bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lipoprotein(a) plasma levels, bone mineral density and risk of hip fracture: a post hoc analysis of the Women’s Health Initiative, USA
Authors: Haring Bernhard , Crandall Carolyn J , Carbone Laura , Liu Simin , Li Wenjun , Johnson Karen C , Wactawski-Wende Jean , Shadyab Aladdin H , Gass Margery L , Kamensky Victor , Cauley Jane A , Wassertheil-Smoller Sylvia 
Published: April 2019

ObjectivesElevated Lipoprotein(a) (Lp[a]) is a well-known risk factor for cardiovascular disease. However, its roles in bone metabolism and fracture risk are unclear. We therefore investigated whether plasma Lp(a) levels were associated with bone mineral density (BMD) and incident hip fractures in a large cohort of postmenopausal women.DesignPost hoc analysis of data from the Women’s Health Initiative (WHI), USA.Setting40 clinical centres in the USA.ParticipantsThe current analytical cohort consisted of 9698 white, postmenopausal women enrolled in the WHI, a national prospective study investigating determinants of chronic diseases including heart disease, breast and colorectal cancers and osteoporotic fractures among postmenopausal women. Recruitment for WHI took place from 1 October 1993 to 31 December 1998.ExposuresPlasma Lp(a) levels were measured at baseline.Outcome measuresIncident hip fractures were ascertained annually and confirmed by medical records with follow-up through 29 August 2014. BMD at the femoral neck was measured by dual X-ray absorptiometry in a subset of participants at baseline.Statistical analysesCox proportional hazards and logistic regression models were used to evaluate associations of quartiles of plasma Lp(a) levels with hip fracture events and hip BMD T-score, respectively.ResultsDuring a mean follow-up of 13.8 years, 454 incident cases of hip fracture were observed. In analyses adjusting for confounding variables including age, body mass index, history of hysterectomy, smoking, physical activity, diabetes mellitus, general health status, cardiovascular disease, use of menopausal hormone therapy, use of bisphosphonates, calcitonin or selective-oestrogen receptor modulators, baseline dietary and supplemental calcium and vitamin D intake and history of fracture, no significant association of plasma Lp(a) levels with low hip BMD T-score or hip fracture risk was detected.ConclusionsThese findings suggest that plasma Lp(a) levels are not related to hip BMD T-score or hip fracture events in postmenopausal women.Trial registration numberNCT00000611; Post-results.
The character variety of some classes of rational knots
Authors: Cavicchioli Alberto , Spaggiari Fulvia 
Published: April 2019

We propose a method to determine the character variety of a class [Formula: see text] of rational knots, which includes the twist knots. The defining polynomials depend only on the variables [Formula: see text] and [Formula: see text]. This answers for these classes of knots a question posed in [H. M. Hilden, M. T. Lozano and J. M. Montesinos–Amilibia, On the character variety of group representations of a 2-bridge link [Formula: see text] into [Formula: see text], Bol. Soc. Mat. Mexicana 37(2) (1992) 241–262], and allows us to give an easy geometrical description of the considered character variety. Our results are obtained by using special presentations of the knot groups whose relators are palindromes.
PCSK9 Inhibitor Use in the Real World: Data From the National Patient‐Centered Research Network
Authors: Chamberlain Alanna M. , Gong Yan , Shaw Kathryn McAuliffe , Bian Jiang , Song Wen‐Liang , Linton MacRae F. , Fonseca Vivian , Price‐Haywood Eboni , Guhl Emily , King Jordan B. , Shah Rashmee U. , Puro Jon , Shenkman Elizabeth , Pawloski Pamala A. , Margolis Karen L. , Hernandez Adrian F. , Cooper‐DeHoff Rhonda M. 
Published: April 2019

Background
PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors effectively lower LDL (low‐density lipoprotein) cholesterol and have been shown to reduce cardiovascular outcomes in high‐risk patients. We used real‐world electronic health record data to characterize use of PCSK9 inhibitors, in addition to standard therapies, according to cardiovascular risk status.

Methods and Results
Data were obtained from 18 health systems with data marts within the National Patient‐Centered Clinical Research Network (PCORnet) using a common data model. Participating sites identified >17.5 million adults, of whom 3.6 million met study criteria. Patients were categorized into 3 groups: (1) dyslipidemia, (2) untreated LDL ≥130 mg/dL, and (3) coronary artery disease or coronary heart disease. Demographics, comorbidities, estimated 10‐year atherosclerotic cardiovascular disease risk, and lipid‐lowering pharmacotherapies were summarized for each group. Participants’ average age was 62 years, 50% were female, and 11% were black. LDL cholesterol ranged from 85 to 151 mg/dL. Among patients in groups 1 and 3, 54% received standard lipid‐lowering therapies and a PCSK9 inhibitor was prescribed in <1%. PCSK9 inhibitor prescribing was greatest for patients with coronary artery disease or coronary heart disease and, although prescribing increased during the study period, overall PCSK9 inhibitor prescribing was low.

Conclusions
We successfully used electronic health record data from 18 PCORnet data marts to identify >3.6 million patients meeting criteria for 3 patient groups. Approximately half of patients had been prescribed lipid‐lowering medication, but <1% were prescribed PCSK9 inhibitors. PCSK9 inhibitor prescribing increased over time for patients with coronary artery disease or coronary heart disease but not for those with dyslipidemia.
Biomarker of Collagen Turnover (C‐Terminal Telopeptide) and Prognosis in Patients With Non‐ST‐Elevation Acute Coronary Syndromes
Authors: Zelniker Thomas A. , Jarolim Petr , Scirica Benjamin M. , Braunwald Eugene , Park Jeong‐Gun , Das Saumya , Sabatine Marc S. , Morrow David A. 
Published: April 2019

Background

Small studies have suggested an association between markers of collagen turnover and adverse outcomes in heart failure (
HF
). We examined C‐terminal telopeptide (beta‐
CT
x) and the risk of cardiovascular death or new or worsening
HF
in non–
ST
‐elevation acute coronary syndrome.

Methods and Results

We measured baseline serum beta‐
CT
x,
NT
‐pro
BNP
(N‐terminal pro‐B‐type natriuretic peptide), hsTnT (high‐sensitivity cardiac troponin T) and hs
CRP
(high‐sensitivity C‐reactive protein) (Roche Diagnostics) in a nested biomarker analysis (n=4094) from a study of patients with non–
ST
‐elevation acute coronary syndrome. The relationship between quartiles of beta‐
CT
x and cardiovascular death or
HF
over a median follow‐up time of 12 months was analyzed using adjusted Cox models. Higher beta‐
CT
x levels identified a significantly higher risk of cardiovascular death/
HF
(Q4 10.9% versus Q1 3.8%, Logrank
P
<0.001). After multivariable adjustment, beta‐
CT
x in the top quartile (Q4) was associated with cardiovascular death/
HF
(Q4 versus Q1: adjusted hazard ratio 2.22 [1.50–3.27]) and its components (Q4 versus Q1: cardiovascular death: adjusted hazard ratio 2.48 [1.46–4.21];
HF
: adjusted hazard ratio 2.04 [1.26–3.30]). In an adjusted multimarker model including
NT
‐pro
BNP
, hsTnT, and hs
CRP
, beta‐
CT
x remained independently associated with cardiovascular death/
HF
(Q4 versus Q1: adjusted hazard ratio 1.98 [1.34–2.93]) and its components. Beta‐
CT
x correlated weakly with
NT
‐pro
BNP
(
r
=0.17,
P
<0.001) and left ventricular ejection fraction (
r
=−0.05,
P
=0.008) and did not correlate with hsTnT (
r
=0.02,
P
=0.20), or hs
CRP
(
r
=−0.03,
P
=0.09).

Conclusions

Levels of beta‐
CT
x, a biomarker of collagen turnover, were associated with cardiovascular death and
HF
in patients with non–
ST
‐elevation acute coronary syndrome. This biomarker, which correlated only weakly or not significantly with traditional biomarkers of cardiovascular death and
HF
, may provide complementary pathobiological insight and risk stratification in these patients.
Intergenerational Exchanges in East Asia: A New Look at Financial Transfers
Authors: Tsai Ming-Chang , Wang Ying-Ting 
Published: April 2019

Abstract
Adult children’s financial support for parents, which has been considered a primary representation of filial values in East Asian society, is not sufficient to understand contemporary familial reciprocation. To fully understand the detailed structure of intergenerational exchange in this region, this study proposes a new two-way typology to look at how parents both give and take with adult children. Using the 2006 East Asian Social Survey, the authors found a high frequency of financial exchange between generations, especially upward transfer, in South Korea, Taiwan, and China. Japan is a case more distant from the Confucian ideal type of family due to high prevalence of independence between parents and children regarding financial exchange. Cross-country differences are much remarked. The limited effects produced by gender and sibling orders in financial transfer show the decreasing influence of patriarchalism in East Asia.
Was Pinker on the Right Track? The Speed of Recent Decline of Violence and Gender Inequality
Authors: Nahkur Oliver , Taagepera Rein 
Published: April 2019

Abstract
Interpersonal violence decreased and gender equality increased from 1991 to 2012 in nearly all of the 26 countries studied. After confirming the direction of change, as asserted by Pinker, we further specify how fast this change is. The lower violence becomes in a country, the harder it is to reduce it even more, and similarly for gender inequality. Apply the model of exponential approach to a limit. The world average Societal Index of Interpersonal Destructiveness (SIID, S) decreases over time as S=13.3 (e-0.0132(t-2001.5)-1), and Welzel’s gender equality (G) increases as G=1-0.378 e-0.0144(t-2001.5). The two are tightly related as G=1-0.120(S+12.6)0.466 (R2=.79 for logarithms). Sweden leads the world by many decades while Russia and Philippines lag the most.
The Psychology of State-Sponsored Disinformation Campaigns and Implications for Public Diplomacy
Authors: Nisbet Erik C. , Kamenchuk Olga 
Published: April 2019

Summary
Policy discourse about disinformation focuses heavily on the technological dimensions of state-sponsored disinformation campaigns. Unfortunately, this myopic focus on technology has led to insufficient attention being paid to the underlying human factors driving the success of state-sponsored disinformation campaigns. Academic research on disinformation strongly suggests that belief in false or misleading information is driven more by individual emotional and cognitive responses — amplified by macro social, political and cultural trends — than specific information technologies. Thus, attention given to countering the distribution and promulgation of disinformation through specific technological platforms, at the expense of understanding the human factors at play, hampers the ability of public diplomacy efforts countering it. This article addresses this lacuna by reviewing the underlying psychology of three common types of state-sponsored disinformation campaigns and identifying lessons for designing effective public diplomacy counter-strategies in the future.
The China Model of Public Diplomacy and its Future
Authors: Zhao Kejin 
Published: April 2019

Summary
Since 2012, China’s top leadership has argued that China’s public diplomacy should integrate with the ‘New Model of Major-Country Diplomacy with Chinese Characteristics’. Among this series of initiatives, China formulates a public diplomacy model that is different from those of other countries. China’s model of public diplomacy falls under the unified leadership of the Communist Party of China (CPC), but coordinates various public diplomacy players culturally rather than institutionally. The current trends of China’s public diplomacy include to evolve from listening to telling, and to be more confident, positive and active. Based on empirical studies, this article concludes that China’s public diplomacy since 2012 has created a unique model that emphasises cultural and other informal norms under the CPC’s leadership. Moreover, public diplomacy will be regarded as a necessary wisdom to understand how China has integrated with the world harmoniously.
Environmental Covariate Representation of Seasonal U.S. Tornado Frequency
Authors: Gensini Vittorio A. , Bravo de Guenni Lelys 
Published: April 2019

AbstractThe significant tornado parameter is a widely used meteorological composite index that combines several variables known to favor tornadic supercell thunderstorms. This research examines the spatial relationship between U.S. tornado frequency and the significant tornado parameter (the predictor covariate) across four seasons in order to establish a spatial–statistical model that explains significant amounts of variance in tornado occurrence (the predictand). U.S. tornadoes are highly dependent on the significant tornado parameter in a climatological sense. The strength of this dependence is seasonal, with greatest dependence found during December–February and least dependence during June–August. Additionally, the strength of this dependence has not changed significantly through the 39-yr study period (1979–2017). Results herein represent an important step forward for the creation of a predictive spatial–statistical model to aid in tornado prediction at seasonal time scales.
Occupational therapy student learning on role-emerging placements in schools
Authors: Dancza Karina , Copley Jodie , Moran Monica 
Published: April 2019

Introduction Placements are considered vital in promoting theory-to-practice learning. With role-emerging placements increasingly being offered, the learning processes experienced by students warrants further investigation. This research explored the learning experiences of students, from both supervisor and student perspectives, over the duration of a role-emerging placement in schools, to contribute to our understanding of this important student learning process. Method Action research was used across four cycles with 14 students and 11 supervisors. Data were collected through reflective field notes, placement documentation and semi-structured interviews. Findings were analysed using template analysis. Findings: Limited established occupational therapy procedures and role models meant that the students created and used knowledge differently from role-established placements. The procedural knowledge upon which students most heavily relied in previous placements was largely inaccessible to students. Students relied on occupational therapy conceptual and dispositional knowledge, with the support of their peer and supervisor to guide practice. Tensions were seen between providing a service for the school and taking the necessary time to understand and implement the occupational therapy process systematically. Conclusion Role-emerging placements are valuable for transformational student learning. These placements do, however, present challenges that require careful negotiation and structured guidance.
Feline abdominal ultrasonography: what’s normal? what’s abnormal? The biliary tree
Authors: Griffin Sally 
Published: April 2019

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. The biliary tree encompasses the liver, gall bladder and bile ducts, although only diseases affecting the latter two are discussed here. Diseases of the bile ducts and gall bladder are more common than those of the liver parenchyma and ultrasound plays an important role in their diagnosis. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. In addition, a lack of pathological change does not necessarily rule out disease; for example, absence of gall bladder and/or extrahepatic biliary distension is not sufficient to exclude the possibility of biliary obstruction, and in many cases of cholangitis the liver and biliary tree are unremarkable on ultrasound examination. Equipment: Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the appearance of the normal and diseased biliary system. It is aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Percutaneous ultrasound-guided cholecystocentesis is also covered. Ultrasound examination of the liver was discussed in an article published in January 2019 and an upcoming article will cover hepatic vascular anomalies. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.
Acute hindlimb lameness in a 6-month-old cat
Authors: Nappier Michael , Robertson Brooke , LeRoith Tanya 
Published: April 2019

Clinical presentation: A 6-month-old female spayed domestic shorthair cat was presented for investigation of acute right hindlimb lameness and paresis. What is your diagnosis? Readers are encouraged to review the case history and consider what their diagnostic suspicion is. Also what is the preferred treatment for this injury? And what is the primary cause of this injury?
New drug, new problem: do hip fracture patients taking NOACs experience delayed surgery, longer hospital stay, or poorer outcomes?
Authors: Hourston George JM , Barrett Michael P , Khan Wasim S , Vindlacheruvu Madhavi , McDonnell Stephen M 
Published: April 2019

Introduction: Neck of femur fractures are common in the comorbid, often anticoagulated, elderly. Non-vitamin K antagonist oral anticoagulants (NOACs) may affect patient outcomes. We aimed to evaluate whether hip fracture patients admitted on warfarin or NOAC therapy were at risk of operative delay, prolonged length of stay, or increased mortality. Methods: We collected data for 845 patients admitted to our centre between October 2014 and December 2016. Multivariable linear regression analysis was performed to test the association between warfarin and NOAC therapy on time to surgery and length of stay. Variables in the regression model were age, sex, admission AMTS, pre-fracture mobility, ASA score, fracture type, and operation type. Fisher’s exact test was used to evaluate whether warfarin or NOAC therapy delayed surgery beyond 36 or 48 hours, or decreased 30-day, 6-month, or 12-month survival. Results: Time to surgery was delayed in anticoagulated patients ( p = 0.028). NOAC therapy was independently associated with increased time to surgery beyond 36 hours ( p = 0.001), although not beyond 48 hours ( p = 0.355), whereas warfarin therapy was not associated with either. Anticoagulation did not increase length of stay ( p = 0.331). Warfarin therapy significantly reduced 30-day survival ( p = 0.007), but NOAC therapy did not ( p = 0.244). Neither warfarin nor NOAC therapy affected further survival. Conclusions: NOAC therapy delays time to surgery beyond the NHS England ‘Best Practice Tariff’ in hip fracture patients. We aim to prospectively investigate long-term outcomes. Without a NOAC antidote, policy must change to ensure time-appropriate surgery for patients on NOACs. Preoperative involvement of the haematology team is essential.
The use of EndoAnchors in endovascular repair of abdominal aortic aneurysms with challenging proximal neck: Single-centre experience
Authors: Giudice Rocco , Borghese Ottavia , Sbenaglia Giorgio , Coscarella Carlo , De Gregorio Claudia , Leopardi Marco , Pogany Gabriele 
Published: April 2019

Objectives The aim of this study was to present a single-centre experience with EndoAnchors in patients who underwent endovascular repair for abdominal aortic aneurysms with challenging proximal neck, both in the prevention and treatment of endograft migration and type Ia endoleaks. Methods We retrospectively analysed 17 consecutive patients treated with EndoAnchors between June 2015 and May 2018 at our institution. EndoAnchors were applied during the initial endovascular aneurysm repair procedure (primary implant) to prevent proximal neck complications in difficult anatomies (nine patients), and in the follow-up after aneurysm exclusion (secondary implant) to correct type Ia endoleak and/or stent-graft migration (eight patients). Results Mean time for anchors implant was 23 min (range 12–41), with a mean of 5 EndoAnchors deployed per patient. Six patients in the secondary implant group required a proximal cuff due to stent-graft migration ≥10 mm. Technical success was achieved in all cases, with no complications related to deployment of the anchors. At a median follow-up of 13 months (range 4–39, interquartile range 9–20), there were no aneurysm-related deaths or aneurysm ruptures, and all patients were free from reinterventions. CT-scan surveillance showed no evidence of type Ia endoleak, anchors dislodgement or stent-graft migration, with a mean reduction of aneurysm diameter of 0.4 mm (range 0–19); there was no sac growth or aortic neck enlargement in any case. Conclusions EndoAnchors can be safely used in the prevention and treatment of type Ia endoleaks in patients with challenging aortic necks, with good results in terms of sac exclusion and diameter reduction in the mid-term follow-up.
Health professionals’ attitudes to patients’ use of wearable technology
Authors: Watt Angus , Swainston Katherine , Wilson Gemma 
Published: April 2019

Objective Wearable technologies for health monitoring are becoming increasingly mainstream. However, there is currently limited evidence exploring use from the perspective of healthcare professionals. This study aimed to explore health professionals’ attitudes toward their patients’ use of wearable technologies. Methods A convenience sample of health professionals was recruited to participate in this study. Qualitative semi-structured interviews were carried out either face-to-face, via Skype or telephone. Interviews were recorded using a Dictaphone, transcribed verbatim and analysed using thematic analysis. Results Four themes emerged from the qualitative findings: ‘opportunities for wearable technology’, ‘usability and understanding’, ‘privacy and surveillance’ and ‘cost’. Conclusions The findings portray health professionals’ ambivalence to the use of wearable technology, and it was apparent that whilst the participants considered the technology as being beneficial to patients, they still had concerns for its use.