bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and distribution of hypertension and related risk factors in Jilin Province, China 2015: a cross-sectional study
Authors: Wu Junduo , Li Tianyi , Song Xianjing , Sun Wei , Zhang Yangyu , Liu Yingyu , Li Longbo , Yu Yunpeng , Liu Yihang , Qi Chao , Liu Bin 
Published: March 2018

ObjectiveThis study aimed to investigate the prevalence and distribution of hypertension and its related factors in Jilin province, China.DesignA cross-sectional study in four cities and four rural counties in Jilin as part of a national Chinese study.Participants and settingA total of 15 206 participants who were ≥15 years old and were selected using a stratified multistage random sampling method.Main outcome measuresThe prevalence of hypertension.ResultsThe prevalence of hypertension in Jilin province was 24.7%. Moreover, the prevalence of hypertension increased with age in both sexes, and was higher in men than in women. The modifiable factors that were associated with hypertension were body mass index, smoking and alcohol drinking. The risk factors identified are similar to those in southern China, except smoking, which has no association with hypertension prevalence in the South.ConclusionsAge, sex, body mass index, smoking and alcohol drinking were risk factors of hypertension. Control of these related risk factors, especially smoking, may be helpful in the treatment and management of hypertension in Jilin province.
Prevalence of stroke, risk factors, disability and care needs in older adults in Singapore: results from the WiSE study
Authors: Teh Wen Lin , Abdin Edimansyah , Vaingankar Janhavi Ajit , Seow Esmond , Sagayadevan Vathsala , Shafie Saleha , Shahwan Shazana , Zhang Yunjue , Chong Siow Ann , Ng Li Ling , Subramaniam Mythily 
Published: March 2018

ObjectivesThe aims of the present study were to establish the prevalence of stroke, and to explore the association between stroke prevalence and sociodemographic and health factors, disability, cognitive functioning and care needs among older adult residents in Singapore.SettingData were drawn from the Well-being of the Singapore Elderly study—a cross-sectional epidemiological survey conducted from 2012 to 2013 on older adults living in Singapore.ParticipantsParticipants were Singapore residents (citizens and permanent residents) 60 years and above who were living in Singapore during the survey period . Older adult residents who were institutionalised were also included in this study. Those who were not living in Singapore or who were not contactable were excluded from the study. The response rate was 65.6 % (2565/3913). A total population sample of 2562 participants completed the survey. Participants comprised 43.6% males and 56.4% females. The sample comprised 39.4% Chinese, 29.1% Malay, 30.1% Indian and 1.4% other ethnicities .Primary and secondary outcome measuresHistory of stroke, along with other health and mental health conditions, disability and cognitive functioning, were determined by self-report.ResultsWeighted stroke prevalence was 7.6% among older adults aged 60 and above. At a multivariate level, Malay ethnicity (OR 0.41, p=0.012, 95% CI 0.20 to 0.82), hypertension (OR 4.58, p=0.001, 95% CI 1.84 to 11.40), heart trouble (OR 2.45, p=0.006, 95% CI 1.30 to 4.63), diabetes (OR 2.60, p=0.001, 95% CI 1.49 to 4.53) and dementia (OR 3.57, p=0.002, 95% CI 1.57 to 8.12) were associated with stroke prevalence.ConclusionsSeveral findings of this study were consistent with previous reports. Given that Singapore’s population is ageing rapidly, our findings may indicate the need to review existing support services for stroke survivors and their caregivers. Future research could investigate the association between various sociodemographic and health conditions and stroke prevalence to confirm some of the findings of this study.
Simulation in shoulder dystocia: does it change outcomes?
Authors: Kim Tana , Vogel Rachel I , Das Kamalini 
Published: March 2018

BackgroundShoulder dystocia is an obstetrical emergency that requires immediate and appropriate provider response to decrease neonatal morbidity.ObjectiveTo determine whether institution of shoulder dystocia simulation training improves maternal and neonatal outcomes at delivery.Study designThis retrospective cohort study compared maternal and neonatal outcomes before (1 September 2008–31 December 2009) and after (1 January 2010–31 December 2014) a mandatory shoulder dystocia simulation curriculum was instituted. Χ2 and Fisher’s exact tests along with multivariate logistic regression models were conducted to adjust for potential confounding.ResultsOf 8930 vaginal deliveries that met eligibility criteria over the 6-year period, 299 (3.3%) deliveries were complicated by a shoulder dystocia. The adjusted frequency of shoulder dystocia was approximately two times higher after training implementation (1.9% vs 3.8%; adjusted OR=1.80 (1.23 to 2.65), p=0.003). Neonatal outcomes such as brachial plexus injury (5.0% vs 7.7%; p=0.75), clavicle fracture (5.0% vs 4.6%; p=1.00) and humerus fracture (0.0% vs 1.9%; p=1.00) were not statistically different after training. Additionally, no significant differences in episiotomy (5.0% vs 4.6%; p=1.00), postpartum haemorrhage (10.0% vs 12.4%; p=0.80) and severe perineal laceration (10.0% vs 6.6%; p=0.50) were observed.ConclusionsThe overall frequency of shoulder dystocia reportedly doubled after training despite stable operative vaginal delivery and caesarean delivery rates. No significant improvements were seen in maternal or neonatal outcomes after simulation training. As shoulder dystocias are rare events, simulation training may not necessarily improve neonatal outcomes, but it may increase overall provider awareness and intervention.
Diagnostic concordance of reporting lymphovascular invasion in breast cancer
Authors: Rakha Emad A , Abbas Areeg , Pinto Ahumada Pablo , ElSayed Maysa E , Colman Derek , Pinder Sarah E , Ellis Ian O 
Published: March 2018

AimsThis study aims to assess the diagnostic agreement of lymphovascular invasion (LVI) in invasive breast cancer (BC).MethodsData on LVI were collected from the UK National Health Service Breast Screening Programme pathology external quality assurance scheme database. 101 BCs assessed over a 10-year period (2004–2014) were included. Cases were scored by an average of 600 pathologists. Three H&E stained slides from each case were reviewed by three pathologists and additional variables were evaluated.ResultsIn the whole series, the overall κ value was 0.4 (range 0.26–0.53). On review, LVI was detected in all three slides in 20 cases (20%), in two slides in 12 cases and in one of the three slides in 9 cases and was not seen in 60 cases. For concordance analysis, the first and last groups were used to represent cases with definite (LVI+) and absent LVI (LVI–), respectively. In the LVI+group (n=20), the level of agreement ranged from 0.54 to 0.99 (median 0.86). In the LVI– group (n=60), the level of agreement ranged from 0.52 to 1.00 (median 0.93), with 44% of cases showing interobserver concordance of >95%. There was a correlation between increasing number of involved lymphovascular spaces in the section and higher LVI reporting concordance. Some degree of retraction/fixation artefacts was observed in 35% of cases; this was associated with a lower concordance rate.ConclusionsThe concordance of reporting LVI is variable. Cases without LVI and those with multiple involved vessels are likely to have the highest concordance and the highest detection rates.
Effect of exercise therapy combined with branched-chain amino acid supplementation on muscle strengthening in persons with osteoarthritis
Authors: Ikeda Takashi , Jinno Tetsuya , Masuda Tadashi , Aizawa Junya , Ninomiya Kazunari , Suzuki Koji , Hirakawa Kazuo 
Published: March 2018

Background: Improving lower limb muscle strength is important in preventing progression of osteoarthritis (OA) and its symptoms. Exercise with branched-chain amino acid (BCAA) supplementation has been reported to affect protein anabolism in young and elderly persons. However, few studies provided daily BCAAs for patients with OA. Objective: This study examined the effects of combined BCAAs and exercise therapy on physical function improvement in women with hip OA scheduled for total hip arthroplasty. Methods: The subjects were 43 women with OA (age: 64.2[Formula: see text][Formula: see text][Formula: see text]9.4). The participants were randomly divided into two groups: BCAA ([Formula: see text]) and control ([Formula: see text]). The combined therapy was carried out for one month. Exercise intervention involved hip abductor muscle exercise in both groups. For the nutritional intervention, 6[Formula: see text]g of BCAAs or 1.2[Formula: see text]g of starch were consumed within 10[Formula: see text]min before starting the exercise. Results: There was a marginally significant difference in the main effect between the groups in 10-m timed gait time. The improvement rate in hip abductor muscle strength of the contralateral side was significantly greater in the BCAA group. Conclusion: By combining BCAA intake and exercise therapy, a significant improvement in hip abductor muscle strength of the contralateral side was achieved in women with OA.
Continuous negative abdominal pressure: mechanism of action and comparison with prone position
Authors: Yoshida Takeshi , Engelberts Doreen , Otulakowski Gail , Katira Bhushan , Ferguson Niall D. , Brochard Laurent , Amato Marcelo B. P. , Kavanagh Brian P. 
Published: March 2018

We recently reported that continuous negative abdominal pressure (CNAP) could recruit dorsal atelectasis in experimental lung injury and that oxygenation improved at different transpulmonary pressure values compared with increases in airway pressure (Yoshida T, Engelberts D, Otulakowski G, Katira BH, Post M, Ferguson ND, Brochard L, Amato MBP, Kavanagh BP. Am J Respir Crit Care Med 197: 534–537, 2018). The mechanism of recruitment with CNAP is uncertain, and its impact compared with a commonly proposed alternative approach to recruitment, prone positioning, is not known. We hypothesized that CNAP recruits lung by decreasing the vertical pleural pressure (Ppl) gradient (i.e., difference between dependent and nondependent Ppl), thought to be one mechanism of action of prone positioning. An established porcine model of lung injury (surfactant depletion followed by ventilator-induced lung injury) was used. CNAP was applied using a plexiglass chamber that completely enclosed the abdomen at a constant negative pressure (−5 cmH2O). Lungs were recruited to maximal positive end-expiratory pressure (PEEP; 25 cmH2O) and deflated in steps of PEEP (2 cmH2O, 10 min each). CNAP lowered the Ppl in dependent but not in nondependent lung, and therefore, in contrast to PEEP, it narrowed the vertical Ppl gradient. CNAP increased respiratory system compliance and oxygenation and appeared to selectively displace the posterior diaphragm caudad (computerized tomography images). Compared with prone position without CNAP, CNAP in the supine position was associated with higher arterial partial pressure of oxygen and compliance, as well as greater homogeneity of ventilation. The mechanism of action of CNAP appears to be via selective narrowing of the vertical gradient of Ppl. CNAP appears to offer physiological advantages over prone positioning. NEW & NOTEWORTHY Continuous negative abdominal pressure reduces the vertical gradient in (dependent vs. nondependent) pleural pressure and increases oxygenation and lung compliance; it is more effective than prone positioning at comparable levels of positive end-expiratory pressure.
Follicular B Cells Promote Atherosclerosis via T Cell–Mediated Differentiation Into Plasma Cells and Secreting Pathogenic Immunoglobulin G
Authors: Tay Christopher , Liu Yu-Han , Kanellakis Peter , Kallies Axel , Li Yi , Cao Anh , Hosseini Hamid , Tipping Peter , Toh Ban-Hock , Bobik Alex , Kyaw Tin 
Published: March 2018

Objective—
B cells promote or protect development of atherosclerosis. In this study, we examined the role of MHCII (major histocompatibility II), CD40 (cluster of differentiation 40), and Blimp-1 (B-lymphocyte–induced maturation protein) expression by follicular B (FO B) cells in development of atherosclerosis together with the effects of IgG purified from atherosclerotic mice.

Approach and Results—

Using mixed chimeric
Ldlr
−/−
mice whose B cells are deficient in MHCII or CD40, we demonstrate that these molecules are critical for the proatherogenic actions of FO B cells. During development of atherosclerosis, these deficiencies affected T–B cell interactions, germinal center B cells, plasma cells, and IgG. As FO B cells differentiating into plasma cells require Blimp-1, we also assessed its role in the development of atherosclerosis. Blimp-1-deficient B cells greatly attenuated atherosclerosis and immunoglobulin—including IgG production, preventing IgG accumulation in atherosclerotic lesions; Blimp-1 deletion also attenuated lesion proinflammatory cytokines, apoptotic cell numbers, and necrotic core. To determine the importance of IgG for atherosclerosis, we purified IgG from atherosclerotic mice. Their transfer but not IgG from nonatherosclerotic mice into
Ldlr
−/−
mice whose B cells are Blimp-1-deficient increased atherosclerosis; transfer was associated with IgG accumulating in atherosclerotic lesions, increased lesion inflammatory cytokines, apoptotic cell numbers, and necrotic core size.

Conclusions—
The mechanism by which FO B cells promote atherosclerosis is highly dependent on their expression of MHCII, CD40, and Blimp-1. FO B cell differentiation into IgG-producing plasma cells also is critical for their proatherogenic actions. Targeting B–T cell interactions and pathogenic IgG may provide novel therapeutic strategies to prevent atherosclerosis and its adverse cardiovascular complications.
Women at Work: Governance and Financial Administration at the Court Beguinages of the Southern Low Countries in the Seventeenth and Eighteenth Centuries
Authors: Moran Sarah Joan 
Published: March 2018

Abstract
From the thirteenth century through the nineteenth, the Court Beguinages, large semi-monastic communities for women called Beguines, were integral to urban life in the Catholic Low Countries. In the wake of the Dutch Revolt and reestablishment of Spanish rule in the Southern provinces from the mid-1580s, the Beguinages became increasingly aligned with the ideology of female monasticism, and particularly with the tradition of Mary and Martha: the mix of contemplative prayer and humble work that had traditionally been at the heart of tertiary convents and other active female congregations. While many Beguines did indeed make their livings from manual labor, the Beguinages also offered women of ambition unparalleled opportunities to take on leadership roles of great responsibility and authority. This essay examines the labor of Beguinage administration in the early modern period and situates the careers of Beguine leaders in their social and gendered contexts.
Return to Play After Hip Arthroscopy: A Systematic Review and Meta-analysis
Authors: O’Connor Michaela , Minkara Anas A. , Westermann Robert W. , Rosneck James , Lynch T. Sean 
Published: March 2018

Background: The use of arthroscopic treatment for intra-articular hip pathology has demonstrated improved patient-reported outcomes (PROs) with a lower rate of complications, reoperation, and patient morbidity as compared with traditional methods. Although the use of this minimally invasive approach has increased in prevalence, no evidence-based return-to-play (RTP) criteria have been developed to ensure an athlete’s preparedness for sporting activities. Purpose: To determine if there exists sufficient evidence in the literature to support an RTP protocol and functional assessment after hip arthroscopy, as well as to assess the mean rate and duration of RTP. Study Design: Systematic review and meta-analysis. Methods: The search terms “hip arthroscopy,” “return to play,” and 10 related terms were searched in PubMed, Cochrane Library, Scopus, and Web of Science, yielding 263 articles. After screening, 22 articles were included. RTP timeline, rehabilitation protocols, and conditional criteria measures were assessed with previously established criteria. Pooled estimates were calculated for RTP rate and duration, and weighted mean scores were determined for PROs. Results: A total of 1296 patients with 1442 total hips were identified. Although 54.5% (12 of 22) of studies did not provide a guideline for RTP duration after hip arthroscopy, 36.4% (8 of 22) recommended a duration of 4 months, while 9.1% (2 of 22) recommended 3 months. The most frequently described postoperative rehabilitation protocols were weightbearing guidelines (15 studies) and passive motion exercises (9 studies). Only 2 studies satisfied the criteria for a sufficient RTP protocol, and 3 provided a specific replicable test for RTP. The mean RTP duration was 7.4 months (95% CI, 6.1-8.8 months), and the return rate was 84.6% (95% CI, 80.4%-88.8%; P = .008) at a mean ± SD follow-up of 25.8 ± 2.4 months. Mean modified Harris Hip Score (mHHS) improved from 63.1 to 84.1 postoperatively (+33.3%), while Non-arthritic Hip Score improved from 61.7 to 86.8 (+40.7%). A lower preoperative mHHS was significantly associated with a higher postoperative improvement ( r = −0.95, P = .0003). Conclusion: Significant variability exists in RTP protocols among institutions owing to a lack of standardization. Despite a high overall rate of RTP and improvement in PROs after hip arthroscopy, the majority of rehabilitation protocols are not evidence based and rely on expert opinion. No validated functional test currently exists to assess RTP.
Thirty-Day and 5-Year Readmissions following First Psychiatric Hospitalization: A System-Level Study of Ontario’s Psychiatric Care
Authors: Chen Sheng , Collins April , Kidd Sean A. 
Published: March 2018

Objective: Analyses of representative, system-level data to examine trends in short- and longer-term readmission rates for psychiatric illnesses are largely absent. The objective of this article is to examine key trends and variables with implications for inpatient care as indicated by 30-day readmission and outpatient care as reflected by readmission within 5 years. Methods: Using OMHRS data from 2005 to 2015, patients who had their first inpatient admission were followed for 5 years to examine their subsequent 30-day and overall admission rates stratified by discharge time and diagnosis. Results: The study cohort consisted of 42,280 patients. The 30-day and 5-year readmission rates for the entire cohort were 7.2% and 35.1%, respectively. Using a time course analysis of readmission for discharges in different years, both 30-day readmission and 5-year readmission rates decreased in a linear manner from 2005 to 2010, primarily because of readmission patterns for patients diagnosed with mood disorders and schizophrenia/other psychotic disorders. It was also evident that both demographic considerations such as age and gender and variables reflective of social determinants such as education level and employment were predictive of rehospitalization risk. Conclusions: The trends of decreasing readmission rates may be reflective of improvements in the quality of hospital and community-based outpatient care. Such system-level indicators warrant tracking and may inform more effective tertiary prevention.
Association Between Intimate Partner Violence and Breastfeeding Duration: Results From the 2004-2014 Pregnancy Risk Assessment Monitoring System
Authors: Wallenborn Jordyn T. , Cha Susan , Masho Saba W. 
Published: March 2018

Background: Intimate partner violence is a major public health problem that disproportionately affects women. Current literature investigating the relationship between intimate partner violence and breastfeeding is inconsistent. Research aim: This study aims to investigate the relationship between physical intimate partner violence that occurs in the preconception or prenatal period and any breastfeeding duration. Methods: Data from the retrospective, cross-sectional 2004-2014 Pregnancy Risk Assessment Monitoring System were analyzed ( N = 195,264). The outcome, breastfeeding duration, was categorized as never breastfed, breastfed 8 weeks or less, and breastfeed more than 8 weeks. Multinomial logistic regression was used to obtain crude and adjusted odds ratios and 95% confidence intervals. Results: Approximately 6% ( n = 11,766) of survey respondents reported preconception and/or prenatal intimate partner violence, and 36.3% ( n = 67,667) of women reported never breastfeeding. The odds of discontinuing breastfeeding before 8 weeks were 18% higher among women who reported experiencing abuse 12 months before pregnancy compared with women who did not report intimate partner violence (adjusted odds ratio = 1.18; 95% confidence interval [1.01, 1.37]). All other estimates showed an overlapping 95% confidence interval. Conclusion: Breastfeeding is essential in improving maternal and child health; however, women in abusive relationships may face additional barriers to breastfeeding. Further research is needed to better understand the impact of violence on breastfeeding behaviors to inform healthcare practices and interventions.
Pharmacists’ Impact on Secondary Stroke Prevention
Authors: Andres Jennifer , Stanton-Ameisen Olivia , Walton Sara , Ruchalski Charles 
Published: March 2018

Background: Patients admitted to our institution with a cerebrovascular accident (stroke) or transient ischemic attack (TIA) are referred to the pharmacist-run stroke prevention clinic (SPC) for medication and risk factor management. Objective: The objective was to determine if patients receiving care from the SPC have better outcomes than patients who received usual care. Methods: This was a retrospective chart review of patients referred to the SPC. At the time of stroke/TIA, before initial visit, and after last SPC visit, risk factor data was collected. Hospital readmissions were reviewed for secondary stroke/TIA, myocardial infarction (MI), and new or incidental peripheral artery disease (PAD). For patients that did not attend SPC visits, data was used as a control. Results: Patients referred to the SPC from October 2012 to December 2014 were reviewed. 455 records were reviewed. The primary composite end point of readmission for stroke/TIA, myocardial infarction, and new or incidental PAD was statistically significantly lower in the SPC group than the control group ( P = .013). All surrogate markers, including blood pressure, Low Density Lipoprotein, Hemoglobin A1c, and smoking status, improved in the SPC group. Conclusion: Pharmacists can play a role in reducing risk factors for secondary stroke/TIA and prevent future hospital admissions.
Hope Tree: An Interactive Art Installation to Facilitate the Expression of Hope in a Hospice Setting
Authors: Collins Andrew , Bhathal Darpanjot , Field Tara , Larlee Randene , Paje Rachael , Young Daneen 
Published: March 2018

Background:Individuals confronting a terminal illness can experience intense psychological distress. Previous research has shown that hope can enhance one’s ability to acknowledge, accept, and fight a terminal illness. Patients can continue to have hope or be hopeful, even in the face of a terminal illness. Can participation in a creative writing practice improve the expression of hope in a hospice setting?Methods:In this program evaluation, each expressed hope placed on the “Hope Tree” was independently coded by all research team members utilizing inductive content analysis. Overall themes were derived using a constant comparative approach and arranged into overarching themes based on consensus.Results:Eight major themes emerged from the data: “Peace,” “Dreams,” “Total well-being,” “Acknowledgment of loss,” “Relationships,” “Hospice care,” “Spirituality,” and “Dichotomies.”Conclusion:The Hope Tree is a creative art project that can be used within a hospice environment to promote hope among family members and the health-care professionals who care for patients.