bluuebunny/crossref_metadata_2025_split huggingface dataset:
Synergistic Utility of Brain Natriuretic Peptide and Left Ventricular Global Longitudinal Strain in Asymptomatic Patients With Significant Primary Mitral Regurgitation and Preserved Systolic Function Undergoing Mitral Valve Surgery
Authors: Alashi Alaa , Mentias Amgad , Patel Krishna , Gillinov A. Marc , Sabik Joseph F. , Popović Zoran B. , Mihaljevic Tomislav , Suri Rakesh M. , Rodriguez L. Leonardo , Svensson Lars G. , Griffin Brian P. , Desai Milind Y. 
Published: June 2016

Background—
In asymptomatic patients with ≥3+ mitral regurgitation and preserved left ventricular (LV) ejection fraction who underwent mitral valve surgery, we sought to discover whether baseline LV global longitudinal strain (LV-GLS) and brain natriuretic peptide provided incremental prognostic utility.

Methods and Results—

Four hundred and forty-eight asymptomatic patients (61±12 years and 69% men) with ≥3+ primary mitral regurgitation and preserved left ventricular ejection fraction, who underwent mitral valve surgery (92% repair) at our center between 2005 and 2008, were studied. Baseline clinical and echocardiographic data (including LV-GLS using Velocity Vector Imaging, Siemens, PA) were recorded. The Society of Thoracic Surgeons score was calculated. The primary outcome was death. Mean Society of Thoracic Surgeons score, left ventricular ejection fraction, mitral effective regurgitant orifice, indexed LV end-diastolic volume, and right ventricular systolic pressure were 4±1%, 62±3%, 0.55±0.2 cm
2
, 58±13 cc/m
2
, and 37±15 mm Hg, respectively. Forty-five percent of patients had flail. Median log-transformed BNP and LV-GLS were 4.04 (absolute brain natriuretic peptide: 60 pg/dL) and −20.7%. At 7.7±2 years, death occurred in 41 patients (9%; 0% at 30 days). On Cox analysis, a higher Society of Thoracic Surgeons score (hazard ratio 1.55), higher baseline right ventricular systolic pressure (hazard ratio 1.11), more abnormal LV-GLS (hazard ratio 1.17), and higher median log-transformed BNP (hazard ratio 2.26) were associated with worse longer-term survival (all
P
<0.01). Addition of LV-GLS and median log-transformed BNP to a clinical model (Society of Thoracic Surgeons score and baseline right ventricular systolic pressure) provided incremental prognostic utility (χ
2
for longer-term mortality increased from 31–47 to 61;
P
<0.001).

Conclusions—
In asymptomatic patients with significant primary mitral regurgitation and preserved left ventricular ejection fraction who underwent mitral valve surgery, brain natriuretic peptide and LV-GLS provided synergistic risk stratification, independent of established factors.
The entry-level occupational therapy clinical doctorate: The next education wave of change in Canada?
Authors: Brown Ted , Crabtree Jeffrey L. , Wells Joe , Mu Keli 
Published: June 2016

Background. Currently, Canada and the United States are the only two countries that mandate entry to the occupational therapy profession at the master’s level. There was a recommendation considered by the American Occupational Therapy Association that by 2025 all education programs would move to the clinical doctorate level. In August 2015, the Accreditation Council for Occupational Therapy Education made the formal decision that for now, the entry-level qualification for occupational therapists in the United States will remain at both the master’s and clinical doctorate levels. Purpose. This article presents an overview of the types of doctorates available, the pros and cons of moving to the clinical doctorate, and some potential questions that will need to be considered. Key issues. Is the next step in the educational progression of occupational therapy in Canada the entry-level clinical doctorate? What are the potential implications for the profession, our clients, and funders? Implications. Further discourse and investigation of this issue is needed.
Cultural adaptations of the Strengthening Families Programme 10-14 in the US Pacific Northwest: A qualitative evaluation
Authors: Roulette Jennifer W , Hill Laura G , Diversi Marcelo , Overath Renee 
Published: June 2016

Objective: Most reports of adaptations to evidence-based prevention programmes for delivery to specific cultural groups describe formal adaptation procedures. In this paper, we report on how practitioners identify and manage issues of perceived cultural mismatch when delivering a scripted, evidence-based intervention. Design: We used grounded systems theory methodology to plan, conduct and interpret facilitator narratives. Method: Interviews and focus groups with 16 facilitators who delivered the Strengthening Families Programme 10-14, a widely disseminated intervention targeting families with young adolescents, to Latino and American Indian families in the Pacific Northwest region of the USA. Setting: Interviews and focus groups were conducted at programme facilitators’ worksites or other location of their choice. Results: Facilitators described important cultural adaptations related to programme format and timing, family composition and dynamics, acculturation challenges and language. Nearly all adaptations reported were consistent with the programme’s stated goals and were designed to retain families or clarify programme concepts. Conclusion: We recommend training practitioners in the importance and understanding of programme logic models and in culturally sensitive approaches to programme adaptation, including an awareness of differences between assimilation and acculturation.
Exercise intensity dependent relevance of protective textile properties for human thermo-physiology
Authors: Fontana Piero , Saiani Fabio , Grütter Marc , Croset Jean-Philippe , Capt André , Camenzind Martin , Morrissey Matthew , Rossi René M , Annaheim Simon 
Published: June 2016

During firefighting, thermoregulation is challenged due to a combination of harsh environmental conditions, high metabolic rates and personal protective clothing (PPC). Consequently, investigations of thermoregulation in firefighters should not only consider climate and exercise intensity, but technical properties of textiles too. Therefore, laboratory textile performance simulations may provide additional insights into textile-dependent thermoregulatory responses to exercise. In order to investigate the thermo-physiological relevance of textile properties and to test how different garments affect thermoregulation at different exercise intensities, we analyzed the results of a standard laboratory test and human subject trials by relating functional properties of textiles to thermo-physiological responses. Ten professional, healthy, male firefighters (age: 43 ± 6 y, weight: 84.3 ± 10.3kg, height: 1.79 ± 0.05m) performed low and moderate intensity exercise wearing garments previously evaluated with a sweating torso system to characterize thermal and evaporative properties. Functional properties of PPC and the control garment differed markedly. Consequently, skin temperature was higher using PPC at both exercise intensities (low: 36.27 ± 0.32 versus 36.75 ± 0.15℃, P < 0.05; moderate: 36.53 ± 0.34 versus 37.18 ± 0.23℃, P < 0.001), while core body temperature was only higher for PPC at moderate (37.54 ± 0.24 versus 37.83 ± 0.27℃, P < 0.05), but not low-intensity exercise (37.26 ± 0.21 versus 37.21 ± 0.19, P = 0.685). Differences in thermal and evaporative properties between textiles are reflected in thermo-physiological responses during human subject trials. However, an appropriate exercise intensity has to be chosen in order to challenge textile performance during exercise tests.
Medical traditions and chronic disease in Ethiopia: a story of wax and gold?
Authors: Levene Dan , Phillips David IW , Alemu Shitaye 
Published: June 2016

Effective medical care for non-communicable diseases (NCD) remains lamentably poor in Ethiopia and many low-income countries. Consequently, where modern medicine does not reach or is rejected, traditional treatments prevail. These are fragmented and esoteric by nature, and their understanding of illness is so fundamentally different that confusion proliferates when attempts are made to introduce modern medical care. Ethiopia is host to a variety of longstanding medical belief systems that coexist and function together, where modern medicine is often viewed as just another choice. This multiplicity of approaches to illness is accompanied by the Ethiopian custom of weaving layers of meaning, often contradictory, into speech and conversation – sometimes referred to as ‘wax and gold’, the ‘wax’ being the literal and the ‘gold’ the deeper, even hidden, meaning or significance. We argue that engagement with traditional belief systems and understanding these subtleties of meaning could assist in more effective NCD care.
Is West Nile Virus infection associated with myasthenia gravis?
Authors: Altay Fatma Aybala , Güven Hayat , Şentürk Gönül Çiçek , Ferik Sevgi , Şencan İrfan , Çomoğlu Selçuk 
Published: June 2016

Background Myasthenia Gravis (MG) is an autoimmune disease which is characterised by disruption of signal transmission at neuromuscular junction. We aimed to search about a newly reported association between MG and West Nile Virus (WNV) infection. Methods We searched WNV IgG by ELISA in serum samples of 50 available MG patients and 38 controls. Results None of the samples gave positive results for past WNV infection. Conclusion No evidence of past WNV infection was found in our study population of MG patients. This may have been because MG has been showed to be related with neuroinvasive WNV, which none of our study subjects seem to have had based on their stories. New multicentre studies focusing on immunological mechanisms and held with larger groups or especially neuroinvasive disease patients can cast light onto the answer of this question.
Patterns of the superficial veins of the cubital fossa: A meta-analysis
Authors: Yammine Kaissar , Erić Mirela 
Published: June 2016

Background The aim of this systematic review is to quantitatively synthesize evidence on the prevalence of superficial vein patterns in the cubital region. Method A systematic literature search was conducted through a number of electronic databases. We identified 27 studies, including 9924 arms, which met the inclusion criteria. Results Meta-analysis showed that “N” shaped arrangement type was the commonest pattern (≈44–60%) followed by “M” shaped arrangement (≈20–25%). The prevalence of “M” type and “M”-like type was significantly higher in males, whereas females showed a significant predominance of “I” or “O” type. No significant differences in various pattern types were found for laterality. The frequency of “M” type is significantly lesser in Indian and Japanese populations, but they have significantly higher frequency of “N” type. In Malay population, “I” or “O” type was significantly higher, while the brachial CV was poorly developed or missing significantly in Indian population. Conclusion This evidence-based clinical anatomy review contributes to our anatomical knowledge regarding the true prevalence of pattern types of the superficial veins in cubital region in humans and, subsequently, might help in performing safer venous access and more direct approaches to these veins, especially under emergency conditions.
Hand rejuvenation: Combining dorsal veins foam sclerotherapy and calcium hydroxylapatite filler injections
Authors: Lim Adrian , Mulcahy Anthea 
Published: June 2016

Background The hands are an important aesthetic feature that can reveal aging through surface pigmentary changes, loss of skin thickness and ectatic dorsal hand veins. Techniques addressing these changes already exists but are not routinely combined for optimum results. Objective The combination techniques of dorsal hand veins sclerotherapy and sub-dermal filler injections are described. Methods The dorsal hand veins are treated with sclerotherapy (0.5% Sodium tetradecyl sulphate). This is then followed by subdermal injection of 0.75 mL–1.5 mL calcium hydroxylapatite (Radiesse, Merz) per hand, in conjunction with tumescent anaesthetic. The dorsal hands should be gently massaged for 2 min (per hand), twice a day for two days. If necessary, the procedure can be repeated after one month for further improvement. Results The techniques of sclerotherapy and filler injections complement each other well in hand rejuvenation. Calcium hydroxylapatite is safe and effective for hands and associated with high patient satisfaction. In suitable patients, the reduction in ectatic veins from sclerotherapy results in a longstanding improvement that complements volume restoration with fillers. Conclusion Aging hands with ectatic dorsal hand veins and skin atrophy/wrinkling not fully responsive to filler correction alone can further improve with the combination of sclerotherapy and filler injections.
The Effectiveness of Vertical Perspective and Pursuit Eye Movements for Disambiguating Motion Parallax Transformations
Authors: Rogers Brian 
Published: June 2016

In the kinetic depth effect, the direction of the perceived depth and the direction of apparent rotation of a 3-D structure are linked, and typically ambiguous, whereas depth from motion parallax during both observer- and object-movement is stable and unambiguous. Rogers and Rogers demonstrated that the vertical perspective transformations play an important role in disambiguating the direction of the perceived depth in parallax-defined surfaces but more recently Nawrot et al. have proposed that pursuit eye movements provide the crucial disambiguating information. Theoretical considerations suggest that pursuit eye movements could not, in principle, provide the necessary information because 3-D objects as surfaces may rotate during observer- or object-movement. The empirical evidence presented here shows that vertical perspective transformations are sufficient for the unambiguous perception of parallax depth whereas pursuit eye movements are not necessary and may not even be sufficient.
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing-like attacks in a pediatric patient found to have a pontine capillary telangiectasia and developmental venous anomaly: A case report exploring the root of the problem
Authors: Liapounova Natalia A , VanderPluym Juliana H , Bhargava Ravi , Kolski Hanna H 
Published: June 2016

Introduction Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT)-like attacks are rarely reported in the pediatric population and may remain undiagnosed and under-investigated as a result. Case presentation We present a case of a 15–year-old male with intermittent, episodic, right-sided brief headaches most in keeping with SUNCT, initially diagnosed as paroxysmal hemicrania, but with no response to indomethacin. The pain was likewise not responsive to typical migraine treatments or steroids. Management and outcome Contrast-enhanced magnetic resonance imaging demonstrated a right pontine capillary telangiectasia with an associated developmental venous anomaly that was adjacent to the root of the right trigeminal nerve. Differential diagnosis included first division trigeminal neuralgia with autonomic features. The patient’s pain was partially alleviated by oxygen administration and responded well to carbamazepine; he remained pain free on carbamazepine a year later. Conclusion This case highlights the diagnostic dilemma of differentiating SUNCT from trigeminal neuralgia with autonomic features, both of which are rare diagnoses in pediatric patients, and the importance of appropriate neuroimaging to rule out secondary causes in patients presenting with trigeminal autonomic cephalalgias, recognizing that abnormalities identified on neuroimaging, such as vessels adjacent to the trigeminal nerve, may not be causative findings.
Comparison Between Single- and Double-Bundle Anterior Cruciate Ligament Reconstruction With 6- to 8-Stranded Hamstring Autograft
Authors: Liu Yulei , Cui Guoqing , Yan Hui , Yang Yuping , Ao Yingfang 
Published: June 2016

Background: Whether double-bundle (DB) anterior cruciate ligament (ACL) reconstruction with 6- to 8-stranded hamstring autograft (HG) is better than single-bundle (SB) ACL reconstruction remains debatable, as long-term follow-up data are lacking. Purpose: To prospectively investigate and compare the long-term results of DB and SB ACL reconstruction with a 6- to 8-stranded HG. Study Design: Randomized controlled clinical trial; Level of evidence: 1. Methods: A total of 80 patients with chronic ACL rupture were randomized to SB or DB ACL reconstruction with a 6- to 8-stranded HG. In the SB group, both the semitendinosus tendon (ST) and the gracilis tendon (GT) were prepared in 3 or 4 strands, with a total of 6 to 8 strands. In the DB group, the ST was prepared in 3 or 4 strands used for the anteromedial bundle, and the GT was prepared in the same manner for the posterolateral bundle. Each graft was fixed with an EndoButton, a bioabsorbable interference screw, and a staple. Outcome assessment was performed by a blinded independent observer using International Knee Documentation Committee (IKDC), Tegner, and Lysholm scores, as well as range of motion (ROM), Lachman test, pivot-shift test, KT-2000 arthrometer side-to-side difference, and return-to-sport data. Results: A total of 68 patients (DB group, 34; SB group, 34) were observed for a mean of 80 months (range, 74-86 months). There were 2 traumatic instability failures and two 5° extension restrictions in the DB group, while no failures or 5° extension restrictions were observed in the SB group. The mean Lysholm, Tegner, and IKDC scores improved significantly in both groups compared with preoperation scores ( P < .05). No patient had a positive Lachman test result. No significant differences were found between groups in functional scores, incidence of pivot shift, ROM, Lachman test, KT-2000 arthrometer anterior laxity, or time and level of return to sport. Conclusion: Both SB and DB ACL reconstruction with 6- to 8-stranded HG showed satisfactory results in subjective scores and anteroposterior and rotational stability over a nearly 7-year follow-up; neither technique was superior.
Comparative Effectiveness of Two Walking Interventions on Participation, Step Counts, and Health
Authors: Smith-McLallen Aaron , Heller Debbie , Vernisi Kristin , Gulick Diana , Cruz Samantha , Snyder Richard L. 
Published: June 2016

Purpose: To (1) compare the effects of two worksite-based walking interventions on employee participation rates; (2) compare average daily step counts between conditions, and; (3) examine the effects of increases in average daily step counts on biometric and psychologic outcomes. Design: We conducted a cluster-randomized trial in which six employer groups were randomly selected and randomly assigned to condition. Setting: Four manufacturing worksites and two office-based worksite served as the setting. Subjects: A total of 474 employees from six employer groups were included. Intervention: A standard walking program was compared to an enhanced program that included incentives, feedback, competitive challenges, and monthly wellness workshops. Measures: Walking was measured by self-reported daily step counts. Survey measures and biometric screenings were administered at baseline and 3, 6, and 9 months after baseline. Analysis: Analysis used linear mixed models with repeated measures. Results: During 9 months, participants in the enhanced condition averaged 726 more steps per day compared with those in the standard condition (p < .001). A 1000-step increase in average daily steps was associated with significant weight loss for both men (−3.8 lbs.) and women (−2.1 lbs.), and reductions in body mass index (−0.41 men, −0.31 women). Higher step counts were also associated with improvements in mood, having more energy, and higher ratings of overall health. Conclusions: An enhanced walking program significantly increases participation rates and daily step counts, which were associated with weight loss and reductions in body mass index.
Supporting parents in late modernity through parent education: A mixed-methods study in Hong Kong
Authors: To Siu-ming , So Yuk-yan , Tsoi Kcon-wah , Iu Kan Siu-mee , Chan Ting-sam 
Published: June 2016

Summary While the increasing awareness of risk in late modernity has resulted in the proliferation and complication of parental roles and choices, few attempts have been made to explore how parent education can empower parents to reconstruct parenthood and transform parental lives. Based on the results of a mixed-methods study conducted in Hong Kong, this article discusses the possible outcomes and experiences of a parent education program that aimed to facilitate parents’ holistic growth in dealing with the prevailing culture of intensive parenting. The program was composed of 30 h of seminars and workshops. The participants included 387 Hong Kong Chinese parents recruited from seven primary schools and 27 nursery schools. A pretest–posttest assessment survey and postintervention focus groups were adopted for the evaluation methods. Findings The quantitative results showed that the participants experienced an enhancement in confidence, understanding, and trust in parenting. The qualitative findings indicated that the program helped the participants reflect upon the meaning of parenthood, underline the gains and accomplishments of parenting, and adjust parental expectations. They could also foster parent–child relationships in accordance with their children’s developmental needs, uniqueness, and emotions. As a result, these parents were more ready to face the challenges of the anxious parenting culture. Applications The findings support the reconceptualization of parent education as a reflexive practice. Such practice can unleash parents’ capacity to construct knowledge from their lived experiences and reconstitute their reflexive and emotional selves to negotiate life choices among the diversity of options in childrearing.
Combination activity of neuraminidase inhibitor oseltamivir and α-tocopherol in influenza virus A (H3N2) infection in mice
Authors: Galabov Angel S , Mileva Milka , Simeonova Lora , Gegova Galina 
Published: June 2016

Background Influenza is a highly contagious viral infection of the respiratory system. To attack two processes involved in flu pathogenesis—viral replication in the infected body and oxidative damages, we studied the combination effect of neuraminidase inhibitor oseltamivir and antioxidant α-tocopherol in experimental model of influenza. Methods After inoculation of albino mice with 10 MLD50 (50% mouse lethal dose) of influenza virus A/Aichi/2/68 (H3N2), oseltamivir was applied orally at three doses, 2.5 mg/kg, 1.25 mg/kg, and 0.625 mg/kg, for five days post infection. α-Tocopherol (120 mg/kg, in sunflower oil) was administered intraperitoneally. Three schemes of α-tocopherol five-day course were tested: onset five or two days before infection, or on the virus inoculation day. Results Strongly dose-dependent augmented antiviral effect of the combination α-tocopherol and 0.625 mg/kg oseltamivir was demonstrated when α-tocopherol was administered simultaneously with oseltamivir: a pronounced decrease in mortality rate (a 78% protection), and a lengthening of mean survival time by 3.2–4 days. Lung parameters showed a substantial decrease in infectious virus content (Δ logs = 3.8/4.1) and a marked diminishment of lung index and pathology. Combination α-tocopherol with 1.25 mg/kg oseltamivir manifested a marked protective effect, but the effect on lung parameters was less. The combination effect of α-tocopherol with 2.5 mg/kg oseltamivir did not surpass the monotherapeutic effect of oseltamivir. When α-tocopherol was applied in courses starting five or two days before infection, its combination with oseltamivir was ineffective. Conclusions Evidently, α-tocopherol could be considered as prospective component of influenza therapy in combination with oseltamivir.