bluuebunny/crossref_metadata_2025_split huggingface dataset:
Novel Screening Tool for Stroke Using Artificial Neural Network
Authors: Abedi Vida , Goyal Nitin , Tsivgoulis Georgios , Hosseinichimeh Niyousha , Hontecillas Raquel , Bassaganya-Riera Josep , Elijovich Lucas , Metter Jeffrey E. , Alexandrov Anne W. , Liebeskind David S. , Alexandrov Andrei V. , Zand Ramin 
Published: April 2017

Background and Purpose—
The timely diagnosis of stroke at the initial examination is extremely important given the disease morbidity and narrow time window for intervention. The goal of this study was to develop a supervised learning method to recognize acute cerebral ischemia (ACI) and differentiate that from stroke mimics in an emergency setting.

Methods—
Consecutive patients presenting to the emergency department with stroke-like symptoms, within 4.5 hours of symptoms onset, in 2 tertiary care stroke centers were randomized for inclusion in the model. We developed an artificial neural network (ANN) model. The learning algorithm was based on backpropagation. To validate the model, we used a 10-fold cross-validation method.

Results—
A total of 260 patients (equal number of stroke mimics and ACIs) were enrolled for the development and validation of our ANN model. Our analysis indicated that the average sensitivity and specificity of ANN for the diagnosis of ACI based on the 10-fold cross-validation analysis was 80.0% (95% confidence interval, 71.8–86.3) and 86.2% (95% confidence interval, 78.7–91.4), respectively. The median precision of ANN for the diagnosis of ACI was 92% (95% confidence interval, 88.7–95.3).

Conclusions—
Our results show that ANN can be an effective tool for the recognition of ACI and differentiation of ACI from stroke mimics at the initial examination.
Social structure of long-finned pilot whales (Globicephala melas) off northern Cape Breton Island, Nova Scotia
Authors: Augusto J.F. , Frasier T.R. , Whitehead H. 
Published: April 2017

Cetacean social structures include fluid and stable elements. Long-finned pilot whales (Globicephalamelas) live in units that interact forming labile groups. In this study conducted off Cape Breton Island, between 1998–2011, we confirm unit membership predicts associations between individuals. We determine how units are structured and interact. We delineated 21 nearly-stable social units, with an average 7 members. For units where multiple individuals are sexed, both sexes are present. Most units showed long-term stability, while one showed evidence of splitting. Three units shared individuals with the largest unit (K, average size = 29). Splitting is likely triggered by size and difficulties maintaining associations between all individuals. Pilot whales face many pressures driving sociality at a range of temporal and social scales producing a multilevel society. While we have produced a more detailed model of long-finned pilot whale social structure, there are still unanswered questions, particularly whether units are strict matrilines.
Bridging the digital disconnect: Exploring the views of professionals on using technology to promote young people’s mental health
Authors: Clarke Aleisha M. , Chambers Derek , Barry Margaret M. 
Published: April 2017

The increasing role of online technologies in young people’s lives has significant implications for professionals’ engagement with technologies to promote youth mental health and well-being. However, relatively little is known about professionals’ views on the role of technologies in supporting youth mental health. This article outlines key findings from a needs assessment survey carried out in Ireland that sought to determine the views of professionals working with young people on the use of online technologies in supporting young people’s mental health and well-being. A total of 900 professionals from across the education, health, and mental health professions completed an online survey. The findings demonstrate the importance of the internet as a resource for professionals working with young people, with over 98% of those surveyed expressing a readiness to use online resources to support young people’s mental health. The nature of preferred online technologies differed according to professional groupings, however, 63% of overall respondents indicated they would look for help on a dedicated mental health website. Guidelines on working with young people and their parents on the promotion of positive mental were requested with the most frequency. Among the barriers identified were concerns about access to reliable information that was relevant to specific professional roles, and the need for organizational support of professionals’ use of online evidence-based resources. Concerns were also expressed that online resources could replace face-to-face support services for young people, and the need for training professionals in their appropriate use. The results highlight the potential role of technology in assisting professionals through the provision of online training, reliable information, and practical resources on the promotion of positive youth mental health.
Self‐Evaluation of Quality of Life Among Patients Receiving Home Parenteral Nutrition: A Validation Study
Authors: Theilla Miriam , Kagan Ilya , Chernov Karina , Cohen Jonathan , Kagan Ilya , Singer Pierre 
Published: April 2017

AbstractBackground: Home parenteral nutrition (HPN) can increase survival and quality of life (QOL) in cases of chronic intestinal failure. The present study compares a gold standard—a validated QOL assessment by Baxter et al (hereafter, HPN‐QOL)—with a shorter questionnaire for QOL evaluation (hereafter, New QOL). Materials and Methods: Both questionnaires were completed by 58 patients attending the nutrition clinic of the Rabin Medical Center (Israel). A z score was used to equate means and variances. Statistical analysis was based on Pearson correlation between variances. Stepwise regression was used to evaluate the best value predictor in the New QOL for QOL during HPN. Cronbach’s α was used for internal consistency, and confirmatory factor analysis was used for structural validity. Results: Results from the sections of the New QOL that relate to the patient’s general health, level of independence, and experience with handling the parenteral nutrition therapy are highly correlated with the HPN‐QOL (r = 0.43 and r = 0.50, respectively). In addition, there was good correlation between the questionnaires with reference to the patient’s social state, mental state, and everyday functioning (r = −0.43, New QOL; r = −0.39, HPN‐QOL). However, the New QOL results show no correlation between the patient’s physical symptoms and QOL during HPN. This was hypothesized to result from the nature of the study population. Conclusion: The results of our new questionnaire are well correlated with the gold standard HPN‐QOL. The New QOL appears to be simple and easy to use.
Cardiac magnetic resonance based evaluation of aortic stiffness and epicardial fat volume in patients with hypertension, diabetes mellitus, and myocardial infarction
Authors: Homsi Rami , Sprinkart Alois M. , Gieseke Juergen , Meier-Schroers Michael , Yuecel Seyrani , Fischer Stefan , Nadal Jennifer , Dabir Darius , Luetkens Julian A , Kuetting Daniel L , Schild Hans H , Thomas Daniel K 
Published: April 2017

Background Aortic stiffness and epicardial fat relate to cardiovascular risk. Their relationship with each other and their role with hypertension, diabetes mellitus (DM), and myocardial infarction (MI) can be evaluated by cardiac magnetic resonance (CMR). Purpose To explore an association between aortic stiffness and epicardial as well as paracardial fat volume (EFV and ParaFV, respectively) in hypertensive patients and to relate the results to the presence of DM and MI. Material and Methods A total of 156 hypertensive and 20 non-hypertensive participants were examined at 1.5 Tesla. A 2D-velocity-encoded sequence was acquired to assess aortic pulse wave velocity (PWV in m/s) as a measure of aortic stiffness. A 3D-Dixon sequence was used to determine EFV and ParaFV. Results PWV correlated with EFV (R = 0.474; P < 0.001), but not with ParaFV. Fat volumes (in mL/m2) and PWV were lower in non-hypertensive controls compared to hypertensive patients. EFV and PWV were significantly higher in diabetic hypertensive patients without MI (n = 19; PWV: 10.4 ± 2.9; EFV: 92.5 ± 19.3) compared to hypertension-only patients (n = 84 [no DM or MI]; EFV: 64.8 ± 25.1, PWV: 9.0 ± 2.6; P < 0.05). Logistic regression analysis showed a significant association between the presence of a MI and a higher EFV ( P < 0.05), but not with PWV ( P = 0.060) or ParaFV ( P = 0.375). Conclusion A relationship between aortic stiffness and EFV was found in hypertensive patients. Both were increased in the presence of DM; however, only EFV was increased in the presence of MI. This may relate to the PWV lowering effect of the antihypertensive medication used by hypertensive patients and underscores the benefit of EFV assessment in this regard.
Dual Burden of Malnutrition Among Adolescents of Smallholder Coffee Farming Households of Jimma Zone, Southwest Ethiopia
Authors: Hassen Kalkidan , Gizaw Getu , Belachew Tefera 
Published: April 2017

Background: Substantial evidence is emerging on the coexistence of double burden of malnutrition on adolescents of low-income countries, shaping the health challenges of the upcoming adult generation for the worst. Whether nutritional status markers of adolescents in the cash crop setting are on par with economic gains remains uncertain. Thus, we investigated the nutritional outcomes of adolescents and their determinants in coffee farming households. Methods: The survey was carried out in 3 top coffee-producing districts of Jimma Zone, Ethiopia. Five hundred fifty mothers/caregivers and their respective adolescents were selected using multistage random sampling. Anthropometric data were converted into height-for-age and body-mass-index-for-age Z scores using WHO Anthroplus software and analyzed by SPSS for windows. Results: Prevalence of thinness, stunting, and overweight/obesity were 11.6%, 15.6%, and 7.1%, respectively. The odds of stunting among adolescents in households in the lowest wealth tertile was nearly 6-fold higher compared to the highest tertile (adjusted odds ratio [AOR] = 5.6 [2.6-12]). Conversely, the odds of overweight/obesity was higher among adolescents in the households in the middle wealth tertile (AOR = 2.72 [1.08-6.86]) compared to the highest tertile. Adolescents living in households with low-dependent age-groups were more than twice likely to be overweight/obese (AOR = 2.58 [1.06-6.24]). Conclusion: The current study revealed the presence of substantial dual burden of malnutrition. In such a setting, it is critical to draw a fine line and trade-off for eliminating morbidity and mortality of undernutrition, without triggering the risk of overweight/obesity.
The value of metaphorical reasoning in bioethics: An empirical-ethical study
Authors: Olsman Erik , Veneberg Bert , van Alfen Claudia , Touwen Dorothea 
Published: April 2017

Background: Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning. Objective: To describe a central set of metaphors in one case and to explore their contribution to moral reasoning. Method: Semi-structured interviews were conducted with 16 parents of a child suffering from the neurodegenerative disease CLN3. The interviews were recorded, transcribed, and metaphors were analyzed. The researchers wrote memos and discussed about their analyses until they reached consensus. Ethical considerations: Participants gave oral and written consent and their confidentiality and anonymity were respected. Findings: A central set of metaphors referred to the semantic field of the hands and arms and consisted of two central metaphors that existed in a dialectical relationship: grasping versus letting go. Participants used these metaphors to describe their child’s experiences, who had to “let go” of abilities, while “clinging” to structures and the relationship with their parent(s). They also used it to describe their own experiences: participants tried to “grab” the good moments with their child and had to “let go” of their child when (s)he approached death. Participants, in addition, “held” onto caring for their child while being confronted with the necessity to “let go” of this care, leaving it to professional caregivers. Discussion: The ethical analysis of the findings shows that thinking in terms of the dialectical relationship between “grasping” and “letting go” helps professional caregivers to critically think about images of good care for children with CLN3. It also helps them to bear witness to the vulnerable, dependent, and embodied nature of the moral self of children with CLN3 and their parents. Conclusion: Metaphorical reasoning may support the inclusion of marginalized perspectives in moral reasoning. Future studies should further explore the contribution of metaphorical reasoning to moral reasoning in other cases.
Anaplasma, Ehrlichia and Rickettsia species infections in cats: European guidelines from the ABCD on prevention and management
Authors: Pennisi Maria Grazia , Hofmann-Lehmann Regina , Radford Alan D , Tasker Séverine , Belák Sándor , Addie Diane D , Boucraut-Baralon Corine , Egberink Herman , Frymus Tadeusz , Gruffydd-Jones Tim , Hartmann Katrin , Horzinek Marian C , Hosie Margaret J , Lloret Albert , Lutz Hans , Marsilio Fulvio , Thiry Etienne , Truyen Uwe , Möstl Karin 
Published: April 2017

Overview: Anaplasma species, Ehrlichia species and Rickettsia species are vector-borne pathogens infecting a wide variety of mammals, but causing disease in very few of them. Infection in cats: Anaplasma phagocytophilum is the most important feline pathogen among these rickettsial organisms, and coinfections are possible. Little information is available on the pathogenesis of these agents in cats. Clinical signs are usually reported soon after tick infestation. They are mostly non-specific, consisting of fever, anorexia and lethargy. Joint pain may occur. Infection in humans: Some rickettsial species ( A phagocytophilum, Ehrlichia chaffeensis, Ehrlichia ewingii, Rickettsia conorii, Rickettsia rickettsii, Rickettsia felis, Rickettsia typhi and Candidatus Neoehrlichia mikurensis) are of zoonotic concern. Direct contact with cat saliva should be avoided because of potential contamination by R felis. Infected cats are ‘sentinels’ of the presence of rickettsial pathogens in ticks and fleas in a given geographical area, and they signal a risk for people exposed to vectors.
Feline biliary tree and gallbladder disease: Aetiology, diagnosis and treatment
Authors: Otte Corma MA , Penning Louis C , Rothuizen Jan 
Published: April 2017

Practical relevance Diseases of the biliary tree and gallbladder are more common in cats than diseases of the liver parenchyma. The parenchyma is usually affected secondarily to systemic illnesses, while the biliary system is the prime target for infectious agents (eg, bacteria and flukes) and non-infectious conditions (eg, neoplasia and cysts). Clinical approaches Cats with biliary disease are evaluated because of common feline clinical signs such as anorexia, nausea, vomiting and lethargy. Icterus may or may not be obvious. Biopsies for histological evaluation, and bile aspirates for culture and cytological evaluation are helpful diagnostically. Antibiotics and immunosuppressive drugs have been used successfully. Hepatosupportive drugs may help in liquefying thick bile and protecting hepatic tissue from damage. Ultrasound is a noninvasive diagnostic tool that may help in identifying dilated bile ducts, liver cysts and choleliths. It is also used to guide percutaneous bile aspiration. Audience This review, written for all veterinarians who treat cats, describes the various conditions that can affect the feline biliary tree and gallbladder. Treatment options are discussed, and brief summaries provided of surgical techniques and diagnostic approaches. Evidence base The veterinary literature pertaining to feline biliary disease is comprehensively reviewed. When appropriate, data on dogs and humans has been included to provide background information. Based on the available literature, more research into feline biliary diseases is needed.
Feline leprosy due to Candidatus ‘Mycobacterium tarwinense’: Further clinical and molecular characterisation of 15 previously reported cases and an additional 27 cases
Authors: O’Brien Carolyn R , Malik Richard , Globan Maria , Reppas George , McCowan Christina , Fyfe Janet A 
Published: April 2017

Objectives: This paper, the first in a series of three on ‘feline leprosy’, provides a detailed description of disease referable to Candidatus ‘Mycobacterium tarwinense’, the most common cause of feline leprosy in Victoria, Australia. Methods: Cases were sourced retrospectively and prospectively for this observational study, describing clinical, geographical and molecular microbiological data for cats definitively diagnosed with Candidatus ‘M tarwinense’ infection. Results: A total of 145 cases of feline leprosy were scrutinised; 114 ‘new’ cases were sourced from the Victorian Infectious Diseases Reference Laboratory records, veterinary pathology laboratories or veterinarians, and 31 cases were derived from six published studies. Forty-two cats were definitively diagnosed with Candidatus ‘M tarwinense’ infection. Typically, cats were between 3 and 11 years of age, with no gender predilection, and were generally systemically well. All had outdoor access. Most cats underwent surgical resection of lesions with adjunctive medical therapy, often utilising a combination of oral clarithromycin and rifampicin for at least 3 months. Prognosis for recovery was generally good. Resolution of lesions was not observed in the absence of treatment, but a number of untreated cats continued to enjoy an acceptable quality of life despite persistence of the disease, which extended locally but did not appear to disseminate to internal organs. Preliminary results of draft genome sequencing confirmed that the species is a member of the Mycobacterium simiae complex. Conclusions and relevance: Candidatus ‘M tarwinense’, a fastidious member of the M simiae complex, is capable of causing feline leprosy with a tendency to produce lesions on the head, particularly involving the eyes and periocular skin. The disease has an indolent clinical course and generally responds favourably to therapy despite lesions often containing large numbers of organisms. Detailed genomic analysis may yield clues as to the environmental niche and culture requirement of this elusive organism. Prospective treatment trials and/or drug susceptibility testing in specialised systems would further inform treatment recommendations.
Telemedical strategies for the improvement of secondary prevention in patients with cerebrovascular events—A systematic review and meta-analysis
Authors: Kraft Peter , Hillmann Steffi , Rücker Viktoria , Heuschmann Peter U 
Published: April 2017

Background Data from European countries consistently show that guideline-conform secondary prevention after stroke/transient ischemic attack is being realized in only 50–80% of patients. Use of telemedicine to support long-term secondary prevention has been effective in other cardiovascular diseases. Aims We reviewed current evidence for telemedical-supported strategies for the improvement of secondary prevention after stroke/transient ischemic attack. A systematic review was performed in accordance with the PRISMA statement searching MEDLINE, the Cochrane Central Register of Controlled Trials, and reference lists of articles published until 18 May 2016. Randomized controlled trials and observational studies were included if they analyzed the effect of a telemedical strategy for supporting secondary prevention after stroke/transient ischemic attack compared to usual care and reported primary (behavior according to guidelines, e.g., medication adherence) or surrogate outcomes (consequences of primary outcome, e.g., blood pressure). Summary of review The review included 13 of 100 identified studies involving 2672 patients. Telemedical support mainly comprised telephone interventions, predominantly done by nurses. Outcomes were heterogeneous: medication adherence did not differ in one randomized controlled trial (p = 0.089). Mortality was reported in one study and was significantly (p < 0.001) higher in patients non-participating in a web-based intervention. Four studies assessed blood pressure in a comparable way that allowed calculation of a meta-analysis. In that, telemedical intervention had a significant blood-pressure lowering effect compared to the control group (mean difference −6.14 (95% confidence interval −10.41, −1.87), p = 0.005). Conclusions Telemedical-supported secondary prevention in cerebrovascular diseases might be effective but larger trials with standardized interventions and outcome measures including clinical endpoints are needed.
Posterior Tibialis Tendon Rupture in a Closed Bimalleolar-Equivalent Ankle Fracture: Case Report
Authors: Wardell Richard M. , Hanselman Andrew E. , Daffner Scott D. , Santrock Robert D. 
Published: April 2017

Ankle fractures with an associated posterior tibialis tendon (PTT) rupture are rare injuries and have only been described in a number of case reports. These prior reports include patients that had an open fracture and/or an associated medial malleolar fracture component. In this unique case report, we present a patient that sustained a closed bimalleolar-equivalent ankle fracture/dislocation without medial malleolar involvement which was irreducible due to a PTT rupture and subsequent distal segment interposition in the tibiotalar joint. Identification of acute PTT rupture with associated ankle fracture is important because early repair is associated with significantly better functional outcomes compared with late repair. These injury patterns may easily be missed due to the limitations with physical examination and standard imaging often encountered during initial evaluation of routine ankle fractures. Therefore, physicians should maintain a high level of suspicion in the appropriate clinical setting in order to provide appropriate diagnosis and timely surgical intervention. Levels of Evidence: Descriptive, Level V: Single case report