bluuebunny/crossref_metadata_2025_split huggingface dataset:
An investigation on the use of snus and its association with respiratory and sleep-related symptoms: a cross-sectional population study
Authors: Gudnadóttir Arna Ýr , Ólafsdóttir Inga Sif , Middelveld Roelinde , Ekerljung Linda , Forsberg Bertil , Franklin Karl , Lindberg Eva , Janson Christer 
Published: May 2017

IntroductionStudies of the health effects of moist oral tobacco, snus, have produced inconsistent results. The main objective of this study is to examine the health effects of snus use on asthma, respiratory symptoms and sleep-related problems, a field that has not been investigated before.Methods and materialThis cross-sectional study was based on a postal questionnaire completed by 26 697 (59.3%) participants aged 16 to 75 years and living in Sweden. The questionnaire included questions on tobacco use, asthma, respiratory symptoms and sleeping problems. The association of snus use with asthma, respiratory symptoms and sleep-related symptoms was mainly tested in never-smokers (n=16 082).ResultsThe current use of snus in never-smokers was associated with an increased risk of asthma (OR 1.51 (95% CI 1.28 to 1.77)), asthmatic symptoms, chronic bronchitis and chronic rhinosinusitis. This association was not present among ex-snus users. Snoring was independently related to both the former and current use of snus ((OR 1.37 (95% CI 1.12 to 1.68)) and (OR 1.59 (95% CI 1.34 to 1.89), respectively)). A higher risk of difficulty inducing sleep was seen among snus users.ConclusionSnus use was associated with a higher prevalence of asthma, respiratory symptoms and snoring. Healthcare professionals should be aware of these possible adverse effects of snus use.
Simplified clinical algorithm for identifying patients eligible for immediate initiation of antiretroviral therapy for HIV (SLATE): protocol for a randomised evaluation
Authors: Rosen Sydney , Fox Matthew P , Larson Bruce A , Brennan Alana T , Maskew Mhairi , Tsikhutsu Isaac , Bii Margaret , Ehrenkranz Peter D , Venter WD Francois 
Published: May 2017

IntroductionAfrican countries are rapidly adopting guidelines to offer antiretroviral therapy (ART) to all HIV-infected individuals, regardless of CD4 count. For this policy of ‘treat all’ to succeed, millions of new patients must be initiated on ART as efficiently as possible. Studies have documented high losses of treatment-eligible patients from care before they receive their first dose of antiretrovirals (ARVs), due in part to a cumbersome, resource-intensive process for treatment initiation, requiring multiple clinic visits over a several-week period.Methods and analysisThe Simplified Algorithm for Treatment Eligibility (SLATE) study is an individually randomised evaluation of a simplified clinical algorithm for clinicians to reliably determine a patient’s eligibility for immediate ART initiation without waiting for laboratory results or additional clinic visits. SLATE will enrol and randomise (1:1) 960 adult, HIV-positive patients who present for HIV testing or care and are not yet on ART in South Africa and Kenya. Patients randomised to the standard arm will receive routine, standard of care ART initiation from clinic staff. Patients randomised to the intervention arm will be administered a symptom report, medical history, brief physical exam and readiness assessment. Patients who have positive (satisfactory) results for all four components of SLATE will be dispensed ARVs immediately, at the same clinic visit. Patients who have any negative results will be referred for further clinical investigation, counselling, tests or other services prior to being dispensed ARVs. After the initial visit, follow-up will be by passive medical record review. The primary outcomes will be ART initiation ≤28 days and retention in care 8 months after study enrolment.Ethics and disseminationEthics approval has been provided by the Boston University Institutional Review Board, the University of the Witwatersrand Human Research Ethics Committee (Medical) and the KEMRI Scientific and Ethics Review Unit. Results will be published in peer-reviewed journals and made widely available through presentations and briefing documents.Trial registrationNCT02891135
What are the current challenges of managing cancer pain and could digital technologies help?
Authors: Adam Rosalind , de Bruin Marijn , Burton Christopher David , Bond Christine M , Giatsi Clausen Maria , Murchie Peter 
Published: May 2017

ObjectivesPain remains a problem for people with cancer despite effective treatments being available. We aimed to explore current pain management strategies used by patients, caregivers and professionals and to investigate opportunities for digital technologies to enhance cancer pain management.MethodsA qualitative study comprising semistructured interviews and focus groups. Patients with cancer pain, their caregivers and health professionals from Northeast Scotland were recruited from a purposive sample of general practices. Professionals were recruited from regional networks.ResultsFifty one participants took part in 33 interviews (eight patients alone, six patient/caregiver dyads and 19 professionals) and two focus groups (12 professionals). Living with cancer was hard work for patients and caregivers and comparable to a ‘full-time job’. Patients had personal goals which involved controlling pain intensity and balancing this with analgesic use, side effects, overall symptom burden and social/physical activities.Digital technologies were embraced by most patients, and made living life with advanced cancer easier and richer (eg, video calls with family). Technology was underutilised for pain and symptom management. There were suggestions that technology could support self-monitoring and communicating problems to professionals, but patients and professionals were concerned about technological monitoring adding to the work of managing illness.ConclusionsCancer pain management takes place in the context of multiple, sometimes competing personal goals. It is possible that technology could be used to help patients share individual symptom experiences and goals, thus enhancing tailored care. The challenge is for digital solutions to add value without adding undue burden.
Application of phase correction to improve the characterization of photooxidation products of lignin using 7 Tesla Fourier-transform ion cyclotron resonance mass spectrometry
Authors: Qi Yulin , Luo Ruoji , Schrader Wolfgang , Volmer Dietrich A. 
Published: May 2017

Lignin is the second most abundant natural biopolymer and potentially a valuable alternative energy source for conventional fossil fuels. In this study, Fourier-transform ion cyclotron resonance-mass spectrometry (FTICR-MS) in conjunction with phase correction was applied to study photooxidation products of lignin using a 7 Tesla (T) mass spectrometer. The application of 7 T FTICR-MS has often been inadequate for the analysis of complex natural organic matter because of insufficient resolving power as compared with high-field FTICR, which led to incorrect assignments of elemental formulae and discontinuous plots in graphical and statistical analyses. Here, the application of phase correction to the FTICR mass spectra of lignin oxidation products greatly improved the spectral quality, and thus, readily permitted characterization of photooxidation processes of lignin compounds under simulated solar radiation conditions.
A new volcanic province: an inventory of subglacial volcanoes in West Antarctica
Authors: van Wyk de Vries Maximillian , Bingham Robert G. , Hein Andrew S. 
Published: May 2017

Abstract
The West Antarctic Ice Sheet overlies the West Antarctic Rift System about which, due to the comprehensive ice cover, we have only limited and sporadic knowledge of volcanic activity and its extent. Improving our understanding of subglacial volcanic activity across the province is important both for helping to constrain how volcanism and rifting may have influenced ice-sheet growth and decay over previous glacial cycles, and in light of concerns over whether enhanced geothermal heat fluxes and subglacial melting may contribute to instability of the West Antarctic Ice Sheet. Here, we use ice-sheet bed-elevation data to locate individual conical edifices protruding upwards into the ice across West Antarctica, and we propose that these edifices represent subglacial volcanoes. We used aeromagnetic, aerogravity, satellite imagery and databases of confirmed volcanoes to support this interpretation. The overall result presented here constitutes a first inventory of West Antarctica's subglacial volcanism. We identified 138 volcanoes, 91 of which have not previously been identified, and which are widely distributed throughout the deep basins of West Antarctica, but are especially concentrated and orientated along the >3000 km central axis of the West Antarctic Rift System.
Randomized, Placebo-Controlled Evaluation of Chlorobutanol, Potassium Carbonate, and Irrigation in Cerumen Removal
Authors: Caballero Miguel , Navarrete Pilar , Prades Eduard , Domenech Juan , Bernal-Sprekelsen Manuel 
Published: May 2017

ObjectivesWe evaluated the efficacy over a short period of time of two ceruminolytic products, Otocerum (chlorobutanol, phenol, turpentine essence, ethyl alcohol; Reig Jofre Laboratories, Barcelona, Spain) and Taponoto (potassium carbonate, ethyl alcohol, glycerol, thymol; Teofarma Iberica SA, Barcelona), in adult subjects with complete occlusion of the ear canal due to cerumen.MethodsNinety subjects with complete occlusion of the ear canal were enrolled in a randomized, subject- and observer-blinded, placebo-controlled clinical trial. The subjects were randomly assigned to one of three different treatments: Otocerum, Taponoto, or sterile saline solution (control group). The test medication was instilled into an occluded ear for 15 minutes. After this treatment, the subject's ear was irrigated with 50 mL of water. The main outcome was the proportion of tympanic membranes completely visualized after treatment.ResultsOne subject among the 90 enrolled did not accept a second ear irrigation and was excluded from the study. Neither Otocerum nor Taponoto was superior to saline solution. Cerumen occlusion resolved in 21 of 32 subjects treated with Otocerum (65.6%), 16 of 29 treated with Taponoto (55.2%), and 12 of 28 treated with saline solution (42.9%).ConclusionsThe use of Taponoto or Otocerum did not significantly improve the proportion of tympanic membranes that were completely visualized compared with saline solution when they were instilled 15 minutes before ear irrigation.
Biosimulation of Inflammation and Healing in Surgically Injured Vocal Folds
Authors: Li Nicole Y. K. , Vodovotz Yoram , Hebda Patricia A. , Verdolini Abbott Katherine 
Published: May 2017

ObjectivesThe pathogenesis of vocal fold scarring is complex and remains to be deciphered. The current study is part of research endeavors aimed at applying systems biology approaches to address the complex biological processes involved in the pathogenesis of vocal fold scarring and other lesions affecting the larynx.MethodsWe developed a computational agent-based model (ABM) to quantitatively characterize multiple cellular and molecular interactions involved in inflammation and healing in vocal fold mucosa after surgical trauma. The ABM was calibrated with empirical data on inflammatory mediators (eg, tumor necrosis factor) and extracellular matrix components (eg, hyaluronan) from published studies on surgical vocal fold injury in the rat population.ResultsThe simulation results reproduced and predicted trajectories seen in the empirical data from the animals. Moreover, the ABM studies suggested that hyaluronan fragments might be the clinical surrogate of tissue damage, a key variable that in these simulations both is enhanced by and further induces inflammation.ConclusionsA relatively simple ABM such as the one reported in this study can provide new understanding of laryngeal wound healing and generate working hypotheses for further wet-lab studies.
Normalization of Temporal Aspects of Swallowing Physiology after the McNeill Dysphagia Therapy Program
Authors: Lan Yue , Ohkubo Mai , Berretin-Felix Giédre , Carnaby-Mann Giselle D. , Crary Michael A. 
Published: May 2017

Objectives We examined the timing of physiological swallowing events in patients before and after completion of an exercise-based dysphagia intervention (McNeill Dysphagia Therapy Program; MDTP) and compared their performance to that of healthy volunteers. Methods Eight adults (mean age, 57.5 years) with chronic dysphagia (mean, 45 months) completed 3 weeks of the MDTP. Before and after the MDTP we measured lingual-palatal and pharyngeal manometric pressures during swallows of thin liquid, thick liquid, and pudding material in 5-mL volumes. Using the pressure peak of the pharyngoesophageal segment clearing wave as the anchor point, we measured the relative timing of pressure peaks from the anterior, middle, and posterior parts of the tongue and the manometric peaks from the base of the tongue, the hypopharynx, and the nadir of the pharyngoesophageal segment. We compared these results to identical measures obtained from 34 healthy adults (mean age, 44.0 years). Results The timing of physiological events before the MDTP was significantly slower than that of the group of healthy volunteers. The timing data from after the MDTP were not significantly different from those of the healthy group. The magnitude change was greatest for thin liquid. Conclusions Dysphagia therapy with the MDTP improves the timing of physiological events during swallowing. Temporal coordination of swallowing components after therapy approximates that of healthy adults, suggesting a normalization of swallow timing after the MDTP.
Intraluminal Stenting in the Management of Adhesional Intestinal Obstruction
Authors: Defriend D J , Klimack O E , Humphrey C S , Schraibman I G 
Published: May 2017

Intraluminal stenting of the small bowel has been advocated as a method of reducing the risk of recurrent adhesional obstruction in patients requiring adhesolysis. We reviewed the complications and efficacy of this technique in 25 patients undergoing surgery for relief of intestinal obstruction due to complex, extensive and dense adhesions. Five patients developed minor and three patients major complications. Three (13%) of 23 patients alive after mean follow-up of 4 years had had episodes of recurrent intestinal obstruction, but none had required reoperation. Intraluminal stenting remains of unproven efficacy. It may find a place as an adjunct to adhesolysis in patients requiring repeated operations for the relief of obstruction due to extensive and dense adhesions; but, in view of the high rate of complications, careful case selection will be necessary.
First Two Years of a Follow-up Breast Clinic Led by a Nurse Practitioner
Authors: Earnshaw J J , Stephenson Y 
Published: May 2017

After special training a nurse practitioner ran an independent clinic for follow-up patients with breast disease. All patients referred to a single surgical firm with breast cancer and most patients with benign disease who required follow-up were included. In the first 2 years of the service 382 clinic visits were recorded (median 5/clinic, range 1–12). The nurse practitioner reviewed 236 (62%) patients alone but involved the consultant surgeon in the remainder. No significant lesion was missed in these patients. The nurse-led clinic is popular with patients and, subject to careful supervision, offers an attractive option for follow-up of patients with breast disease.
The long-term course of mastalgia
Authors: Davies E L , Gateley C A , Miers M , Mansel R E 
Published: May 2017

Mastalgia is a common condition in women of reproductive years. We have assessed the long-term course in patients with severe mastalgia by distributing a postal questionnaire to 212 patients previously studied in 1983 who had attended the mastalgia clinic at the University Hospital of Wales, Cardiff. 175 patients (83%) responded, with an original diagnosis of cyclical mastalgia (CM) in 120 and non-cyclical mastalgia (NCM) in 55. The median age of onset of breast pain was 36 years (range 12–63 years). The average duration of pain was long (median 12 years), especially if it started in the second or third decade of life. Pain persisted in 68 (57%) of CM and 35 (64%) of NCM patients. In CM patients resolution was commonly associated with a ‘hormonal' event, notably the menopause; in NCM patients it more often seemed to be spontaneous. Severe mastalgia ran a chronic relapsing course often requiring repeated drug treatments.
Vitamin B status in patients with chronic fatigue syndrome
Authors: Heap L C , Peters T J , Wessely S 
Published: May 2017

Some patients with chronic fatigue syndrome say they benefit from taking vitamin supplements. We assessed functional status for the B vitamins pyridoxine, riboflavin and thiamine in 12 vitamin-untreated CFS patients and in 18 healthy controls matched for age and sex. Vitamin-dependent activities—aspartate aminotransferase (AST) for pyridoxine, glutathione reductase (GTR) for riboflavin, transketolase (TK) for thiamine—were measured in erythrocyte haemolysates before and after in-vitro addition of the relevant vitamin. For all three enzymes basal activity (U/g Hb) was lower in CFS patients than in controls: AST 2.84 (SD0.62) vs 4.61 (1.43), P<0.001; GTR 6.13 (1.89) vs 7.42 (1.25), P<0.04; TK 0.50 (0.13) vs 0.60 (0.07), P<0.04. This was also true of activated values: AST 4.91 (0.54) vs 7.89 (2.11), P<0.001; GTR 8.29 (1.60) vs 10.0 (1.80), P<0.001; TK0.56 (0.19) vs 0.66 (0.08), P<0.07. The activation ratios, however, did not differ between the groups. These data provide preliminary evidence of reduced functional B vitamin status, particularly of pyridoxine, in CFS patients.
Switching to statins: a challenge for primary care
Authors: Fisher N G , Marshall A J , Went J 
Published: May 2017

In 1997, doctors in England received official guidelines on the use of statins (3-hydroxy-3-methylglutaryl coenzyme A inhibitors) for primary and secondary prevention of coronary heart disease (CHD). Six months later we determined the status of patients who had been discharged from a specialist lipid clinic in 1989. 195 patients received questionnaires, with the consent of their general practitioners, regarding morbidity in the subsequent decade and present medication, and were asked to have their cholesterol checked. Analysis was confined to the 86 with a current cholesterol measurement. Of 61 patients who had been discharged on a regimen of dietary advice and/or medication for primary prevention of CHD, 8 had been changed to a statin and 6 had been started on one. According to the new guidelines, none of these qualified for treatment. Of 25 patients who had been discharged on drugs for secondary prevention, all qualified for a statin but only 14 were receiving one—in 6 cases without achieving the recommended reductions in cholesterol. In many of the patients reviewed, treatment had not been altered to conform with the new guidelines. If hyperlipidaemic patients are to benefit promptly from advances in treatment, one solution might be a central registry that arranged regular tests and reported back to general practitioners. However, since many patients at risk do not have very high cholesterol levels, a coordinated approach to CHD risk factors would be preferable.
Cost-Effectiveness of Atorvastatin for the Prevention of Coronary and Stroke Events: An Economic Analysis of the Anglo-Scandinavian Cardiac Outcomes Trial—Lipid-Lowering Arm (ASCOT-LLA)
Authors: Lindgren Peter , Buxton Martin , Kahan Thomas , Poulter Neil R. , Dahlöf Björn , Sever Peter S. , Wedel Hans , Jönsson Beng 
Published: May 2017

Background The aim of this study is to assess the cost-effectiveness of the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) where patients from seven countries with hypertension and no history of coronary heart disease (CHD) were randomized to receive 10 mg atorvastatin or placebo. Design Economic analysis of a randomized controlled trial. Methods Data on resource use were aggregated for all patients during the entire trial period (median 3.3 years) and multiplied with unit costs for Sweden and the UK. The total number of cardiovascular events and procedures avoided was used as the measure of effectiveness. Results Patients treated with atorvastatin had an additional net costs of 449 ϵ (4114 SEK) in Sweden and 414 ϵ (£260) in the UK, but fewer events per patient (0.097 compared to 0.132). The incremental cost-effectiveness ratios were 12673 ϵ (116119 SEK) and 11693 ϵ (£7349) per event avoided. Conclusion Based on comparisons with the WOSCOPS and 4S studies, atorvastatin at 10 mg to treat patients as in the ASCOT study, appears to be a cost-effective strategy. Eur J Cardiovasc Prev Rehabil 12:29-36 © 2005 The European Society of Cardiology
Inequity in Recording of Risk in a Local Population-Based Screening Programme for Cardiovascular Disease
Authors: Bartys Serena , Baker Deborah , Lewis Philip , Middleton Elizabeth 
Published: May 2017

Background Screening for cardiovascular disease is an important primary preventive measure, yet research has documented that not all population groups receive the same quality of preventive healthcare. Design Longitudinal analysis of cardiovascular disease risk factor recording. Methods Data were made available from a local population-based screening programme for cardiovascular disease (1989-1999), whereby residents aged 35-60 years were invited for screening every 5 years (n = 84 646). Data were recorded for major risk factors including blood pressure, cholesterol, body mass index, smoking status, and alcohol consumption. Completeness of risk factor recording was compared between groups in the screened population defined by gender, ethnicity (Caucasian/South Asian) and employment status (employed/unemployed). Results Recording of risk in the screened population was significantly less complete for women and South Asian participants over the duration of the screening programme, compared with men and Caucasian participants respectively. Conversely, recording of risk was significantly more complete for the unemployed compared with the employed participants. Conclusions These findings present evidence of a less systematic screening procedure for women and South Asians, whilst it seems that men, Caucasian participants and the unemployed were appropriately screened. Inequalities at the primary preventive level will likely influence outcome, because equitable identification of risk is important for the provision of successful treatment measures, and to reduce inequalities in morbidity and mortality due to cardiovascular disease.