bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous tirofiban therapy for patients with capsular warning syndrome
Authors: Li Wei , Wu Ya , Li Xiao-Shu , Liu Cheng-Chun , Huang Shu-Han , Liang Chun-Rong , Wang Huan , Zhang Li-Li , Xu Zhi-Qiang , Wang Yan-Jiang , Zhang Meng 
Published: January 2019

BackgroundCapsular warning syndrome (CWS) is defined as recurrent episodes of transient ischaemic attacks ≥3 times during a short time frame. There is no effective therapy to stop these attacks. We, herein, report our experience of using intravenous tirofiban to treat CWS.MethodsAll patients with CWS in our hospital from January 2013 to September 2017 were reviewed. Patients in tirofiban group (T-group) were treated by intravenous tirofiban at 0.4 μg/kg/min for 30 min followed by 0.1–0.15 µg/kg/min infusion. Other treatments (non-T-group) included thrombolytic, oral antiplatelet agents and anticoagulant. Intracerebral haemorrhage (ICH), systematic bleeding, new attacks after treatment, National Institutes of Health Stroke Scale (NIHSS) scores at 24 hours and modified Rankin Scales (mRSs) at 3 months were recorded. Descriptive statistics were used for analysis.ResultsOf 23 patients qualified (15 in T-group, 8 in non-T-group), the duration of symptoms ranged from 2 to 100 min before treatments. After treatment, in T-group, four patients (26.7%) had recurrent attacks, and NIHSS scores were 0 in 11 patients (73.3%) at 24 hours. All patients reached a favourable outcome (mRS ≤2 at 3 months. In non-T-group, five patients (62.5%) had new attacks. NIHSS scores were 0 in two patients (25%) at 24 hours. At 3 months, seven patients (87.5%) reached a favourable outcome. Neither ICH nor systematic bleeding or thrombocytopaenia occurred in both groups of patients.ConclusionsIntravenous tirofiban can be a potentially effective and safe therapy to stop early symptomatic fluctuations and shorten the duration of functional deficits in patients with CWS.
Effect of frequent interruptions of sedentary time on nutrient metabolism in sedentary overweight male and female adults
Authors: De Jong Nathan P. , Rynders Corey A. , Goldstrohm David A. , Pan Zhaoxing , Lange Andrew H. , Mendez Carlos , Melanson Edward L. , Bessesen Daniel H. , Bergouignan Audrey 
Published: January 2019

This study compared 24-h nutrient oxidation responses between a sedentary condition (SED) and a condition in which short 5-min bouts of moderate-intensity physical activity were performed hourly for nine consecutive hours over 4 days (MICRO). To determine whether any shifts in fuel use were due solely to increases in energy expenditure, we also studied a condition consisting of a single isoenergetic 45-min bout of moderate-intensity exercise (ONE). Twenty sedentary overweight or obese adults (10 men/10 women; 32.4 ± 6.3 yr; BMI, 30.6 ± 2.9 kg/m2) completed all three conditions (MICRO, SED, and ONE) in a randomized order. Each condition consisted of a 3-day free-living run-in followed by a 24-h stay in a whole-room calorimeter to measure total energy expenditure (TEE) and substrate utilization. Dietary fat oxidation was also assessed during the chamber stay by administering a [1-13C] oleic acid tracer at breakfast. Energy intake was matched across conditions. Both MICRO and ONE increased TEE relative to SED, resulting in a negative energy balance. HOMA-IR improved in both activity conditions. MICRO increased 24-h carbohydrate oxidation compared with both ONE and SED ( P < 0.01 for both). ONE was associated with higher 24-h total fat oxidation compared with SED, and higher 24-h dietary fat oxidation compared with both SED and MICRO. Differences in substrate oxidation remained significant after adjusting for energy balance. In overweight and obese men and women, breaking up sitting time increased reliance upon carbohydrate as fuel over 24 h, while a single energy-matched continuous bout of exercise preferentially relies upon fat over 24 h. NEW & NOTEWORTHY Insulin sensitivity, as assessed by HOMA-IR, was improved after 4 days of physical activity, independent of frequency and duration of activity bouts. Temporal patterns of activity across the day differentially affect substrate oxidation. Frequent interruptions of sedentary time with short bouts of walking primarily increase 24-h carbohydrate oxidation, whereas an energy-matched single continuous bout of moderate intensity walking primarily increased 24-h fat oxidation.
Prognostic Relevance of Left Ventricular Myocardial Performance After Transcatheter Aortic Valve Replacement
Authors: Asami Masahiko , Pilgrim Thomas , Lanz Jonas , Heg Dik , Franzone Anna , Piccolo Raffaele , Langhammer Bettina , Praz Fabien , Räber Lorenz , Valgimigli Marco , Roost Eva , Windecker Stephan , Stortecky Stefan 
Published: January 2019

Background:
The left-ventricular myocardial performance index Tei is an echocardiographic parameter that incorporates the information of systolic and diastolic time intervals. While the prognostic value of selected systolic and diastolic parameters is well established after transcatheter aortic valve replacement, the role of Tei has not been evaluated in this setting.

Methods and Results:

Between August 2007 and December 2015, consecutive patients with symptomatic, severe aortic stenosis and transthoracic echocardiography pre- and post-transcatheter aortic valve replacement were considered eligible for this analysis. The primary end point was all-cause mortality at 1 year after transcatheter aortic valve replacement. Of 824 patients with echocardiographic images to calculate Tei, pre-Tei was normal (<0.45) in 639 and high (≥0.45) in 185, whereas post-Tei was normal in 602 and high in 120, respectively. After adjustment for confounding factors, high pre-Tei was associated with an increased risk of all-cause mortality at 30 days (adjusted hazard ratio [HR
adj
] 3.62; 95% CI, 1.89–6.91) and 1 year (HR
adj
2.56; 95% CI, 1.78–3.69). Similarly, post-Tei was associated with an increased risk of mortality between 30 days and 1-year follow-up (HR
adj
6.70; 95% CI, 4.22–10.63). At multivariable analysis Tei emerged as an independent predictor of early (pre-Tei index per 0.1–HR
adj
1.40; 95% CI, 1.23–1.60) and late mortality (post-Tei index per 0.1–HR
adj
1.40; 95% CI, 1.31–1.50), respectively.

Conclusions:
The left-ventricular myocardial performance index Tei is associated with impaired clinical outcomes during short- and longer-term follow-up after transcatheter aortic valve replacement.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01368250.
DÖVİZ KURUNDAKİ DEĞİŞİMİN SATIŞ RAKAMLARI ÜZERİNDEKİ ETKİSİNİN MARKOV ZİNCİRİ MODELİ İLE ANALİZİ
Authors: ALP Selçuk , SARIOĞLU Kübra 
Published: January 2019

Çalışmanın amacı, Euro döviz kurunda yaşanan
değişimin, ithal edilen bir malın satış rakamları üzerine etkisinin incelenmesidir.
Euro döviz kurunun ilgili malın satışları üzerindeki etkisini incelemek için
Markov Zinciri Modeli’nden faydalanılmıştır. Markov Zinciri Modeli Analizi ile
sistemin uzun durum denge durumları belirlenmiştir. Çalışmanın sonucunda birçok
ulusal ve uluslararası çalışmadaki bulunan sonuçlara benzer şekilde Euro döviz
kuru ile satış rakamları arasında göreceli olarak ters bir ilişki olduğu ortaya
konulmuştur.
KÜMELENME POTANSİYELİ GÖSTEREN SEKTÖRLERİN BELİRLENMESİ: TRA 1 DÜZEY 2 BÖLGESİ ÜZERİNE BİR UYGULAMA
Authors: DEMİRDÖĞEN Serkan 
Published: January 2019

Bu
çalışmanın amacı, TRA 1 bölgesi ve bu bölgede yer alan Erzurum, Erzincan ve
Bayburt illerinde kümelenme potansiyeli gösteren sektörlerin belirlenmesidir.
Bu bağlamda, kümelenme potansiyeli gösteren sektörlerin belirlenmesinde Sosyal
Güvenlik Kurumundan (SGK) temin edilen NACE Rev. 2’ ye göre sınıflandırılmış
2016 yılına ait istihdam ve işyeri sayısı verileri kullanılarak “üç yıldız
analizi” yapılmıştır.

Yapılan
bu araştırmanın, şuana kadar herhangi bir sektörde bir kümenin kurulmadığı TRA
1 bölgesi ve bölge illerinde kümelenmeyle ilgili bir farkındalık oluşmasına ve
kümelenmeyle ilgili olarak bölgede yapılması olası çalışmalara önemli katkılar
sağlayacağı düşünülmektedir. Araştırmanın sonuçlarına göre Tarım, Hayvancılık,
Madencilik ve Ormancılık sektörleri başta olmak üzere Gıda ürünleri imalatı,
İçecek imalatı, Madencilik sektörü, İnşaat sektörü, Sağlık sektörü ve Kış
turizmi sektörü kümelenmeye gidilebilecek olası sektörler olarak
belirlenmiştir.
Training teachers to implement physical activity: Applying social cognitive theory
Authors: Hivner Elizabeth A , Hoke Alicia M , Francis Erica B , Lehman Erik B , Hwang Grace W , Kraschnewski Jennifer L 
Published: January 2019

Objective: To evaluate the impact of three types of social cognitive theory (SCT)-based elementary school classroom physical activity (PA) training on teachers’ implementation rates, attitudes, knowledge and behaviour. Design: Key stakeholder focus groups informed development of phase II which took the form of a randomised controlled trial of three different intensities of teacher training to conduct classroom-based PA sessions. Setting: The study was conducted over one school year (2016–2017), across four elementary schools in the USA. Methods: Researchers delivered professional development to teachers, focusing on effective methods for PA use in the classroom through three formats: webinar, in-person training and in-person with personalised assistance. Training content was built on SCT constructs. This study examined the impact of the PA training on SCT construct outcomes among elementary school classroom teachers ( n = 41). Study outcome measures included reciprocal determinism, behavioural capability, outcome expectations and self-efficacy. Over the 12-week period following the training, teachers completed surveys to measure SCT construct outcomes. Results: Results of the intervention demonstrated an increase in teacher self-efficacy and knowledge ( p < .01 and p < .01). There was a significant increase of teachers who started using PA in the classroom who indicated no use at baseline (from 21% to 6% not using). Conclusion: The use of SCT to provide a teacher training is an effective method to increase classroom PA, while improving teacher self-efficacy and knowledge concerning PA implementation.
Compression therapy in lymphedema: Between past and recent scientific data
Authors: Mosti Giovanni , Cavezzi Attilio 
Published: January 2019

Aim To extrapolate and discuss the scientific data on compression in lymphedema treatment, so to review old and innovative concepts about pressure, stiffness and other interplaying factors related to its efficacy and comfort. Material and methods Narrative review based on search in Medline/Google Scholar through key-words related to compression in lymphedema. Results Currently available literature lacks relevant details about data on protocol, devices, techniques, interface pressure, stiffness, as well as biases are represented by the different descriptions to present the outcomes. More recent evidence from adjustable wrap devices and elastic garments question the need for high pressure (especially for the upper limb) and stiffness in lymphedema treatment. Conclusions At present time a very strong compression pressure exerted by material with high stiffness seem to be questionable in lymphedema treatment. A low pressure provides the best outcomes in arm lymphedema, while a pressure in the range of 40–60 mm Hg seems to provide higher efficacy in lower limb lymphedema, provided it is maintained overtime. A high stiffness seems to be unnecessary to treat chronic edema. Future clinical trials, including proper description of treatment methodology and adequate investigating instrumental tools, are awaited to possibly corroborate the conclusive outcomes of our review.
Percutaneous transhepatic biliary tract embolization using gelatin sponge
Authors: Augustin Anne Marie , Cao Victoria , Fluck Friederika , Kunz Julian , Bley Thorsten , Kickuth Ralph 
Published: January 2019

Background Percutaneous biliary drainage (PTBD) is a necessary procedure in several benign and malignant conditions. After PTBD removal biliocutaneous fistula is a rare but potential complication. Different embolization agents have been used for transhepatic catheter tract embolization in the past, while there is only little experience using gelatin sponge for this procedure. Purpose To evaluate the feasibility and safety of PTBD tract embolization with gelatin sponge. Material and Methods Between July 2008 and August 2017, 98 patients have been treated with PTBD access embolization using gelatin sponge. PTBD was performed in patients with malignant (67%) or benign (33%) bile duct obstruction. Outcome measures included technical success (complete cessation of bile flow out of the percutaneous access tract), clinical success (intermediate and long-term absence of biliocutaneous fistula, absence of right upper quadrant pain as typical symptom for bile leakage into the peritoneal cavity and absence of hemorrhage out of the catheter tract during follow-up inspections), and the rate of major and minor complications. Results Technical success with effective control of bile flow out of the percutaneous access tract was achieved in 97/98 patients (99.0%). Clinical success attributed to gelatin sponge embolization was documented in 96/98 procedures (98.0%). In one case, slight bleeding out of the percutaneous drainage tract occurred after drainage removal and embolization of the access tract. Bleeding was self-limiting; no blood transfusion or surgical intervention was necessary. Conclusion PTBD tract embolization with gelatin sponge is a feasible and safe method with a low rate of therapeutically relevant complications.
The making of a doctor: the matrix and self
Authors: Gerada Clare 
Published: January 2019

Foulkes’ concept of the matrix, the hypothetical web of communication, has long since left the consulting room and entered the wider sphere of communities, countries, and institutions. This article will discuss how the matrix encompasses a whole profession, that of medical doctors. Together with a deep-rooted sense of identity, which I refer to as the medical self, the medical matrix contributes to doctors’ professional wellbeing but also begins to explain the enormous recent increase in mental illness in the medical profession seen across the world. The article focuses on doctors. However, the ideas are relevant to any group (for example, teachers, the clergy, psychotherapists) which has a strong personal and professional identity, with all its attendant privileges and problems.
Screening for Post-Stroke Depression and Cognitive Impairment at Baseline Predicts Long-Term Patient-Centered Outcomes After Stroke
Authors: Kapoor Arunima , Lanctot Krista L. , Bayley Mark , Herrmann Nathan , Murray Brian J. , Swartz Richard H. 
Published: January 2019

Background: Independence and reintegration into community roles are important patient-centered outcomes after stroke. Depression and cognitive impairment are common post-stroke conditions that may impair long-term function even years after a stroke. However, screening for these post-stroke comorbidities remains infrequent in stroke prevention clinics and the utility of this screening for predicting long-term higher-level function has not been evaluated. Aims: To evaluate the ability of a validated brief Depression, Obstructive sleep apnea, and Cognitive impairment screen (DOC screen) to predict long-term (2-3 years after stroke) community participation and independence in instrumental activities of daily living post stroke. Methods: One hundred twenty-four patients (mean age, 66.3 [standard deviation = 15.7], 52.4% male) completed baseline depression and cognitive impairment screening at first stroke clinic visit, and telephone interviews 2 to 3 years post stroke to assess community independence (Frenchay Activities Index [FAI]) and participation (Reintegration to Normal Living Index [RNLI]). A subset of these patients also consented to complete detailed neuropsychological testing at baseline. Univariate and multivariate linear (FAI) and logistic (RNLI) regression analyses were used to determine the individual relationship between baseline data (predictors) and follow-up scores. Results: Older age (β = −0.17, P = .001), greater stroke severity (β = 1.84, P = .015), more depressive (β = −2.41, P = .023), and cognitive (β = −2.15, P = .046) symptoms independently predicted poor instrumental activity ( R2 = .27; P < .001). Measures of executive dysfunction were the strongest correlates of poor instrumental activity. Higher depression risk was the only significant predictor of participation on the RNLI in regression modeling (odds ratio = 0.46, P = .028). Conclusions: Baseline DOC screening in stroke prevention clinics shows that symptoms of depression and cognitive impairment are independent predictors of impaired higher-level functioning and community reintegration 2 to 3 years after stroke. Novel rehabilitation and psychological interventions targeting people with these conditions are needed to improve long-term patient-centered outcomes.
Experiences of caregivers of people with dementia in a Korean dementia simulation program
Authors: Han Areum , Kim Tae Hui , Hong Hyeon 
Published: January 2019

Objectives Experiencing dementia-related challenges in a dementia simulation program can be useful for caregivers to understand perspectives of people with dementia possibly leading to improvement in the quality of care and positive outcomes in caregivers and people with dementia. Previous studies about dementia simulation programs have been conducted in Western countries and no research has been conducted in Asian countries. The purpose of this qualitative study was to explore experiences of caregivers of people with dementia who participated in a Korean dementia simulation program. Methods A descriptive phenomenological study using thematic analysis with ATLAS.ti 8 software was used. A total of 28 Korean caregivers were interviewed about two weeks after participating in the Korean dementia simulation program that was modified from a program developed in USA by considering Korean cultures. Results Three key themes with seven subthemes emerged. The present study demonstrated that participation in the program helped caregivers have more empathy, affected their care strategies positively leading to emotional and social benefits on the care dyads, and increased awareness in possible changes due to aging and the risk of dementia. Conclusions The present study was the first study that demonstrated caregivers’ positive experiences in and benefits from participation in a dementia simulation program in an Asian country. Caregivers in the other Asian countries may have similar benefits from participation in dementia simulation programs.
Functional outcome after the nonsurgical treatment for adolescent spasmodic valgus foot
Authors: Rizk Ahmed Shawkat , Kandil Mahmoud Ibrahim 
Published: January 2019

Background: Adolescent spasmodic valgus foot is usually associated with resistant pain and deformity. It shows controversy regarding its incidence, etiology, and treatment. Our study aimed to evaluate the functional outcome after the nonsurgical treatment for such condition. Methods: This study included 50 planovalgus feet secondary to peroneal or peroneo-extensor spasm in 33 adolescents with a mean age of 14 ± 2.8 years. The procedure included foot manipulation under general anesthesia, sinus tarsi injection with corticosteroids, and a walking cast in the neutral position. Patients were evaluated functionally (using the American Orthopedic Foot and Ankle Society (AOFAS)) and radiologically before the procedure, after cast removal, and 3, 9, and 18 months later with special attention given for recurrence during the follow-up period with a mean duration of 22.5 ± 3.5 months. Results: Once general anesthesia had been conducted, the deformity was corrected without any manipulation, and full passive inversion could be easily obtained in 26 feet, the deformity was corrected only after manipulation, and full passive inversion had been obtained in 14 feet, while 10 feet remained stiff even after manipulation. The mean AOFAS score was significantly improved ( p < 0.001) from 40.9 ± 3.5 at presentation to 73.56 ± 5.2 at the last follow-up in which 12 feet was painless and freely mobile and 24 feet had partial relapse, while 14 feet had complete relapse. Conclusion: The nonsurgical treatment for adolescent spasmodic valgus foot could be a simple and effective treatment. Apart from limited complete recurrence, the overall functional outcome was satisfactory. Level of evidence: type IV case series.
Psychaesthenic Syndrome: A Review on its Implication in Female Sexual Arousal
Authors: Koneru Amulya , J. Shivanand Manohar , Rao T. S. Sathyanarayana 
Published: January 2019

Objectives: Psychaesthenic syndrome in the recent classification of DSM-5 comes under ‘Cultural Concepts of Distress.’ This can be the equivalent of Dhat syndrome in males. There is a paucity of literature regarding psychaesthenic syndrome. In this paper, we have tried to review the available literature regarding psychiatric and sexual comorbidities of psychaesthenic syndrome. Our paper also aims to ascertain the role and implication of psychaesthenic syndrome in female sexual arousal. Methods: PubMed, Google Scholar, and other databases were used to conduct the search. Research published in English was included. We searched the databases using the terms ‘psychaesthenic syndrome,’ ‘female Dhat syndrome,’ ‘nonpathological white discharge per vagina (NPWDPV),’ ‘leucorrhea,’ ‘female sexual disorders,’ etc. Results: For this review, we could find around 65 papers pertaining to the subject. These focused on the presence and effect of psychiatric disorders on sexual functioning. The effect of psychaesthenic syndrome on sexual functioning was also explored. The discomfort caused by NPWDPV may itself lead to decreased interest in sex. As inhibited sexual desire and sexual arousal disorder are estimated to be among the most common sexual disorders in women, it is probable that difficulty in sexual arousal is one of the major perceived effects of psychaesthenic syndrome. It has been found that depression often leads to difficulty in sexual arousal, amongst other sexual dysfunctions. Thus, there is an indirect causation of female sexual arousal disorder in psychaesthenic syndrome if depression is the manifestation of the syndrome. Conclusion: Very few studies have been done regarding the role of psychaesthenic syndrome in female sexual arousal till now. We are in the process of a major population-based study to delineate the epidemiological aspects, clinical features, management, and prevention aspects related to psychaesthenic syndrome. This review presents the available literature, issues of concern, and methods to manage NPWDPV.
Classic hairy cell leukemia complicated by pancytopenia and severe infection: a report of 3 cases treated with vemurafenib
Authors: Shenoi Daniel P. , Andritsos Leslie A. , Blachly James S. , Rogers Kerry A. , Moran Mollie E. , Anghelina Mirela , Jones Jeffrey A. , Grever Michael R. 
Published: January 2019

Key Points
Infections are a major cause of morbidity and mortality in HCL patients, and myelosuppressive therapies increase the risk of poor outcomes. Vemurafenib achieves rapid hematologic improvement in HCL and may facilitate management during life-threatening infection.