
2.5
) induces quantitative and qualitative defects in bone marrow–derived endothelial progenitor cells of mice, and similar outcomes in humans may contribute to vascular dysfunction and the cardiovascular morbidity and mortality associated with
PM
2.5
exposure. Nevertheless, mechanisms underlying the pervasive effects of
PM
2.5
are unclear and effective interventional strategies to mitigate against
PM
2.5
toxicity are lacking. Furthermore, whether
PM
2.5
exposure affects other types of bone marrow stem cells leading to additional hematological or immunological dysfunction is not clear.

Methods and Results
Mice given normal drinking water or that supplemented with carnosine, a naturally occurring, nucleophilic di‐peptide that binds reactive aldehydes, were exposed to filtered air or concentrated ambient particles. Mice drinking normal water and exposed to concentrated ambient particles demonstrated a depletion of bone marrow hematopoietic stem cells but no change in mesenchymal stem cells. However, HSC depletion was significantly attenuated when the mice were placed on drinking water containing carnosine. Carnosine supplementation also increased the levels of carnosine‐propanal conjugates in the urine of CAPs–exposed mice and prevented the concentrated ambient particles–induced dysfunction of endothelial progenitor cells as assessed by in vitro and in vivo assays.

Conclusions

These results suggest that exposure to
PM
2.5
has pervasive effects on different bone marrow stem cell populations and that
PM
2.5
‐induced hematopoietic stem cells depletion, endothelial progenitor cell dysfunction, and defects in vascular repair can be mitigated by excess carnosine. Carnosine supplementation may be a viable approach for preventing
PM
2.5
‐induced immune dysfunction and cardiovascular injury in humans.
Cardiovascular Risk Scores to Predict Perioperative Stroke in Noncardiac Surgery
Authors: Wilcox Tanya , Smilowitz Nathaniel R. , Xia Yuhe , Berger Jeffrey S. 
Published: June 2019

Background and Purpose—
Perioperative stroke is associated with significant morbidity and mortality. Conventional cardiovascular risk scores have not been compared to predict acute stroke after noncardiac surgery.

Methods—

Patients undergoing noncardiac surgery between 2009 and 2010 were identified from the US National Surgical Quality Improvement Program (n=540 717). Patients were prospectively followed for 30 days postoperatively for the primary outcome of stroke. Established cardiovascular and perioperative risk scores (CHADS
2
, CHA
2
DS
2
-VASc, Revised Cardiac Risk Index, Mashour et al risk score, Myocardial Infarction or Cardiac Arrest risk score, and National Quality Improvement Project American College of Surgeons surgical risk calculator) were assessed to predict perioperative stroke.

Results—

Stroke occurred in the perioperative period of 1474 noncardiac surgeries (0.27%). Patients with perioperative stroke were older, more frequently male, had lower body mass index, and were more likely to have undergone vascular surgery or neurosurgery than patients without stroke (
P
<0.001 for each comparison). All risk prediction models were associated with increased risk of perioperative stroke (C statistic [AUC] range, 0.743–0.836). The Myocardial Infarction or Cardiac Arrest risk score (AUC, 0.833) and American College of Surgeons surgical risk calculator (AUC, 0.836) had the most favorable test characteristics and a greater ability to discriminate perioperative stroke when compared with Revised Cardiac Risk Index, CHADS
2
, CHA
2
DS
2
-VASc, and Mashour risk scores (
P
for comparison, <0.001; Delong). Risk scores did not provide consistent discriminative ability across surgery types and were least predictive in vascular surgery (AUC range, 0.588–0.672).

Conclusions—
The Myocardial Infarction or Cardiac Arrest risk score and American College of Surgeons surgical risk calculator surgical risk scores provide excellent risk discrimination for perioperative stroke in most patients undergoing noncardiac surgery. Stroke prediction was less optimal in patients undergoing vascular surgery.
A new species of feather mite: Timalinyssus Mironov, 2001 (Astigmata: Pteronyssidae) from Garrulax canorus canorus (Linnaeus) (Passeriformes: Timaliidae) in China
Authors: WANG ZI-YING , WANG JIN-JUN 
Published: June 2019

Many regard the Pteronyssidae as a subfamily of Avenzoariidae Oudemans, 1905, but Mironov (2001) recently recognized the group as a family, based on the unique character of a ventral membrane on tarsi I, and other distinguishing features of the Pteronyssinae Oudemans, 1941 (vide: Gaud & Atyeo 1996) and the specificity their host associations. To date, 140 species in 23 genera are described (Mironov 2001, 2005). The genus Timalinyssus was established by Mironov (2001) to accommodate two species collected from babblers (Passeriformes: Timaliidae). It is closely related to Mouchetia Gaud but differs in the following characters: prodorsal shield is fused with the scapular shields, c2 setiform and short in both sexes; tarsi III are cone-like with acute apex in male; opisthosomal lobes are long and separated by narrow terminal cleft in female (Gaud & Atyeo 1996; Mironov 2001).
The Effect of QPF on Real-Time Deterministic Hydrologic Forecast Uncertainty
Authors: Adams Thomas E. , Dymond Randel 
Published: June 2019

Abstract
The use of quantitative precipitation forecast (QPF) in hydrologic forecasting is commonplace, but QPF is subject to considerable error. When QPF is included as a model forcing in the hydrological forecast process, significant error propagates through the hydrologic predictions. Two questions arise: 1) are the resulting observed hydrologic forecast errors sufficiently large to suggest the use of zero QPF in the forecast process, and 2) if the use of nonzero QPF is indicated, how many periods (hours) of QPF (1, 6, 12, …, 72 h) should be used? Also, do forecast conditions exist under which the use of QPF should be different? This study presents results from two real-time hydrologic forecast experiments, focused on the NOAA/NWS Ohio River Forecast Center (OHRFC). The experiments rely on forecasts from subbasins at 39 forecast point locations, ranging in drainage area, geographic location within the Ohio River Valley, and watershed response time. Results from an experiment, spanning all flow ranges, for the 10 August 2007–31 August 2009 period, show that nonzero QPF produces smaller hydrologic forecast error than zero QPF. A second experiment, 23 January 2009–15 September 2010, suggests that QPF should be limited to 6–12-h duration for flood forecasts. Beyond 12 h, hydrologic forecast error increases substantially across all forecast ranges, but errors are much larger for flood forecasts. Increased durations of QPF produce smaller forecast error than shorter QPF durations only for nonflood forecasts. Experimental results are shown to be consistent with NWS April 2001–October 2016 forecast verification statistics for the OHRFC.
Which Phish Is on the Hook? Phishing Vulnerability for Older Versus Younger Adults
Authors: Sarno Dawn M. , Lewis Joanna E. , Bohil Corey J. , Neider Mark B. 
Published: June 2019

Objective To determine if there are age-related differences in phishing vulnerability and if those differences exist under various task conditions (e.g., framing and time pressure). Background Previous research suggests that older adults may be a vulnerable population to phishing attacks. Most research exploring age differences has used limiting designs, including retrospective self-report measures and restricted email sets. Method The present studies explored how older and younger adults classify a diverse sample of 100 legitimate and phishing emails. In Experiment 1, participants rated the emails as either spam or not spam. Experiment 2 explored how framing would alter the results when participants rated emails as safe or not safe. In Experiment 3, participants performed the same task as Experiment 1, but were put under time pressure. Results No age differences were observed in overall classification accuracy across the three experiments, rather all participants exhibited poor performance (20%–30% errors). Older adults took significantly longer to make classifications and were more liberal in classifying emails as spam or not safe. Time pressure seemed to remove this bias but did not influence overall accuracy. Conclusion Older adults appear to be more cautious when classifying emails. However, being extra careful may come at the cost of classification speed and does not seem to improve accuracy. Application Age demographics should be considered in the implementation of a cyber-training methodology. Younger adults may be less vigilant against cyber threats than initially predicted; older adults might be less prone to deception when given unlimited time to respond.
Lifetime experiences of gender-based violence, depression and condom use among female sex workers in Cameroon
Authors: Abelson Anna , Lyons Carrie , Decker Michele , Ketende Sosthenes , Mfochive Njindam Iliassou , Fouda Ghislaine , Ndonko Flavien , Levitt Daniel , Tamoufe Ubald , Billong Serge , Bissek Anne-Cecile Zoung-Kanyi , Baral Stefan D 
Published: June 2019

Background: In general populations, consistent data highlight the relationships among violence, HIV risk behavior and depression; however, these patterns are not well understood among female sex workers (FSWs). We examined the relationship between FSWs’ experiences with sexual violence and consistent condom use as a key HIV risk behavior and explored mental health as a potential mediator. Methods: In total, 2,165 FSWs were recruited via respondent-driven sampling in Cameroon in 2016. The women answered questions about violence, condom use and mental health. Results: Inconsistent condom use with clients was reported by 23.5% of participants (508/2,165). Lifetime sexual violence was prevalent with 33.0% (713/2,163) of participants. Almost 50% (1,067/2,143) of respondents had some level of depression. Sexual violence was significantly associated with inconsistent condom use (adjusted risk ratio (aRR) 1.4, 95% confidence interval (CI) (1.2–1.6)). Of FSWs with no depression, 24.9% (267/1,071) reported sexual violence, versus 56.1% (32/57) of respondents with severe depression ( p < .01). Severe depression significantly increased risk of condomless sex (aRR 1.8, 95% CI (1.3–2.6)); in mediation analysis, both sexual violence and severe depression remained significant predictors of condomless sex (aRR 1.4, 95% CI (1.2, 1.6) and aRR 1.7, 95% CI (1.2–2.4), respectively). Depression did not mediate the relationship between sexual violence and condom use. Conclusion: Sexual violence and depression are prevalent and independently associated with condom nonuse with clients among FSWs in Cameroon. Results highlight the need for interventions to address mental health as well as gender-based violence for FSWs.
Outcomes of Vocal Fold Motion Impairment and Dysphagia after Pediatric Cardiothoracic Surgery: A Systematic Review
Authors: Orzell Susannah , Joseph Rahul , Ongkasuwan Julina , Bedwell Joshua , Shin Jennifer , Raol Nikhila 
Published: June 2019

ObjectiveThe objective of this study was to systematically review the literature regarding vocal fold motion impairment (VFMI), respiratory outcomes, and swallowing outcomes in children following congenital heart surgery (CHS).Data SourcesPubMed, Embase, Medline, and CINAHL databases.Review MethodsData sources were searched from inception to November 30, 2018. Studies that described recovery of VFMI and swallowing function following CHS were included, and a qualitative analysis was performed.ResultsA total of 1371 studies were identified, of which 8 met inclusion criteria for VFMI and 5 met inclusion criteria for swallowing outcomes. Studies including patients who underwent isolate patent ductus arteriosus ligation were excluded. VFMI was present in 8% to 59% of subjects, and rates of recovery ranged from 9% to 96% at 6 months to 6 years of follow‐up. Inability to maintain an oral diet occurred in 14% to 100% of subjects with VFMI and 11% to 61% without VFMI following surgery. Tolerance of an oral diet without tube feeding was present in 66% to 75% of subjects with VFMI and 88% to 100% without VFMI at 24 days to 3.2 years of follow‐up. Limited data suggest that time to extubation is longer in VFMI subjects, but overall hospital length of stay and mortality may not be affected by VFMI status.ConclusionsData evaluating dysphagia and VFMI after CHS are limited. Most studies suggest significant improvement in swallowing function, while rate of recovery of VFMI is variable. Future prospective studies with standardized screening and follow‐up are needed to better elucidate outcomes to help develop algorithms for identification and management of VFMI after CHS.
Ultrasound criteria for managing postpartum patients with suspicion of retention of conception products
Authors: Levinsohn-Tavor Orna , Feldman Noa , Svirsky Ran , Smorgick Noam , Nir-Yoffe Arava , Maymon Ron 
Published: June 2019

Background Retention of conception products is a common complication following delivery and remains a diagnostic and management challenge due to non-specific symptoms and ultrasound findings. Purpose To introduce a clinical approach for managing patients with suspected retained products of conception following delivery. Material and Methods The ultrasound examination included gray-scale and Doppler parameters which classified the patients into three groups: high, moderate, or low probability for retained products of conception. The same classification was used both to stratify individual risk for retained products of conception, as well as for counseling the appropriate management. Results The study included 66 patients. Retained products of conception was confirmed in 62%, 32% and 0% of the high, moderate and low probability groups, respectively. Additionally, each group was further divided according to the timing of the ultrasound examination: before or after 42 postpartum days. A significant increase, from 12% to 64%, in the positive predictive value was observed in the moderate probability group when the ultrasound was performed ≥ 42 days postpartum. Conclusions In the low probability group, no surgical intervention is recommended. When ultrasound findings are classified as high probability for retained products of conception, surgical evacuation of the uterine content is recommended. For clinically stable women with ultrasound findings consistent with moderate probability, ultrasound follow-up at the end of the puerperal period (42 days) is recommended. This approach may improve the sonographic prediction of retained products of conception and prevent unnecessary interventions.
The role of low keV virtual monochromatic imaging in increasing the conspicuity of primary breast cancer in dual-energy spectral thoracic CT examination for staging purposes
Authors: Metin Yavuz , Metin Nurgül Orhan , Özdemir Oğuzhan , Taşçı Filiz , Kul Sibel 
Published: June 2019

Background The additive value of dual-energy spectral computerized tomography (DESCT) in breast cancer imaging is still unknown. Purpose To investigate the role of DESCT in improving the conspicuity of primary breast cancer. Material and Methods Twenty-nine patients who were histopathologically diagnosed with breast cancer and underwent DESCT for staging of lung metastasis were evaluated retrospectively. The visual conspicuity of breast cancer was scored by two readers separately in reconstructed virtual monochromatic images obtained at 40, 60, 80, and 100 keV. A circular region of interest slightly smaller than the maximum contrasted portion of the primary breast cancer was manually placed. Iodine enhancement (HU) and iodine content (mg/mL) values of tumor, normal breast tissue and pectoral muscle, and contrast-to-noise values of images at four different energy levels were calculated. Results The lesion conspicuity score peaked at 40-keV series for both readers and was significantly higher than those at other energy levels (all P < 0.001). Lesion iodine enhancement was highest at 40-keV virtual monochromatic image reconstructions ( P < 0.001). The iodine content was significantly higher in tumor than normal breast tissue, and pectoral muscle ( P < 0.001). The highest contrast-to-noise value was obtained at 60 keV (4.0 ± 2.5), followed by 40 keV (3.9 ± 2.2), without a significant difference ( P = 0.33). Conclusion The conspicuity of primary breast cancer was significantly higher in low keV virtual monochromatic images obtained by DESCT. This gives us hope that DESCT may play an effective role in detecting incidental breast lesions. It also raises the question of whether quantitative values obtained by DESCT can be used for characterization of primary breast lesion.