bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐Term Acute Care Hospital Use of Non‐Mechanically Ventilated Hospitalized Older Adults
Authors: Makam Anil N. , Nguyen Oanh Kieu , Xuan Lei , Miller Michael E. , Halm Ethan A. 
Published: September 2018

ObjectivesTo determine why non‐mechanically ventilated hospitalized older adults are transferred to long‐term acute care (LTAC) hospitals rather than remaining in the hospital.DesignObservational cohort.SettingNational Medicare data.ParticipantsNon‐mechanically ventilated hospitalized adults aged 65 and older with fee‐for‐service Medicare in 2012 who were transferred to an LTAC hospital (n=1,831) or had a prolonged hospitalization without transfer (average hospital length of stay or longer of those transferred to an LTAC hospital) and had one of the 50 most common hospital diagnoses leading to LTAC transfer (N=12,875).MeasurementsWe assessed predictors of transfer using a multilevel model, adjusting for patient‐, hospital‐, and hospital referral region (HRR)‐level factors. We estimated proportions of variance at each level and adjusted hospital‐ and HRR‐specific LTAC transfer rates using sequential models.ResultsThe strongest predictor of transfer was being hospitalized near an LTAC hospital (<1.4 vs > 33.6 miles, adjusted odds ratio=6.2, 95% confidence interval (CI)=4.2–9.1). After adjusting for case mix, differences between hospitals explained 15.4% of the variation in LTAC use and differences between regions explained 27.8%. Case mix–adjusted LTAC use was high in the South, where many HRRs had rates between 20.3% and 53.1%, whereas many HRRs were less than 5.4% in the Pacific Northwest, North, and New England. From our fully adjusted model, the median adjusted hospital LTAC transfer rate was 7.2% (interquartile range 2.8–17.5%), with substantial within‐region variation (intraclass coefficient=0.25, 95% CI=0.21–0.30).ConclusionsNearly half of the variation in LTAC use is independent of illness severity and is explained by which hospital and what region the individual was hospitalized in. Because of the greater fragmentation of care and Medicare spending with LTAC transfers (because LTAC hospitals generate a separate bundled payment from the hospital), greater attention is needed to define the optimal role of LTAC hospitals in caring for older adults. J Am Geriatr Soc 66:2112–2119, 2018.
Iron chelation therapy
Authors: HOFFBRAND A.V. , WONKE B. 
Published: September 2018

Desferrioxamine (DFX) remains the most effective and safe iron chelator for treatment of patients with transfusional iron overload. It is usually given by intermittent subcutaneous infusions for 8–12 h on 4–6 days weekly using a battery‐driven pump. Disposable balloon infusers provide a suitable method of giving continuous subcutaneous infusions with improved patient compliance. For patients with cardiac abnormalities due to iron overload, continuous intravenous desferrioxamine is essential to eliminate toxic plasma non‐transferrin bound iron and to reduce body iron stores.Deferiprone (L1, 1–2 dimethy1‐3hydroxy‐pyrid‐4‐one) is a less effective iron chelator but has the advantage of being orally active. Long‐term trials in which patients have taken 75 mg/kg/day have shown that deferiprone is capable of maintaining body iron stores at safe levels in a proportion of thalassaemia major patients but body iron stores, assessed by liver biopsy remain at high levels (>15.0 mg/g dry weight) in a substantial number of patients. These concentrations have been associated with tissue damage. Trials of increased doses of deferiprone (up to 100 mg/kg/day) or of combined therapy with daily deferiprone and DFX or 1 or 2 days each week are being carried out in an attempt to achieve lower body iron burden in these patients. Preliminary results show that the drugs can be given safely together and urine iron excretion produced is additive, implying that the drugs chelate different body iron pools.Patients previously well chelated with serum ferritin levels less than 2500 μg/L have the fewest side‐effects from deferiprone and usually may be kept at the same level of body iron for periods of at least 4 years, assessed by serum ferritin and urine iron excretion. The side‐effects of deferiprone result in some patients discontinuing therapy. These side‐effects, especially arthropathy, mainly occur in previously poorly chelated and so the most heavily iron‐loaded patients. Nausea and other gastrointestinal symptoms, agranulocytosis or milder degrees of neutropenia account with arthropathy for nearly all the withdrawals from deferiprone therapy. Patients with cardiomyopathy due to iron overload should be given intravenous DFX rather than deferiprone. Deferiprone, licensed for pharmaceutical use in India, awaits official approval for widespread clinical use in Western Europe and North America. Meanwhile, attempts to find new orally active iron chelators and improved methods of administration of desferrioxamine are in progress.
Apparent inbreeding preference despite inbreeding depression in the American crow
Authors: Townsend Andrea K. , Taff Conor C. , Jones Melissa L. , Getman Katherine H. , Wheeler Sarah S. , Hinton Mitch G. , Logsdon Ryane M. 
Published: September 2018

AbstractAlthough matings between relatives can have negative effects on offspring fitness, apparent inbreeding preference has been reported in a growing number of systems, including those with documented inbreeding depression. Here, we examined evidence for inbreeding depression and inbreeding preference in two populations (Clinton, New York, and Davis, California, USA) of the cooperatively breeding American crow (Corvus brachyrhynchos). We then compared observed inbreeding strategies with theoretical expectations for optimal, adaptive levels of inbreeding, given the inclusive fitness benefits and population‐specific magnitude of inbreeding depression. We found that low heterozygosity at a panel of 33 microsatellite markers was associated with low survival probability (fledging success) and low white blood cell counts among offspring in both populations. Despite these costs, our data were more consistent with inbreeding preference than avoidance: The observed heterozygosity among 396 sampled crow offspring was significantly lower than expected if local adults were mating by random chance. This pattern was consistent across a range of spatial scales in both populations. Adaptive levels of inbreeding, given the magnitude of inbreeding depression, were predicted to be very low in the California population, whereas complete disassortative mating was predicted in the New York population. Sexual conflict might have contributed to the apparent absence of inbreeding avoidance in crows. These data add to an increasing number of examples of an “inbreeding paradox,” where inbreeding appears to be preferred despite inbreeding depression.
The role of stress in controlling infrared radiation during coal and rock failures
Authors: Ma Liqiang , Sun Hai , Zhang Yao , Hu Honglei , Zhang Chengguo 
Published: September 2018

AbstractDuring coal failure under loading, variations in infrared radiation (IR) characteristics can be observed in response to stress drops. To explore the quantitative relation between the stress and IR characteristics, a new quantitative failure indicator called the variance of successive minus infrared image temperature (VSMIT) has been developed to study IR characteristics during the uniaxial compression loading. Results from this study indicate that the role of stress in controlling IR characteristics of the coal sample is universal during loading with the ratio of 90.2%. In addition, the role of stress in controlling IR is significant, given that the average sudden change coefficient of VSMIT is at least three orders of magnitudes of the stress drop coefficient of the coal sample. Moreover, the control effect has predictability (precursor). Before failure and instability, simultaneous sudden changes of VSMIT and stress can be observed in 76.2% of coal samples, which can thus be regarded as the IR precursor of coal failure. The present work can provide a new method and some novel indexes for monitoring stress state as well as fracture development in coal rocks, which will also be of theoretical guidance for promoting the applications of IR‐based forecasting and early warning of some natural and rock engineering disasters mainly including rockbursts and coalbursts induced by the fractures in the coal rock.
Successful heart‐kidney transplantation from a Hepatitis C viremic donor to negative recipient: One year of follow‐up
Authors: Wettersten Nicholas , Tran Hao , Mekeel Kristin , Pretorius Victor , Adler Eric , Aslam Saima 
Published: September 2018

AbstractEvery year the number of patients waiting for a heart transplant increases faster than the number of available donor organs. Some potential donor organs are from donors with active communicable diseases, including hepatitis C virus (HCV), potentially making donation prohibitive. The advent of direct‐acting antiviral agents for HCV has drastically changed the treatment of HCV. Recently, these agents have been used to treat HCV in organ donor recipients who acquired the disease from the donor organ. We report a case of heart‐kidney transplantation from an HCV viremic donor to HCV negative recipient with successful treatment and sustained virologic response.
Hip and Trunk Muscle Activity During the Star Excursion Balance Test in Healthy Adults
Authors: Bhanot Kunal , Kaur Navpreet , Brody Lori Thein , Bridges Jennifer , Berry David C. , Ode Joshua J. 
Published: September 2018

Context: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool. Objective: To determine the electromyographic activity of the hip and the trunk muscles during the SEBT. Design: Descriptive. Setting: University campus. Participants: Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat). Intervention: Surface electromyographic data were collected on 22 healthy adults of the erector spinae, external oblique, and rectus abdominis bilaterally, and gluteus medius and gluteus maximus muscle of the stance leg. A 2-way repeated measures analysis of variance was used to determine the interaction between the percentage maximal voluntary isometric contraction (%MVIC) and the reach directions. The %MVIC for each muscle was compared across the 8 reach directions using the Sidak post hoc test with α at .05. Main Outcome Measures: %MVIC. Results: Significant differences were observed for all the 8 muscles. Highest electromyographic activity was found for the tested muscles in the following reach directions—ipsilateral external oblique (44.5% [38.4%]): anterolateral; contralateral external oblique (52.3% [40.8%]): medial; ipsilateral rectus abdominis (8% [6.6%]): anterior; contralateral rectus abdominis (8% [5.3%]): anteromedial; ipsilateral erector spinae (46.4% [20.2%]): posterolateral; contralateral erector spinae (33.5% [11.3%]): posteromedial; gluteus maximus (27.4% [11.7%]): posterior; and gluteus medius (54.6% [26.1%]): medial direction. Conclusions: Trunk and hip muscle activation was direction dependent during the SEBT. This information can be used during rehabilitation of the hip and the trunk muscles.
Comparing the Effects of SUREE Programs on People With Scapular Downward Rotation Syndrome: A Randomized Clinical Trial
Authors: Derakhshani Alireza , Letafatkar Amir , Khosrokiani Zohre 
Published: September 2018

Context:Scapular downward rotation syndrome (SDRS) is an impaired alignment that causes shoulder and neck pain. Interventions may lead to the reduction of pain intensity and joint position error (JPE) and improved range of motion (ROM).Objective:To evaluate the effects of 6-week Scapular Upward Rotation and Elevation Exercises (SUREE) with and without visual feedback on pain, ROM, and JPE in people with SDRS.Study Design:Randomized control trial.Setting:Institutional practice.Participants:Forty-two young and active subjects (22.61 [1.80] y; 27 males and 15 females) with unilateral SDRS randomly assigned into 3 groups (2 intervention groups and 1 control group).Interventions:SUREE without and with visual feedback programs.Main Outcome Measures:Pain, neck-flexion and rotation ROMs, and JPE were measured using visual analog scale (score), double inclinometer method, universal goniometer method (degrees), and a dual digital inclinometer (degrees), respectively, before and after interventions.Results:The results showed statistically significant changes within the experimental groups in all variables except for the neck rotation ROM in the SUREE intervention without visual feedback (P < .05). However, there were no changes in the control group before and after the interventions in all dependent variables (P < .05). Also, there were no significant differences between both experimental groups concerning all dependent variables except for the rotation ROM (P < .05).Conclusion:The results suggest that the 6-week SUREE with and without visual feedback programs result in decreased neck pain and improved flexion ROM and JPE during active neck motions in subjects with unilateral SDRS. However, the 6-week SUREE with visual feedback may improve the neck rotation ROM in subjects with unilateral SDRS. However, further studies are needed to confirm the results of this study.
Trends in mental health service utilisation in immigrant youth in Ontario, Canada, 1996–2012: a population-based longitudinal cohort study
Authors: Saunders Natasha Ruth , Lebenbaum Michael , Lu Hong , Stukel Therese A , Urquia Marcelo Luis , Guttmann Astrid 
Published: September 2018

ObjectiveTo describe trends in mental health service use of youth by immigration status and characteristics.DesignPopulation-based longitudinal cohort study from 1996 to 2012 using linked health and administrative datasets.SettingOntario, Canada.ParticipantsYouth 10–24 years, living in Ontario, Canada.ExposureThe main exposure was immigration status (recent immigrants vs long-term residents). Secondary exposures were region of origin and refugee status.Main outcome measureMental health hospitalisations, emergency department (ED) visits and outpatient visits within consecutive 3-year time periods. Poisson regression models estimated rate ratios (RR).ResultsOver 2.5 million person years per period were included. Rates of recent immigrant mental health service utilisation were at least 40% lower than long-term residents (p<0.0001).Mental health hospitalisation and ED visit rates increased in long-term residents (hospitalisations, RR 1.09 (95% CI 1.08 to 1.09); ED visits, RR 1.15 (1.14 to 1.15)) and recent immigrants (hospitalisations RR 1.05 (1.03 to 1.07); ED visits, RR 1.08 (1.05 to 1.11)). Mental health outpatient visit rates increased in long-term residents (RR 1.03 (1.03 to 1.03)) but declined in recent immigrant (RR 0.94 (0.93 to 0.95)). Comparable divergent trends in acute care and outpatient service use were observed among refugees and across most regions of origin. Recent immigrant acute care use was driven by longer-term refugees (hospitalisations RR 1.12 (1.03 to 1.21); ED visits RR 1.11 (1.02 to 1.20)).ConclusionsMental health service utilisation was lower among recent immigrants than long-term residents. While acute care use is increasing at a faster rate among long-term residents than recent immigrants, the decrease in outpatient mental health visits in immigrants highlights a potential emerging disparity in access to preventative care.
Cohort profile: Thrombolysis in Ischemic Stroke Patients (TRISP): a multicentre research collaboration
Authors: Scheitz Jan F , Gensicke Henrik , Zinkstok Sanne M , Curtze Sami , Arnold Marcel , Hametner Christian , Pezzini Alessandro , Turc Guillaume , Zini Andrea , Padjen Visnja , Wegener Susanne , Nordanstig Annika , Kellert Lars , Kägi Georg , Bejot Yannick , Michel Patrik , Leys Didier , Nolte Christian H , Nederkoorn Paul J , Engelter Stefan T 
Published: September 2018

PurposeThe ThRombolysis in Ischemic Stroke Patients (TRISP) collaboration aims to address clinically relevant questions about safety and outcomes of intravenous thrombolysis (IVT) and endovascular thrombectomy. The findings can provide observational information on treatment of patients derived from everyday clinical practice.ParticipantsTRISP is an open, investigator-driven collaborative research initiative of European stroke centres with expertise in treatment with revascularisation therapies and maintenance of hospital-based registries. All participating centres made a commitment to prospectively collect data on consecutive patients with stroke treated with IVT using standardised definitions of variables and outcomes, to assure accuracy and completeness of the data and to adapt their local databases to answer novel research questions.Findings to dateCurrently, TRISP comprises 18 centres and registers >10 000 IVT-treated patients. Prior TRISP projects provided evidence on the safety and functional outcome in relevant subgroups of patients who were excluded, under-represented or not specifically addressed in randomised controlled trials (ie, pre-existing disability, cervical artery dissections, stroke mimics, prior statin use), demonstrated deficits in organisation of acute stroke care (ie, IVT during non-working hours, effects of onset-to-door time on onset-to-needle time), evaluated the association between laboratory findings on outcome after IVT and served to develop risk estimation tools for prediction of haemorrhagic complications and functional outcome after IVT.Future plansFurther TRISP projects to increase knowledge of the effect and safety of revascularisation therapies in acute stroke are ongoing. TRISP welcomes participation and project proposals of further centres fulfilling the outlined requirements. In the future, TRISP will be extended to include patients undergoing endovascular thrombectomy.
Future projection of the physician workforce and its geographical equity in Japan: a cohort-component model
Authors: Hara Koji , Kunisawa Susumu , Sasaki Noriko , Imanaka Yuichi 
Published: September 2018

IntroductionThe geographical inequity of physicians is a serious problem in Japan. However, there is little evidence of inequity in the future geographical distribution of physicians, even though the future physician supply at the national level has been estimated. In addition, possible changes in the age and sex distribution of future physicians are unclear. Thus, the purpose of this study is to project the future geographical distribution of physicians and their demographics.MethodsWe used a cohort-component model with the following assumptions: basic population, future mortality rate, future new registration rate, and future in-migration and out-migration rates. We examined changes in the number of physicians from 2005 to 2035 in secondary medical areas (SMAs) in Japan. To clarify the trends by regional characteristics, SMAs were divided into four groups based on urban or rural status and initial physician supply (lower/higher). The number of physicians was calculated separately by sex and age strata.ResultsFrom 2005 to 2035, the absolute number of physicians aged 25–64 will decline by 6.1% in rural areas with an initially lower physician supply, but it will increase by 37.0% in urban areas with an initially lower supply. The proportion of aged physicians will increase in all areas, especially in rural ones with an initially lower supply, where it will change from 14.4% to 31.3%. The inequity in the geographical distribution of physicians will expand despite an increase in the number of physicians in rural areas.ConclusionsWe found that the geographical disparity of physicians will worsen from 2005 to 2035. Furthermore, physicians aged 25–64 will be more concentrated in urban areas, and physicians will age more rapidly in rural places than urban ones. The regional disparity in the physician supply will worsen in the future if new and drastic measures are not taken.
Evaluating the effect of income support policies on social health inequalities (SHIs) at birth in Montreal and Brussels using a contextualised comparative approach and model family method: a study protocol
Authors: Sow Mouctar , De Spiegelaere Myriam , Raynault Marie-France 
Published: September 2018

IntroductionAssessing the effects of social policies on social health inequalities (SHIs) is a complex issue. Variations in social policy between countries or regions provide natural experiments in policy implementation to perform comparative research. Comparisons are most enlightening when: the object of the evaluation is well defined (types of policies, population groups); the context of policy is analysed (history, implementation); the impact of policy on household poverty is outlined in detail; the influence of various factors (other than poverty) on SHI is taken into consideration.Methods and analysisThis study aims to understand how income support policies (ISPs) in Brussels and Montreal influence the poverty level of households receiving social assistance, and how they are associated with SHI at birth. Two cases studies will be carried out from a comparative perspective. The analysis includes four stages : (1) The model family method will be used to compare ISPs and their impact on disposable income and poverty of households receiving social assistance in both regions. (2) Statistical analysis of administrative databases will enable the description and comparison of SHI in adverse pregnancy outcomes across the two regions. (3) Analysis of databases and documents will allow for description of various factors which are likely to interact with poverty and influence SHI at birth. (4) Based on the Diderichsen model, results from the previous stages will be used to formulate hypotheses about the mechanisms by which ISPs contribute to increasing or reducing SHI at birth in both regions.Ethics and disseminationThis research was approved by the Human Research Ethics Committee for Health research of Université de Montréal. In Belgium, the access to linked databases was approved by the Commission for the Protection of Privacy. Databases de-identified according to Belgian and Canadian legislation will be used. Results will be disseminated in scientific publications and will be shared with policy makers and field actors through collaborations with local organisations in Brussels and Montreal.