bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of switching to very low nicotine content cigarettes plus nicotine patch versus reducing daily cigarette consumption plus nicotine patch to decrease dependence: an exploratory randomized trial
Authors: Klemperer Elias M. , Hughes John R. , Callas Peter W. , Benner Joy A. , Morley Nicholas E. 
Published: May 2019

AbstractBackground and AimsThe United States Food and Drug Administration has proposed regulation to require that cigarettes contain very low nicotine content (VLNC). In contrast, reducing the number of cigarettes per day (CPD) is the most common current method to reduce nicotine. This trial aims to explore whether gradually transitioning to VLNC cigarettes plus nicotine patch or reducing CPD plus nicotine patch is more effective at decreasing nicotine dependence.DesignA two‐arm, individually randomized open‐label trial.SettingCommunity setting, Vermont, USA.ParticipantsSixty‐eight adult daily smokers (40% female) of ≥ 10 cigarettes/day who were not planning to quit in the next 30 days.InterventionsAll participants smoked study cigarettes with a nicotine yield similar to most commercial cigarettes ad libitum for 1 week (baseline). Participants then gradually reduced to 70, 35, 15 and 3% of baseline nicotine over 4 weeks by either (a) transitioning to lower nicotine content cigarettes (n = 36) or (b) reducing the number of full nicotine cigarettes (n = 32). All participants received nicotine patches.MeasurementsThe primary outcome was change in nicotine dependence assessed at baseline and weekly during the intervention with the Nicotine Dependence Syndrome Scale.FindingsDependence declined over time for both VLNC and CPD participants, but declined more for VLNC (mean decrease in Z‐score of 1.0) than CPD (mean decrease in Z‐score of 0.5) participants over time (interaction P = 0.018).ConclusionsTransitioning to very low nicotine content cigarettes reduced nicotine dependence over a 4‐week period to a greater extent than reducing cigarettes per day when both conditions were aided by nicotine patch.
Prescription opioid use patterns, use disorder diagnoses and addiction treatment receipt after the 2014 Medicaid expansion in Oregon
Authors: Springer Rachel , Marino Miguel , Bailey Steffani R. , Angier Heather , O'Malley Jean P. , Hoopes Megan , Lindner Stephan , DeVoe Jennifer E. , Huguet Nathalie 
Published: May 2019

AbstractBackground/AimsEvidence suggests that Medicaid beneficiaries in the United States are prescribed opioids more frequently than are people who are privately insured, but little is known about opioid prescribing patterns among Medicaid enrollees who gained coverage via the Affordable Care Act Medicaid expansions. This study compared the prevalence of receipt of opioid prescriptions and opioid use disorder (OUD), along with time from OUD diagnosis to medication‐assisted treatment (MAT) receipt between Oregon residents who had been continuously insured by Medicaid, were newly insured after Medicaid expansion in 2014 or returned to Medicaid coverage after expansion.DesignCross‐sectional study using inverse‐propensity weights to adjust for differences among insurance groups.SettingOregon.ParticipantsA total of 225 295 Oregon Medicaid adult beneficiaries insured during 2014–15 and either: (1) newly enrolled, (2) returning in 2014 after a > 12‐month gap or (3) continuously insured between 2013 and 2015. We excluded patients in hospice care or with cancer diagnoses.MeasurementsAny opioid‐dispensed, chronic (> 90‐days) and high‐dose (> 90 daily morphine milligram equivalence) opioid use, documented OUD diagnosis and MAT receipt.FindingsCompared with the continuously insured, newly and returning insured enrollees were less likely to be dispensed opioids [newly: 42.3%, 95% confidence interval (CI) = 42.0–42.7%; returning: 49.3%, 95% CI = 48.8–49.7%; continuously: 52.5%, 95% CI = 52.0–53.0%], use opioids chronically (newly: 12.8%, 95% CI = 12.4–13.1%; returning: 11.9%, 95% CI = 11.5–12.3%, continuously: 15.8%, 95% CI = 15.4–16.2%), have OUD diagnoses (newly: 3.6%, 95% CI = 3.4–3.7%; returning: 3.9%, 95% CI = 3.8–4.1%, continuously: 4.7%, 95% CI = 4.5–4.9%) and receive MAT after OUD diagnosis [hazard ratio newly: 0.57, 95% CI = 0.53–0.61; hazard ratio returning: 0.60, 95% CI = 0.56–0.65 (ref: continuously)].ConclusionsResidents of Oregon, United States who enrolled or re‐enrolled in Medicaid health insurance after expansion of coverage in 2014 as a result of the Affordable Care Act were less likely than those already covered to receive opioids, use them chronically or receive medication‐assisted treatment for opioid use disorder.
Morphological assessment of cat kidneys using computed tomography
Authors: Darawiroj Damri , Choisunirachon Nan 
Published: May 2019

AbstractThere are numerous publications about feline renal imaging information; however, none have established reference values for kidney size using computed tomography (CT). This study aimed to determine renal size and shape as well as the morphology of renal‐related structures in clinically normal cats (Felis catus) that underwent CT. Twenty‐seven healthy cats underwent pre‐ and post‐iodinated contrast‐enhanced CT. Most cat (59%) kidneys were located at the same level. The average pre‐contrast dimensions of the left kidney included a width of 2.46 ± 0.28 cm, a length of 3.52 ± 0.44 cm and a height 2.19 ± 0.31 cm, whereas those of the right kidneys were 2.45 ± 0.27 cm, 3.54 ± 0.46 cm and 2.05 ± 0.23 cm, respectively. After contrast enhancement, kidneys were slightly enlarged though not significantly. Additionally, renal length (LK or RK) was compared with second lumbar vertebra (L2) length and abdominal aorta diameter (AO). AO was significantly larger in male cats whereas L2 length appeared longer in male cats, but was not statistically different from the female cats. The LK/L2 and RK/L2 ratios were 2.29 ± 0.23 and 2.36 ± 0.20, respectively, and the LK/AO and RK/AO were 11.72 ± 1.37 and 12.05 ± 1.47, respectively. Renal vessels were examined. The renal vein was obviously larger than the renal artery, and paired renal veins were observed periodically. This study provides CT information about the feline kidney, which may help to establish reference values and information regarding renal structure prior to surgery in practice.
Cultural difference in maladaptive functions of perfectionistic self‐presentation
Authors: Wang Yiheng , Li Liman Man Wai , Xie Fuzhe 
Published: May 2019

Perfectionistic self‐presentation (PSP), which describes an expressive aspect of perfectionism in the interpersonal domain, is a defensive form of perfectionism that has been relatively understudied. Although existing evidence obtained from Western societies has consistently shown maladaptive functions of PSP, the question of whether these patterns are universal remains unanswered. The current research explored the potential moderating effect of culture by evaluating whether the negative influence of PSP is weaker in Asian societies that encourage the use of defensive interpersonal strategies than in Western societies. Two studies recruiting Chinese and North American participants were conducted. In Study 1 (n = 302), the results showed that the relation between PSP and personal mastery was positive among Chinese participants and was negative among North American participants. In contrast, a positive relation between PSP and perceived constraints was observed in both cultures. Study 2 (n = 295) replicated the findings obtained in Study 1. In addition, the findings showed that the relation between PSP and self‐esteem, but not that between PSP and depression, was moderated by participants’ cultural backgrounds. Taken together, these results indicate both universal and culturally specific patterns regarding the influence of PSP, suggesting that PSP is a complex construct.
Duodenal eosinophilia is associated with functional dyspepsia and new onset gastro‐oesophageal reflux disease
Authors: Ronkainen Jukka , Aro Pertti , Walker Marjorie M. , Agréus Lars , Johansson Sven‐Erik , Jones Mike , Talley Nicholas J. 
Published: May 2019

SummaryBackgroundIt is unexplained why functional dyspepsia and gastro‐oesophageal reflux disease (GERD) overlap more often than expected by chance. Post‐prandial distress syndrome has been linked to impaired gastric fundic accommodation which may induce increased transient lower oesophageal sphincter relaxations and consequent GERD. Duodenal eosinophilia has been linked to functional dyspepsia and post‐prandial distress syndrome.AimTo identify if there is an association between duodenal eosinophilia in functional dyspepsia and symptoms of GERD and whether post‐prandial distress syndrome or epigastric pain syndrome are associated with new onset GERD.MethodsParticipants (n = 1000) were randomly selected from the national Swedish population register and surveyed by questionnaires and oesophagogastroduodenoscopy in 1999‐2001. All eligible subjects (n = 887) were invited to a follow‐up study in 2010 (response rate 79%). In a case‐control study of 213 subjects (functional dyspepsia vs healthy controls), histology from the duodenum was evaluated at baseline and the possible association of eosinophilia to new onset GERD symptoms was analysed.ResultsFunctional dyspepsia (OR 7.6; 95% CI 2.93‐19.4, P < 0.001) and post‐prandial distress syndrome at baseline (OR 9.0, 95% CI 3.36‐24.0, P < 0.001) were associated with an increased risk of GERD at follow‐up. Eosinophilia in the second part of duodenum only was independently associated with an increased risk of GERD amongst those with functional dyspepsia (OR 4.2; 95% CI 1.2‐4.77, P = 0.024) and post‐prandial distress syndrome at baseline (OR 6.0; 95% CI 1.50‐23.6, P = 0.011), respectively.ConclusionsDuodenal eosinophilia is associated with increased risk of GERD at 10‐year follow‐up in those with functional dyspepsia and post‐prandial distress syndrome at baseline. Duodenal eosinophilia may explain the link between GERD and functional dyspepsia, suggesting subsets of functional dyspepsia and GERD may be part of the same disease spectrum.
Why the embryo rescue case is a bad argument against embryonic personhood
Authors: Hendricks Perry 
Published: May 2019

AbstractThe embryo rescue case (ERC) is a thought experiment that is used to argue against the view that embryos have a right to life (i.e., are persons). I will argue that cognitive science undermines the intuition elicited by the ERC. I will show that whether or not embryos have a right to life, our mental tools will make it very difficult to believe that they do have the said right. This suggests that the intuition elicited by the ERC is not truth‐indicative. The upshot of this is that we have an undercutting defeater for our intuition that embryos do not have a right to life. Thus, the ERC is a bad argument against embryonic personhood.
A four‐group urine risk classifier for predicting outcomes in patients with prostate cancer
Authors: Connell Shea P. , Yazbek‐Hanna Marcelino , McCarthy Frank , Hurst Rachel , Webb Martyn , Curley Helen , Walker Helen , Mills Rob , Ball Richard Y. , Sanda Martin G. , Pellegrini Kathryn L. , Patil Dattatraya , Perry Antoinette S. , Schalken Jack , Pandha Hardev , Whitaker Hayley , Dennis Nening , Stuttle Christine , Mills Ian G. , Guldvik Ingrid ,   Movember GAP1 Urine Biomarker Consortium, Parker Chris , Brewer Daniel S. , Cooper Colin S. , Clark Jeremy 
Published: May 2019

ObjectivesTo develop a risk classifier using urine‐derived extracellular vesicle (EV)‐RNAcapable of providing diagnostic information on disease status prior to biopsy, and prognostic information for men on active surveillance (AS).Patients and MethodsPost‐digital rectal examination urine‐derivedEV‐RNAexpression profiles (n= 535, multiple centres) were interrogated with a curated NanoString panel. ALASSO‐based continuation ratio model was built to generate four prostate urine risk (PUR) signatures for predicting the probability of normal tissue (PUR‐1), D'Amico low‐risk (PUR‐2), intermediate‐risk (PUR‐3), and high‐risk (PUR‐4) prostate cancer. This model was applied to a test cohort (n= 177) for diagnostic evaluation, and to anASsub‐cohort (n= 87) for prognostic evaluation.ResultsEachPURsignature was significantly associated with its corresponding clinical category (P< 0.001).PUR‐4 status predicted the presence of clinically significant intermediate‐ or high‐risk disease (area under the curve = 0.77, 95% confidence interval [CI] 0.70–0.84). Application ofPURprovided a net benefit over current clinical practice. In anASsub‐cohort (n= 87), groups defined byPURstatus and proportion ofPUR‐4 had a significant association with time to progression (interquartile range hazard ratio [HR] 2.86, 95%CI1.83–4.47;P< 0.001).PUR‐4, when used continuously, dichotomized patient groups with differential progression rates of 10% and 60% 5 years after urine collection (HR8.23, 95%CI3.26–20.81;P< 0.001).ConclusionUrine‐derived EV‐RNAcan provide diagnostic information on aggressive prostate cancer prior to biopsy, and prognostic information for men onAS.PURrepresents a new and versatile biomarker that could result in substantial alterations to current treatment of patients with prostate cancer.
Maternal glycaemic control and risk of neonatal hypoglycaemia in Type 1 diabetes pregnancy: a secondary analysis of the CONCEPTT trial
Authors: Yamamoto J. M. , Corcoy R. , Donovan L. E. , Stewart Z. A. , Tomlinson G. , Beardsall K. , Feig D. S. , Murphy H. R. ,   the CONCEPTT Collaborative Group*
Published: May 2019

AbstractAimsTo examine the relationship between maternal glycaemic control and risk of neonatal hypoglycaemia using conventional and continuous glucose monitoring metrics in the Continuous Glucose Monitoring in Type 1 Diabetes Pregnancy Trial (CONCEPTT) participants.MethodsA secondary analysis of CONCEPTT involving 225 pregnant women and their liveborn infants. Antenatal glycaemia was assessed at 12, 24 and 34 weeks gestation. Intrapartum glycaemia was assessed by continuous glucose monitoring measures 24 hours prior to delivery. The primary outcome was neonatal hypoglycaemia defined as glucose concentration < 2.6 mmol/l and requiring intravenous dextrose.ResultsNeonatal hypoglycaemia occurred in 57/225 (25.3%) infants, 21 (15%) term and 36 (40%) preterm neonates. During the second and third trimesters, mothers of infants with neonatal hypoglycaemia had higher HbA1c [48 ± 7 (6.6 ± 0.6) vs. 45 ± 7 (6.2 ± 0.6); P = 0.0009 and 50 ± 7 (6.7 ± 0.6) vs. 46 ± 7 (6.3 ± 0.6); P = 0.0001] and lower continuous glucose monitoring time‐in‐range (46% vs. 53%; P = 0.004 and 60% vs. 66%; P = 0.03). Neonates with hypoglycaemia had higher cord blood C‐peptide concentrations [1416 (834, 2757) vs. 662 (417, 1086) pmol/l; P < 0.00001], birthweight > 97.7th centile (63% vs. 34%; P < 0.0001) and skinfold thickness (P ≤ 0.02). Intrapartum continuous glucose monitoring was available for 33 participants, with no differences between mothers of neonates with and without hypoglycaemia.ConclusionsModest increments in continuous glucose monitoring time‐in‐target (5–7% increase) during the second and third trimesters are associated with reduced risk for neonatal hypoglycaemia. While more intrapartum continuous glucose monitoring data are needed, the higher birthweight and skinfold measures associated with neonatal hypoglycaemia suggest that risk is related to fetal hyperinsulinemia preceding the immediate intrapartum period.
Instruments to measure the ability to self‐reflect: A systematic review of evidence from workplace and educational settings including health care
Authors: Williams Julie C. , Ireland Tony , Warman Sheena , Cake Martin A. , Dymock David , Fowler Ellayne , Baillie Sarah 
Published: May 2019

AbstractIntroductionSelf‐reflection has become recognised as a core skill in dental education, although the ability to self‐reflect is valued and measured within several professions. This review appraises the evidence for instruments available to measure the self‐reflective ability of adults studying or working within any setting, not just health care.Materials and MethodsA systematic review was conducted of 20 electronic databases (including Medline, ERIC, CINAHL and Business Source Complete) from 1975 to 2017, supplemented by citation searches. Data were extracted from each study and the studies graded against quality indicators by at least two independent reviewers, using a coding sheet. Reviewers completed a utility analysis of the assessment instruments described within included studies, appraising their reported reliability, validity, educational impact, acceptability and cost.ResultsA total of 131 studies met the inclusion criteria. Eighteen were judged to provide higher quality evidence for the review and three broad types of instrument were identified, namely: rubrics (or scoring guides), self‐reported scales and observed behaviour.ConclusionsThree types of instrument were identified to assess the ability to self‐reflect. It was not possible to recommend a single most effective instrument due to under reporting of the criteria necessary for a full utility analysis of each. The use of more than one instrument may therefore be appropriate dependent on the acceptability to the faculty, assessor, student and cost. Future research should report on the utility of assessment instruments and provide guidance on what constitutes thresholds of acceptable or unacceptable ability to self‐reflect, and how this should be managed.
Pregnancy and delivery in women with von Willebrand disease
Authors: Castaman Giancarlo , James Paula D. 
Published: May 2019

AbstractGiven the wide heterogeneity of phenotypes and of the underlying pathophysiological mechanisms associated with the disorder, pregnancy and delivery in von Willebrand disease (VWD) represent a significant clinical challenge. The variable pattern of changes observed during pregnancy of von Willebrand factor (VWF) and factor VIII (FVIII), the protein carried by VWF, prompts a careful evaluation of pregnant women with VWD to plan the most appropriate treatment at the time of parturition. However, there are also instances during pregnancy (amniocentesis, vaginal bleeding associated with placental detachment, sudden abortion) that may require urgent hemostatic treatment to prevent bleeding. Thus, women with VWD should start pregnancy after being well characterised as to their type, subtype and treatments. Women with VWD who have VWF and FVIII basal levels >30 U/dL typically normalise these levels at the end of pregnancy and specific anti‐haemorrhagic prophylaxis is seldom required. On the contrary, those with basal levels <20 U/dL usually show a lesser increase and specific treatment is required. Some women with DNA variants associated with increased clearance can be treated with desmopressin, while those unresponsive or with contra‐indications to this agent need replacement therapy. For these latter women, the risk of vaginal bleeding during pregnancy may be increased and prophylaxis with VWF concentrates required. Similarly, women with type 2 VWD who maintain reduced VWF activity throughout pregnancy require replacement therapy with FVIII/VWF concentrates. Delayed postpartum bleeding may occur when replacement therapy is not continued for some days. Tranexamic acid is useful at discharge to avoid excessive lochia.
Use of a whole‐cell ELISA to detect additional antibodies in setting of suspected heparin‐induced thrombocytopenia
Authors: Bashover Eva M. , Stefaniuk Catherine M. , Harding Clifford V. , Maitta Robert W. 
Published: May 2019

AbstractObjectivesType II heparin‐induced thrombocytopenia (HIT) is mediated by formation of antibodies to platelet factor 4 (PF4)‐heparin complexes. We evaluated anti–PF4‐heparin‐negative samples for the presence of additional anti‐platelet and anti‐red blood cell (RBC) antibodies using whole‐cell platelet/ RBC ELISAs we developed.MethodsSeventy‐three samples tested for anti–PF4‐heparin by ELISA were included: 62 tested negative, 9 tested positive, and 2 had equivocal results. Plasma specimens from healthy donors were used as controls.Results100% (9/9) anti–PF4‐positive samples had anti‐platelet antibodies detected by whole‐cell platelet ELISA. 42.2% (27/64) anti–PF4‐heparin‐negative samples were negative for anti‐platelet and anti‐RBC antibodies. 32.8% (21/64) negative samples showed reactivity to both platelets and RBC; 12.5% (8/64) negative samples were each reactive with either platelet or RBC ELISA, respectively. Additionally, two samples that tested equivocal by anti–PF4‐heparin ELISA had antibodies to both platelets and RBC by whole‐cell ELISA.ConclusionsOur study suggests that patients with thrombocytopenia testing negative for anti–PF4‐heparin may still harbor antibodies to platelets. However, additional research is needed to determine the significance of these antibodies. Nevertheless, these findings may encourage clinicians to further investigate patients with possible immune‐mediated etiologies of thrombocytopenia and anemia.
The use of magnetic resonance imaging for the assessment of distal limb wounds in horses: A pilot study
Authors: Sherlock C. , Fairburn A. , Lawson A. , Mair T. 
Published: May 2019

SummaryThe utility of magnetic resonance (MR) imaging in the evaluation of equine solar foot penetrations is well established. The objective of this pilot study was to evaluate the utility of MR imaging in assessment of equine distal limb wounds excluding solar penetrations. Low‐field MR images of 23 horses that had previously sustained distal limb wounds were reviewed in consensus by two ECVDI diplomats. Structures (bone; synovial structure; subcutaneous tissue and skin; and ligament/tendon) were identified as normal or abnormal on MR images, radiographs and ultrasound images and reports. All abnormalities were described. The presence of artefacts and their effect on image interpretation were also noted for each modality. Comparisons were made between imaging modalities, and it was noted if MR imaging influenced case management. Abnormalities of the bone were identified in 26% of horses on MR images and 17% of horses on radiographs; there were no osseous abnormalities identified on radiographs that were not identified on MR images, and additional features and better characterisation of lesions were noted on MR images. Tendon/ligament abnormalities were identified in 57% horses on MR and 47% of horses on ultrasound images. Magnetic susceptibility artefacts compromised MR image interpretation in 17% of horses. MR imaging of equine distal limb wounds allowed identification of both osseous and tendon/ligament abnormalities in more cases than either radiography or ultrasonography, and altered case management in 20/23 horses. Although MR imaging should not replace conventional imaging, this study highlights that MR imaging of equine distal limb wounds can yield information not detected on conventional imaging which may direct treatment and affect prognostication.