bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care Settings and Clinical Characteristics of Older Adults with Moderately Severe Dementia
Authors: Harrison Krista L. , Ritchie Christine S. , Patel Kanan , Hunt Lauren J. , Covinsky Kenneth E. , Yaffe Kristine , Smith Alexander K. 
Published: August 2019

OBJECTIVESLittle population‐level evidence exists to guide the development of interventions for people with dementia in non–nursing home settings. We hypothesized people living at home with moderately severe dementia would differ in social, functional, and medical characteristics from those in either residential care or nursing home settings.DESIGNRetrospective cohort study using pooled data from the National Health and Aging Trends Study, an annual survey of a nationally representative sample of Medicare beneficiaries.SETTINGUS national sample.PARTICIPANTSRespondents newly meeting criteria for incident moderately severe dementia, defined as probable dementia with functional impairment: 728 older adults met our definition between 2012 and 2016.MEASUREMENTS
Social characteristics examined included age, sex, race/ethnicity, country of origin, income, educational attainment, partnership status, and household size. Functional characteristics included help with daily activities, falls, mobility device use, and limitation to home or bed. Medical characteristics included comorbid conditions, self‐rated health, hospital stay, symptoms, and dementia behaviors.RESULTSExtrapolated to the population, an estimated 3.3 million older adults developed incident moderately severe dementia between 2012 and 2016. Within this cohort, 64% received care at home, 19% in residential care, and 17% in a nursing facility. social, functional, and medical characteristics differed across care settings. Older adults living at home were 2 to 5 times more likely to be members of disadvantaged populations and had more medical needs: 71% reported bothersome pain compared with 60% in residential care or 59% in nursing homes.CONCLUSIONOver a 5‐year period, 2.1 million people lived at home with incident moderately severe dementia. People living at home had a higher prevalence of demographic characteristics associated with systematic patterns of disadvantage, more social support, less functional impairment, worse health, and more symptoms compared with people living in residential care or nursing facilities. This novel study provides insight into setting‐specific differences among people with dementia. J Am Geriatr Soc 67:1907–1912, 2019
The Epidemiology of Patient‐Reported Hypersomnia in Persons With Advanced Age
Authors: Miner Brienne , Gill Thomas M. , Yaggi Henry Klar , Redeker Nancy S. , Van Ness Peter H. , Han Ling , Vaz Fragoso Carlos A. 
Published: August 2019

OBJECTIVETo examine the epidemiology and key demographic and clinical correlates of patient‐reported hypersomnia in persons with advanced age.DESIGNCross‐sectional design.SETTINGCommunity.PARTICIPANTSA total of 357 community‐dwelling persons from the Yale Precipitating Events Project with a mean age of 84.2 years (range = 78‐102 years).MEASUREMENTSWe studied patient‐reported hypersomnia, defined categorically by an Epworth Sleepiness Scale (ESS) score of 10 or greater; as well as the severity of hypersomnia symptoms, defined continuously by an ESS score range of 0 to 24 (higher scores denote greater sleepiness). In multivariable regression models, we examined cross‐sectional associations between key correlates and ESS score, expressed as categorical and continuous variables. Key correlates included: demographics, education, smoking status, body mass index, self‐reported medical conditions, Center for Epidemiologic Studies Depression score, Mini‐Mental State Examination score, Physical Activity Scale for the Elderly, restless legs syndrome (RLS), self‐reported sleep‐disordered breathing (SDB), medications, and Insomnia Severity Index.RESULTSMean ESS score for all participants was 6.4. Patient‐reported hypersomnia (ESS score ≥10) was established in 82 participants (23.0%)—their mean ESS score was 13.0. In multivariable models, male sex, nonwhite race, arthritis, depressive symptoms, low physical activity, RLS, SDB, central nervous system depressant medications, and insomnia severity were cross‐sectionally associated with patient‐reported hypersomnia (higher adjusted odds ratios, ranging from 1.93‐2.86) and/or with the severity of hypersomnia symptoms (higher ESS scores, ranging from 0.11‐2.86 points).CONCLUSIONPatient‐reported hypersomnia was prevalent in a sample of community‐dwelling persons with advanced age. In addition, based on cross‐sectional associations with the ESS score, key demographic and clinical characteristics were identified that may inform screening strategies for hypersomnia in advanced age. J Am Geriatr Soc 67:2545–2552, 2019
Effect of local diets on nutritional and sensory quality of meat of indigenous goats in Tunisian arid regions
Authors: Ayeb Naziha , Addis Margherita , Fiori Myriam , Atti Naziha , Barmat Ahmed , Hammadi Mohamed , Boukhris Hager , Damergi Chokri , Khorchani Touhami 
Published: August 2019

AbstractThe valorization of natural resources in small ruminants feeding can reduce the cost of feed and produce good meat quality. The objective was to evaluate the effects of local feed resources on the physico‐chemical aspects, the sensorial characteristics and the fatty acid profile of goat kid's meat. Twenty‐six kids are divided in three groups (average body weight = 15.85 kg; age = 4 months). The groups received oat hay (group control C), dried olive leaves + dried Stipa tenacissima (group OL) or grass hay (group Ko). The animals were slaughtered after 90 days of experience, with an approximate final live weight of 18.5 kg. Total solids, pH, fat, crude protein, vitamin, cholesterol and fatty acid contents of meat were determined. The OL group had the highest ultimate pH (6.82 vs. 6.73); cooking loss, gross composition (total solids, protein and fat), cholesterol and colour coordinates (L, a* and b*) were similar among groups. The vitamin E, affected by diet, was higher in group OL than the other groups (3.71 mg/kg vs. 1.32 and 2.17 mg/kg, respectively, for C and Ko groups). Moreover, meat from this group showed the highest saturated fatty acid. Unsaturated fatty acids content was higher in the meat of C and Ko groups. On the other side, polyunsaturated fatty acid level was not affected by the diet treatment. The n6/n3 ratio was significantly affected by the diet; it was lower in meat of groups Ko and OL (3.17 and 3.38 respectively). The feeding effect on sensory quality of meat was not significant.
Mycobacterium tuberculosis requires glyoxylate shunt and reverse methylcitrate cycle for lactate and pyruvate metabolism
Authors: Serafini Agnese , Tan Lendl , Horswell Stuart , Howell Steven , Greenwood Daniel J. , Hunt Deborah M. , Phan Minh‐Duy , Schembri Mark , Monteleone Mercedes , Montague Christine R. , Britton Warwick , Garza‐Garcia Acely , Snijders Ambrosius P. , VanderVen Brian , Gutierrez Maximiliano G. , West Nicholas P. , de Carvalho Luiz Pedro S. 
Published: August 2019

SummaryBacterial nutrition is an essential aspect of host–pathogen interaction. For the intracellular pathogen Mycobacterium tuberculosis (Mtb), the causative agent of tuberculosis in humans, fatty acids derived from lipid droplets are considered the major carbon source. However, many other soluble nutrients are available inside host cells and may be used as alternative carbon sources. Lactate and pyruvate are abundant in human cells and fluids, particularly during inflammation. In this work, we study Mtb metabolism of lactate and pyruvate combining classic microbial physiology with a ‘multi‐omics’ approach consisting of transposon‐directed insertion site sequencing (TraDIS), RNA‐seq transcriptomics, proteomics and stable isotopic labelling coupled with mass spectrometry‐based metabolomics. We discovered that Mtb is well adapted to use both lactate and pyruvate and that their metabolism requires gluconeogenesis, valine metabolism, the Krebs cycle, the GABA shunt, the glyoxylate shunt and the methylcitrate cycle. The last two pathways are traditionally associated with fatty acid metabolism and, unexpectedly, we found that in Mtb the methylcitrate cycle operates in reverse, to allow optimal metabolism of lactate and pyruvate. Our findings reveal a novel function for the methylcitrate cycle as a direct route for the biosynthesis of propionyl‐CoA, the essential precursor for the biosynthesis of the odd‐chain fatty acids.
Improvement of abnormal systolic motion of the interventricular septum with cardiac resynchronization therapy
Authors: Yaman Belma , Kemal Hatice S , Dönmez Yurdaer , Cerit Levent , Usalp Songül , Yüksek Ümit , Günsel Aziz , Duygu Hamza , Akpınar Onur 
Published: August 2019

AbstractBackgroundThere is no consensus in the literature regarding what is the responsible mechanism of left ventricular dyssynchrony; septal dyskinesia or late movement of left ventricle (LV) lateral wall. We aim to evaluate the abnormal systolic motion in each myocardial segment and the improvement of LV systolic function with pulsed tissue Doppler imaging (TDI) in patients undergoing cardiac resynchronization therapy (CRT) with left bundle branch block (LBBB).MethodsA total of 26 patients undergoing CRT implantation with LBBB, wide QRS duration (≥120 ms), and low ejection fraction (EF) (<35%) were included. Pulsed TDI was taken from apical 4‐chamber view and parasternal short axis view (PSAX). All echocardiographic parameters were measured when CRT is on and off.ResultsSystolic ejection time (ET) of anteroseptal and posterolateral wall of LV in PSAX was statistically significantly longer in CRT on group (321.6 ± 62.7 vs 237.5 ± 59.3 ms, P < .001; 323.9 ± 58.0 vs 289.4 ± 43.7 ms, P = .015, respectively). In apical 4‐chamber view, septal annulus systolic ET is significantly longer in CRT on group than CRT off group (315.8 ± 57.2 vs 287.3 ± 42.2, P = .014). Also, there was a strong correlation between systolic ET of the septum in PSAX with aortic velocity time integral (VTI), QRS duration and EF (r = .587, P = .002; r = .479, P = .013; r = .440, P = .025; respectively).ConclusionCircumferential contraction of septal myocardial fibers is improved with CRT and it is strongly correlated with increase of aortic VTI and shortening of QRS duration. These findings predict the deterioration of septal contraction as the main mechanism in patients with LBBB pattern and, CRT may improves myocardial contraction by correcting septal systolic motion.
Ventricular asystole in a CRT‐D device. What is the mechanism?
Authors: Reddy Pavan , Do Khuyen , Doshi Rahul , Shinbane Jerold , Konecny Tomas 
Published: August 2019

AbstractWe present a case of an 89‐year‐old man with a left ventricular assist device and cardiac resynchronization therapy device (CRT‐D) who presented with multiple presyncopal events. On the night of admission, telemetry revealed a 13‐s pause with appropriately timed pacing spikes but with failure to capture, followed by intermittent ventricular contraction with different QRS morphology. What was the mechanism for his ventricular asystole?
Gender and technology in Frantz Fanon: Confrontations of the clinical and political
Authors: Paris William Michael 
Published: August 2019

AbstractOne of the most pertinent sites of investigation in Fanon studies is the question of how Fanon theorizes the imbrication of gender with that of race and colonialism. For many, his silence or disavowals, whether explicit or implicit, allow an uncritical masculinism to slip into his theories of subjectivity, subjugation, and revolution. This article contributes to these discussions by arguing that for Fanon, gender and race are colonial technologies rather than natural sites of experience. Bringing together Fanon's recently translated clinical writings and his political essay on the revolutionary roles of Algerian women in the war against French colonization, it is possible to see how Fanon theorizes the French imposition of gender norms as attempts to engineer the social reproduction of a marginalized and racialized population. In short, gender is an implicitly racialized technology in French colonial society whose aim is the naturalization of political and sexual arrangements of power that justify the continuation of French occupation. Fanon works to demystify gender and race as technologies so that the colonized may seize them in the interest of their own liberatory invention.
Incorporating sprawl and adjacency measures in land‐use forecasting model: A case study of Collin County, TX
Authors: Sinha Parmanand , Griffith Daniel A. 
Published: August 2019

AbstractSprawl measures have largely been neglected in land‐use forecasting models. The current approach for land‐use allocation using optimization mostly utilizes objective functions and constraints that are non‐spatial in nature. Application of spatial constraints could take care of the contiguity and compactness of land uses and can be utilized to address urban sprawl. Because a land‐use model is used as an input to transportation modeling, a better spatial allocation strategy for more compact land‐use projections will promote better transportation planning and sustainable development. This study formulates a scenario‐based approach to normative modeling of urban sprawl. In doing so, it seeks to improve the land‐use projections by employing a spatial optimization model with contiguity and compactness consideration. This study incorporates urban sprawl measures based on smart growth principles together with a mixed‐use factor, and adjacency consideration of nearby land uses. The objective function used in the study maximizes net suitability based on imposed constraints. These constraints are based on smart growth principles that enhance walkability in neighborhoods, promote better health for residents, and encourage mixed‐use development. The formulated model has been applied to Collin County, TX, a fast‐developing suburban county located to the north of the Dallas–Fort Worth metroplex. The suitability of land cells indicates the probability of conversion, which is calculated using spatial discrete choice analysis with Moran eigenvector spatial filtering for vacant cells at a resolution of 150 × 150 m employing factors of the built environment, and socioeconomic and demographic characteristics. This study demonstrates how spatial proximity between land uses, which has been ignored to date, can be used to control sprawl, resulting in better mixing of different land uses based on constraints imposed in a spatial optimization problem.
A targeted fungal prophylaxis protocol with static dosed fluconazole significantly reduces invasive fungal infection after liver transplantation
Authors: Jorgenson Margaret R. , Descourouez Jillian L. , Marka Nicholas A. , Leverson Glen E. , Smith Jeannina A. , Andes David R. , Fernandez Luis A. , Foley David P. 
Published: August 2019

AbstractBackgroundInvasive fungal infection (IFI) after liver transplant (LTx) is associated with extensive morbidity and mortality. Targeted prophylaxis reduces risk, but qualifying criteria, drug of choice and regimen are unclear and compliance is inconsistent.ObjectiveAssess the impact of a risk factor‐based fungal prophylaxis protocol (FPP) after LTx on fungal infection rates, fungal epidemiology, and transplant outcomes.MethodsObservational cohort study of adult LTx recipients between July 1, 2009, and June 30, 2017. Patients in the FPP group were given a set dose of 400 mg fluconazole without renal adjustment on POD 1‐14 via pharmacist delegation protocol.ResultsOne hundred and eighty‐nine patients met inclusion criteria; 50 in the FPP and 139 in the pre‐implementation comparator group. Of those who would be considered high‐risk, 22.3% received antifungal prophylaxis prior to FPP implementation vs 92% after implementation (P < .0001). There were significantly fewer fungal infections in the FPP group at 1 year (12.5% vs 26.6%, P = .03). IFI in the pre‐implementation control group was due to Candida species in 95% of cases; 30% were species with reduced fluconazole susceptibility. IFI in the FPP group was due to Candida species in all cases, and no isolates had reduced fluconazole susceptibility. Aspergillus did not account for any IFI between the groups. One‐year patient and graft survival were similar between groups. In a multivariable model accounting for patient and donor age, donor type, MELD, and cold ischemic time, FPP was protective against fungal infection (HR 0.3, P = .015). FPP did not significantly impact graft survival (HR 0.4, P = .14), but trended toward improved patient survival. (HR 0.18, P = .06).ConclusionImplementation of a targeted FPP utilizing static dosing of fluconazole 400 mg × 14 days to those that meet high‐risk criteria significantly reduces invasive fungal infection after liver transplant. Use of this protocol did not adversely affect fungal epidemiology and may have a positive impact on allograft and patient survival. Future large prospective studies are needed to better evaluate survival impact.
Prevalence and health effects of communicable and non‐communicable disease comorbidity in rural KwaZulu‐Natal, South Africa
Authors: Sharman Monica , Bachmann Max 
Published: August 2019

AbstractObjectivesTo describe changes in prevalence of hypertension, diabetes, HIV and tuberculosis, and prevalence of comorbidity, and to investigate associations between each condition, and combinations of conditions, with self‐reported general health and hospital admission.MethodsThis study used data from a longitudinal population‐based HIV and health surveillance cohort, conducted by the Africa Health Research Institute in Umkhanyakude district of rural KwaZulu‐Natal, South Africa.ResultsPrevalence of hypertension, HIV and diabetes increased from 2009 to 2015, and prevalence of tuberculosis decreased. 81% of the 47 334 participants were female; hypertension and diabetes were the commonest conditions in people over age 50, whereas HIV was most common in those younger than 50 years. Comorbidity of communicable and non‐communicable conditions was commonest in 40‐ to 60‐year‐olds. The adjusted odd ratios (OR) for better self‐reported general health with multimorbidity were 0.53 (95% CI 0.51–0.56), 0.29 (95% CI 0.27–0.29), 0.25 (95% CI 0.21–0.37) and 0.21 (95% CI 0.12–0.37) for one, two, three and four conditions, respectively, vs. no conditions. Tuberculosis was most strongly and inversely associated with better general health (OR 0.34 (0.31–0.37) and most strongly associated with hospital admission (OR 3.26 (2.32–2.99)).ConclusionThe high prevalence of communicable and non‐communicable conditions in this rural South African population is giving rise to a burden of multimorbidity, as increased access to antiretroviral treatment has reduced mortality in people with HIV. Healthcare systems must adapt by working towards integrated primary care for HIV/AIDS and non‐communicable diseases.
Laparoscopic Cholecystectomy with Single Port Access System in 15 Dogs
Authors: Simon Allen , Monnet Eric 
Published: August 2019

AbstractObjectiveTo evaluate the outcome of laparoscopic cholecystectomy performed with a single port access system (SPAS) in dogs.Study DesignRetrospective study.AnimalsFifteen client‐owned dogs with nonobstructive gallbladder disease.MethodsMedical records were reviewed for signalment, clinical signs, diagnostic imaging, surgical findings, and outcome until suture removal.ResultsThe SPAS was placed 1 cm caudal to the umbilicus. The procedure was completed with the SPAS alone in two cases. An additional cannula was added in 12 cases. In the last 10 cases, the additional cannula was placed at the beginning of the procedure. Dissection began at the cystic duct in 11 dogs (73%). In three cases (20%), the SPAS procedure was converted to a laparotomy; two of these conversions were elective, and one was emergent. The risk of conversion was affected by the experience of the surgeon (odds ratio = 0.53; P = .0105), and the rate of conversion was reduced when a cannula was added at the beginning of the procedure (P = .022). Fourteen dogs were discharged from the hospital. One dog died after being discharged due to severe cholangiohepatitis, and another dog died due to leakage of a gastrostomy tube.ConclusionsThe use of SPAS for cholecystectomy in dogs has an acceptable outcome. The experience gained by the surgeon and the addition of a cannula reduced the risk of conversion.Clinical Relevance/ImpactLaparoscopic cholecystectomy can be performed with a SPAS. The placement of an additional cannula at the beginning of the procedure is highly recommended.
Thrombosis after umbilical venous catheterisation: prospective study with serial ultrasound
Authors: Dubbink-Verheij Gerdina H , Visser Remco , Roest Arno A , van Ommen Cornelia Heleen , te Pas Arjan B , Lopriore Enrico 
Published: August 2019

BackgroundUmbilical venous catheters (UVCs) are associated with thrombus formation. Most studies on thrombosis in infants with UVCs focus on only one part of the route, and none assessed a control group of infants without UVCs.ObjectiveTo determine the incidence and location of thrombi in infants after umbilical catheterisation and compare this with a control group of infants without umbilical catheters.DesignProspective observational study with serial ultrasonography of the UVC route from the umbilico-portal confluence to the heart. Ultrasonography was performed until day 14 after catheterisation in cases and day 14 after birth in controls.ResultsThrombi in the UVC route were detected in 75% (30/40) of infants with UVCs in the study group, whereas no thrombi were detected in the control group of infants without UVCs (0/20) (p<0.001). Six thrombi (20%) were located in the right atrium. Most of these were also partly present in the ductus venosus. Six thrombi (20%) were located in the ductus venosus only, and in 12 infants (40%), the thrombus was at least partly located in the umbilico-portal confluence. Thrombi persisted after UVC removal in 25/30 cases. Two infants with thrombotic events were treated with low-molecular-weight heparin and resolution was found. In the other 23 infants managed expectantly, 2 died due to necrotising enterocolitis, 1 was lost to follow-up and in 20 spontaneous regression was seen.ConclusionsThrombotic events occur frequently in infants after umbilical catheterisation. Most thrombi were asymptomatic and regressed spontaneously with expectant management. Routine screening for thrombi in UVCs is therefore not advised.