bluuebunny/crossref_metadata_2025_split huggingface dataset:
Petrology and Geochemistry of Serpentinites Associated with the Ultra-High Pressure Lago di Cignana Unit (Italian Western Alps)
Authors: Gilio Mattia , Scambelluri Marco , Agostini Samuele , Godard Marguerite , Peters Daniel , Pettke Thomas 
Published: May 2019

AbstractIn the Western Alps, the ophiolitic Zermatt–Saas Zone (ZSZ) and the Lago di Cignana Unit (LCU) record oceanic lithosphere subduction to high (540°C, 2·3GPa) and ultra-high pressure (600°C, 3·2GPa), respectively. The top of the Zermatt–Saas Zone in contact with the Lago di Cignana Unit consists of olivine + Ti-clinohumite-bearing serpentinites (the Cignana serpentinite) hosting olivine + Ti-clinohumite veins and dykelets of olivine + Ti-chondrodite + Ti-clinohumite. The composition of this serpentinite reveals a refertilized oceanic mantle peridotite protolith that became subsequently enriched in fluid-mobile elements (FME) during oceanic serpentinization. The olivine + Ti-clinohumite veins in the Cignana serpentinite display Rare Earth Element (REE) and FME compositions quite similar to the host-rock, which suggests closed-system dehydration of this serpentinite during subduction. The Ti-chondrodite-bearing dykelets are richer in REE and FME than the host-rock and the dehydration olivine + Ti-clinohumite veins: their Nd composition points to a mafic protolith, successively overprinted by oceanic metasomatism and by subduction zone recrystallization. These dykelets are comparable in composition to eclogites within the ultra-high pressure LCU that derive from subducted oceanic mafic crust. Different from the LCU, serpentinites from the core domains of the ZSZ display REE compositions indicating a depleted mantle protolith. The oceanic serpentinization of these rocks led to an increase in FME and to seawater-like Sr isotope compositions. The serpentinites sampled at increasing distance from the ultra-high pressure LCU reveal different mantle protoliths, still preserve an oceanic geochemical imprint and contain mafic dykelets affected by oceanic metasomatism. The subduction zone history of these rocks thus occurred under relatively closed system conditions, the only possible change during subduction being an enrichment in As and Sb recorded by the serpentinites closer to the crustal LCU. The ZSZ and Cignana serpentinites thus likely evolved in a slab setting and were weakly exposed to interaction with slab-derived fluids characteristic of plate interface settings. Our data suggest two possible scenarios for the evolution of the studied ZSZ and Cignana serpentinites. They are either part of a coherent ophiolite unit whose initial lithospheric mantle was variably affected by depletion and re-fertilization processes, or they belong to separate tectonic slices derived from two different oceanic mantle sections. In the Cignana serpentinite atop the ZSZ, the presence of Ti-chondrodite dykelets similar in composition to the LCU eclogites suggests these two domains were closely associated in the oceanic lithosphere and shared the same evolution to ultra-high pressure conditions during Alpine subduction.
Flares in rheumatoid arthritis: do patient-reported swollen and tender joints match clinical and ultrasonography findings?
Authors: Kuettel Dorota , Terslev Lene , Weber Ulrich , Østergaard Mikkel , Primdahl Jette , Petersen Randi , Ammitzbøll-Danielsen Mads , Möller Sören , Hørslev-Petersen Kim 
Published: May 2019

AbstractObjectivesTo investigate how patient-reported flares in RA are related to clinical joint examination and inflammation detected by US.MethodsEighty RA patients with DAS28-CRP &lt;3.2 and no swollen joints at baseline were followed for 1 year. In case of patient-reported hand flare with swollen and tender joints (SJ and TJ, respectively), patients underwent clinical examination for SJ/TJ and US of bilateral wrists, MCP and PIP 1st–5th, six extensor tendon compartments and wrist flexor tendons for synovitis/tenosynovitis. Percentage agreement and kappa were calculated between patient-reported SJ and TJ, clinical examination for SJ/TJ and US findings indicative of inflammation. With US as reference, sensitivity, specificity, positive/negative predictive value and accuracy of patient-reported and clinically examined joints were determined.ResultsHand flare was reported by 36% (29/80) of patients. At time of flare, all clinical and ultrasonographic measures of disease activity deteriorated compared with baseline. Agreement between patient-reported SJ/TJ, clinically examined SJ/TJ and US was slight (kappa = 0.02–0.20). Patients and clinicians agreed in 79–93% of joints, more frequently on SJ than TJ. With US as reference, specificities were 86–100% and 88–100%, and sensitivities 12–34% and 4–32% for patient-reported SJ/TJ and clinically examined SJ/TJ, respectively.ConclusionOver 12 months of follow-up, hand flare was reported by every third RA patient. Self-reported flares were associated with increased disease activity as determined by clinical examination and US. Patient-reported joint assessment may aid in capturing flares between routine clinical visits.
Intake behaviors of yearling steers grazing irrigated pasture and receiving either a free-choice salt-based mineral or a low-moisture molasses-based tub mineral
Authors: Yelich Joel V , Ellison Melinda J , Hall John B , McGee Marcus 
Published: May 2019

Abstract
Mineral intake in grazing cattle is highly variable and research evaluating behavioral aspects of intake are minimal. Development of the GrowSafe System to monitor feed intake allows researchers to record individual feeding behaviors of cattle 24 h per day. In the current experiment conducted during June and July, the GrowSafe System was utilized to evaluate intake behaviors of grazing steers during a short-term free-choice supplementation of either salt-based loose minerals (LM; n = 24; 408 ± 57 kg) or low-moisture molasses-based tub minerals (TUB; n = 24; 396 ± 64 kg). Each treatment was randomized to two of the four irrigated pastures (~5 ha each) consisting of orchard grass (Dactylis glomerat L.), red clover (Trifolium pretense L.), and smooth brome (Bromus inermis). Individual intake was evaluated over three 7-d periods: d – 7 to 0 (adaptation period; AP), d 1 to 7 (period 1; P1), and d 15 to 22 (period 2; P2) of the experiment. The LM mineral mix contained 28% salt during the AP and more salt was added at the initiation of P1 to prevent excessive mineral intake observed during the AP. The LM mineral mix contained 38% salt during P1 and P2. Daily bunk attendance was greater (P &lt; 0.001) for LM (93%) than TUB (67%) steers for the AP. Whereas there was a treatment × period effect (P &lt; 0.001) on daily bunk attendance across P1 (LM: 92%; TUB: 64%) and P2 (LM: 91%; TUB: 82%). Daily mineral intake (as-fed) was greater (P &lt; 0.001) for LM (568 g) than TUB (283 g) during the AP. For P1 and P2, there were no treatment (P = 0.46) and period (P = 0.77) effects on daily mineral intake (LM, 370 g vs. TUB, 343 g), but LM (3.1 visits) had more (P &lt; 0.001) bunk visits per day than TUB (2.0 visits). During the AP, LM (8.5 min) had a greater (P = 0.04) duration of mineral intake per day than TUB (5.6 min); whereas during P1 and P2, TUB (P1 = 8.6; P2 = 12.8 min) had a greater (P ≤ 0.05) duration of mineral intake per day than LM (P1 = 4.9; P2 = 5.7 min). In conclusion, mineral delivery method significantly affected bunk attendance, number of bunk visits per day, and time spent consuming mineral. These results provide additional evidence that mineral type and associated feeding behaviors contribute to the significant variation observed in daily mineral intake in grazing cattle.
MALONDIALDEHYDE LEVELS IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION
Authors: Pinna Antonio , Boscia Francesco , Paliogiannis Panagiotis , Carru Ciriaco , Zinellu Angelo 
Published: May 2019

Background/Purpose:The role of blood malondialdehyde (MDA) in age-related macular degeneration (AMD), the leading cause of new blindness in industrialized countries, is still matter of debate. We performed a systematic review and meta-analysis of the published data on the MDA levels in AMD patients.Methods:PubMed, ISI Web of Sciences, and Scopus searches were performed according to MOOSE guidelines. Case–control studies were eligible for inclusion. Participants and controls were AMD patients and subjects without AMD, respectively. The main outcome measures were wet AMD and dry AMD. MDA level was the main exposure variable. Data were pooled using a random-effects model.Results:Twelve case–control studies were identified. A total of 634 AMD patients (mean age 66.7 years) and 656 controls without AMD (mean age 67.8 years) were evaluated. Extreme between-study heterogeneity was observed (I2= 96.8%,P< 0.001). Pooled standardized mean difference showed that MDA values were significantly higher in patients with AMD (standardized mean difference = 1.91µmol/L, 95% confidence interval = 1.08–2.74;P< 0.001). In a model including five studies, homogenous for age, sample matrix, and laboratory testing for MDA, heterogeneity decreased from extreme to moderate (I2= 46.4%,P= 0.113), and pooled standardized mean difference, though attenuated, remained significantly higher in AMD patients (standardized mean difference = 1.07µmol/L, 95% confidence interval = 0.82–1.31;P< 0.001).Conclusion:There is some evidence of higher levels of MDA in AMD patients compared with healthy controls; however, this result should be interpreted with caution because of extreme between-study heterogeneity and the possible effect of publication bias. Future studies, preferably well age-matched and of cohort design, are necessary before any firm conclusions on the putative role of elevated MDA on AMD can be drawn.
Simple Endoscopic Score of Crohn Disease and Magnetic Resonance Enterography in Children
Authors: Weiss Batia , Turner Dan , Griffiths Anne , Walters Tom , Herman‐Sucharska Izabela , Coppenrath Eva , Anupindi Sudha A. , Towbin Alexander J. , O’Brien Kathy , Silverstein Jared , Navas Victor , Koletzko Sibylle , Sladek Malgorzata , Gavish Matan , Amitai Michal M. ,   ImageKids study group. NCT01881490
Published: May 2019

ABSTRACTObjectives:We aimed to explore the ability of magnetic resonance enterography (MRE) to impute the simple endoscopic score of Crohn disease (SES‐CD) in children with CD, in whom failure of ileal intubation is common and may impair SES‐CD calculation in clinical studies.Methods:This is a substudy of the prospective ImageKids study in which children with CD underwent ileocolonoscopy (scored by SES‐CD) and MRE (scored on a 100 mm visual analogue scale [VAS] and by MaRIA). Mucosal healing (MH) was defined as SES‐CD <3, MRE‐VAS <20 mm, and/or MaRIA <7.Results:A total of 237 children (22 centers, age 11.5 ± 3.3 years), were enrolled. Ileal intubation has failed in 40 of 237 (17%). The agreement between SES‐CD and MRE was 75% (k = 0.508, P < 0.001) in the ileum, and 68% to 85% in the colonic segments (k = 0.21–0.50, P < 0.001). The sensitivity and specificity of ileal MRE‐VAS for MH were 91.7% (95% confidence interval 0.84–0.96) and 53.1% (95% confidence interval 0.43–0.63), respectively. The ileal MaRIA score (calculated in 33/40) was higher in the children without ileal intubation than in the others (20.5 ± 7.1 vs 15.1 ± 10.8, respectively, P = 0.0018). In 7% (16/237) of children, isolated active ileal disease would have been missed when considering SES‐CD only. A multivariable model predicted the ileal SES‐CD subscore from the MaRIA: SES‐CDileum = 1.145 + 0.169 × MaRIAileum rounded to the nearest whole number (R2 = 0.17). Applying this model to the children without ileal intubation revealed that 29 of 33 (88%) had ileal disease; 8 of 29 patients (28%) with normal colonic SES‐CD had imputed ileal SES‐CD ≥3.Conclusions:MRE is useful for imputing the ileal disease in pediatric clinical studies, overcoming the problem of ileal nonintubation.
De Novo Crohn's Disease of the Pouch in Children Undergoing Ileal Pouch‐Anal Anastomosis for Ulcerative Colitis
Authors: Jarchin Lauren , Spencer Elizabeth A. , Khaitov Sergey , Greenstein Alexander , Jossen Jacqueline , Lai Joanne , Dunkin David , Pittman Nanci , Benkov Keith , Dubinsky Marla C. 
Published: May 2019

ABSTRACTBackground:Approximately 10% of children with ulcerative colitis (UC) undergo colectomy with ileal pouch‐anal anastomosis (IPAA). We aimed to describe the postoperative outcomes, with an emphasis on chronic pouch inflammation including de novo Crohn disease (CD) at a tertiary care inflammatory bowel disease center.Methods:Electronic medical records of all children who underwent colectomy ≤18 years between 2008 and 2017 were reviewed. Clinical and laboratory data were recorded. Primary outcome was frequency of chronic pouch inflammation including de novo CD. Secondary outcomes included early (≤30 days from index surgery) and late postoperative complications. Descriptive statistics (median and interquartile range) summarized the data and univariate analysis tested associations with outcomes.Results:Fifty‐eight children underwent colectomy and 56 completed IPAA. Median age at diagnosis was 14 years (12–16.2) and at colectomy 16.2 years (14.2–17.7) with median follow‐up of 13 months (5–43). Sixty‐six percent underwent 3‐stage IPAA and 78% were biologic exposed. Eleven had chronic pouchitis, 73% antibiotic refractory and 25% met criteria for de novo CD by median of 19 months (9–41). A total of 21% and 50% experienced early and late surgical complications, most commonly ileus and recurrent IPAA stricture. The pouch failure rate was 3.6%. Chronic pouch inflammation was associated with a later diagnosis of de novo CD (P = 0.0025).Conclusions:In pediatric UC, CD is not uncommon after IPAA. Chronic pouch inflammation often precedes a diagnosis of de novo CD. Families should be informed of the short‐ and long‐term outcomes in children before UC surgery.
Leveraging Electronic Health Records and Machine Learning to Tailor Nursing Care for Patients at High Risk for Readmissions
Authors: Brom Heather , Brooks Carthon J. Margo , Ikeaba Uchechukwu , Chittams Jesse 
Published: May 2019

Background:
Electronic health record–derived data and novel analytics, such as machine learning, offer promising approaches to identify high-risk patients and inform nursing practice.

Purpose:
The aim was to identify patients at risk for readmissions by applying a machine-learning technique, Classification and Regression Tree, to electronic health record data from our 300-bed hospital.

Methods:
We conducted a retrospective analysis of 2165 clinical encounters from August to October 2017 using data from our health system's data store. Classification and Regression Tree was employed to determine patient profiles predicting 30-day readmission.

Results:
The 30-day readmission rate was 11.2% (n = 242). Classification and Regression Tree analysis revealed highest risk for readmission among patients who visited the emergency department, had 9 or more comorbidities, were insured through Medicaid, and were 65 years of age and older.

Conclusions:
Leveraging information through the electronic health record and Classification and Regression Tree offers a useful way to identify high-risk patients. Findings from our algorithm may be used to improve the quality of nursing care delivery for patients at highest readmission risk.
The Advanced Practice Nurse Will See You Now
Authors: McClain Jesse V. , Chance Elisha A. 
Published: May 2019

Background:
There is a paucity of evidence-based, posthospital stroke care in the United States proven to reduce preventable hospital readmissions.

Local Problem:
Follow-up with a provider after hospitalization for stroke or transient ischemic attack had low compliance rates. This may contribute to preventable readmissions.

Methods:
A retrospective, descriptive chart review to determine whether an advanced practice registered nurse (APRN)-led transitional care clinic for stroke survivors impacted 30- and 90-day hospital readmissions. Readmissions between clinic patients and nonclinic patients were compared.

Interventions:
The site implemented an APRN-led transitional care stroke clinic to improve patient transitions from hospital to home.

Results:
The 30-day readmission proportion was significantly higher in nonclinic patients (n = 335) than in clinic patients (n = 68) (13.4% vs 1.5%, respectively; P = .003). The 90-day readmission proportion was numerically higher in nonclinic patients (12.8% vs 4.4%, respectively; P = .058).

Conclusions:
The results suggest the APRN-led clinic may impact 30-day hospital readmissions in stroke/transient ischemic attack survivors.
Evidence-Based Quality Improvement Training Programs
Authors: Sarff Laura , O'Brien Roxanne 
Published: May 2019

Background:
Patient harm from medical errors is frequently the result of poorly designed systems. Quality improvement (QI) training programs should build staff capability and organizational capacity for improving systems.

Problem:
Lack of internal expertise in QI and financial impact of hiring consultants deter organizations from developing QI training.

Approach:
One safety net hospital, with minimal resources, used evidence-based elements to create a Quality Academy Program.

Outcomes:
Significant outcomes demonstrated individual capability in undertaking QI initiatives. Staff who continued QI posttraining and the number of initiatives launched demonstrated organizational capacity. Feedback showed an increase in confidence with projects intended to improve care processes and patient outcomes.

Conclusions:
The elements shown to be essential in QI programs to build capability and capacity for organizational improvement can improve patient outcomes and organizational work processes as well as impact staff engagement and morale.
Central Conditions Mimicking Benign Paroxysmal Positional Vertigo: A Case Series
Authors: Power Laura , Murray Kate , Bullus Kristian , Drummond Katherine J. , Trost Nicholas , Szmulewicz David J. 
Published: May 2019

Background and Purpose:
Benign paroxysmal positional vertigo (BPPV) is the most common cause of positional vertigo. The term “benign” is consistent with a peripheral vestibular disorder that does not carry the potentially sinister sequelae of a central nervous system (CNS) cause. However, in 12% to 20% of cases, positional vertigo may be attributed to CNS pathology, including tumors of the cerebellum.

Case Description:
Here, we present a series of 3 cases in which positional vertigo and nystagmus were the only presenting features in 2 cases of cerebellar tumor and 1 case of obstructive hydrocephalus.

Intervention:
All patients underwent surgical intervention for removal of posterior fossa tumors or posterior fossa decompression for obstructive hydrocephalus. Following surgery, all 3 patients underwent a period of vestibular rehabilitation for postoperative motion sensitivity and balance impairment.

Outcomes:
Despite the continuing presence of central positioning nystagmus, all 3 patients recovered well, putatively with the aid of vestibular rehabilitation.

Discussion:
The presence of central positioning nystagmus may be the sole presenting feature of serious neurological conditions such as posterior fossa tumor. It is recommended that a diagnosis of BPPV can only be made if Dix-Hallpike or supine roll maneuver elicits nystagmus that is consistent with BPPV. Any features of the nystagmus, which are not consistent with BPPV, should raise suspicion of central pathology, and warrant further investigation.

Video Abstract available for more insights from the authors (see Video Abstract, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A265).
Exergaming-Based Dexterity Training in Persons With Parkinson Disease: A Pilot Feasibility Study
Authors: van Beek Judith J. W. , van Wegen Erwin E. H. , Bohlhalter Stephan , Vanbellingen Tim 
Published: May 2019

Background and Purpose:
Many individuals with Parkinson disease (PD) suffer from impaired dexterity, which impacts activities of daily living and quality of life. Exergaming, video game-based training with augmented virtual reality, may have value for improving function. The aim of the present pilot study was to comprehensively evaluate the feasibility of a dexterity training program using exergaming, in individuals with PD.

Methods:
Ten participants with PD (aged between 55 and 75 years, Hoehn and Yahr stages II-IV) trained over a period of 4 weeks, twice a week for 30 minutes. Baseline (T0) and postintervention (T1) assessments were done. Primary outcomes with respect to feasibility were the adherence rate, open-end questions, the level of participation (Pittsburgh Rehabilitation Participation Scale), and the usability (System Usability Scale). Dexterous function was measured with the Nine-Hole Peg Test and the Dexterity Questionnaire-24. Upper limb motor impairment was assessed by a modified version of the Movement Disorders Society Unified Parkinson's Disease Rating Scale III. Finally, quality of life was assessed by the 39-item Parkinson's Disease Questionnaire (PDQ-39).

Results:
Adherence rate was 99%, motivation increased significantly from 3.9 to 4.8 (Pittsburgh Rehabilitation Participation Scale, P = 0.03), and system usability of the exergaming system was acceptable to very good. Regarding potential efficacy, participants with impaired dexterity at T0 significantly improved in the Nine-Hole Peg Test and the PDQ-39.

Discussions and Conclusions:
The outcomes of this pilot study suggest that exergaming is feasible and has potential to improve dexterity in individuals with PD. Its efficacy should be investigated in a properly powered randomized controlled trial.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A270).
Measuring Alcohol Outlet Density: An Overview of Strategies for Public Health Practitioners
Authors: Sacks Jeffrey J. , Brewer Robert D. , Mesnick Jessica , Holt James B. , Zhang Xingyou , Kanny Dafna , Elder Randy , Gruenewald Paul J. 
Published: May 2019

Context:
Excessive alcohol use is responsible for 88 000 deaths in the United States annually and cost the United States $249 billion in 2010. There is strong scientific evidence that regulating alcohol outlet density is an effective intervention for reducing excessive alcohol consumption and related harms, but there is no standard method for measuring this exposure.

Program:
We overview the strategies available for measuring outlet density, discuss their advantages and disadvantages, and provide examples of how they can be applied in practice.

Implementation:
The 3 main approaches for measuring density are container-based (eg, number of outlets in a county), distance-based (eg, average distance between a college and outlets), and spatial access–based (eg, weighted distance between town center and outlets).

Evaluation:
While container-based measures are the simplest to calculate and most intuitive, distance-based or spatial access–based measures are unconstrained by geopolitical boundaries and allow for assessment of clustering (an amplifier of certain alcohol-related harms). Spatial access–based measures can also be adjusted for population size/demographics but are the most resource-intensive to produce.

Discussion:
Alcohol outlet density varies widely across and between locations and over time, which is why it is important to measure it. Routine public health surveillance of alcohol outlet density is important to identify problem areas and detect emerging ones. Distance- or spatial access–based measures of alcohol outlet density are more resource-intensive than container-based measures but provide a much more accurate assessment of exposure to alcohol outlets and can be used to assess clustering, which is particularly important when assessing the relationship between density and alcohol-related harms, such as violent crime.