bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intrecci linguistici. Lingue e dialetti italiani tra i giovani italoamericani nella grande area di New York
Authors: Serra Rosemary 
Published: June 2017

Da quando furono introdotti dai primi immigrati che si insediarono sul suolo americano, la lingua e i dialetti italiani negli Stati Uniti si sono continuamente trasformati. Sui comportamenti linguistici degli emigrati italiani all’estero incisero fattori di natura sociale, culturale, geografica ed economica, nonché le diverse ondate migratorie. In particolare, nelle comunità italoamericane, la lingua e i dialetti italiani andarono a comporre un continuum linguistico che si accompagnò all’inglese secondo combinazioni diverse e con un variegato ventaglio di forme. Questo saggio si propone di ripercorrere le tappe che hanno segnato questi cambiamenti, analizzando alcune ricerche svolte a partire dagli anni Ottanta nonché i dati della condizione in cui versa attualmente la lingua italiana negli Stati Uniti. Vengono, inoltre, presentati i risultati legati all’uso della lingua e dei dialetti, frutto di una survey condotta nel 2013 su un campione di giovani italoamericani residenti nella grande area di New York. Nonostante le differenze tra le diverse generazioni d’immigrazione dei giovani partecipanti allo studio, emerge come vi sia, soprattutto nelle nuove generazioni di italoamericani, una tendenza alla ripresa di interesse verso la lingua delle origini e i dialetti, espressa anche attraverso la volontà di trasmetterla ai propri figli.
Does diathermy smoke contaminate processed salvaged blood in cardiac surgery?
Authors: Hulme Katherine R. , van den Burg Jon 
Published: June 2017

Introduction: A cell salvage device is used in cardiac surgery with the aim of reducing allogeneic blood transfusion. Suction of blood from the operating field used for the device is often accompanied by diathermy smoke. There is limited published research to know if this blood is then contaminated with clinically significant levels of harmful chemicals from this smoke. Postoperative cardiac surgery patients are already physiologically vulnerable, making the optimization of salvaged blood worth considering. Methods: Ten patients who had cardiac surgery using a cell salvage device from a single institution had samples taken from the processed blood just prior to transfusion. Samples were tested for carbon monoxide (CO), cyanide and benzene. Results were compared to preoperative co-oximetry results and normal adult laboratory reference ranges. Demographic data about the patients was collected, including the type of operation, gender, age, body mass index, smoking status and amount of salvaged blood collected and processed. Results: Primary surgery was coronary artery bypass grafting (CABG) in three patients, mitral valve repair or replacement in three patients and one each of aortic valve replacement (AVR)/CABG, AVR/plication of the aorta, CABG/external wrapping of the aorta and valve-sparing root replacement. None were smokers. Neither the blood CO level prior to surgery nor in the processed salvaged blood was above the normal limit of 2% for non-smokers. There was no processed blood benzene found. Cyanide levels in the processed blood ranged from 1.8 to 44.1 μmol/l (where <8 μmol/l is considered within the normal adult laboratory limit). Conclusion: Despite the obvious limitations of the current study, it shows that cyanide levels can be found many times the normal level in processed salvaged blood. Whilst the total dose of cyanide is small, the potential impact may be clinically significant due to cyanide’s effect on mitochondrial metabolism in the heart and brain.
Myocardial infarction risk and antipsychotics use revisited: a meta-analysis of 10 observational studies
Authors: Huang Kai-Lin , Fang Ching-Ju , Hsu Chien-Chi , Wu Shu-I , Juang Jimmy JM , Stewart Robert 
Published: June 2017

Objective: Associations between antipsychotic agent (AP) use and myocardial infarction (MI) risk have been inconsistent and remain controversial. We therefore conducted a meta-analysis of observational studies to address this knowledge gap. Method: Detailed electronic database searches were performed to identify reports of observational studies that evaluated the association between AP use and the risk of MI. Pooled odds ratios (ORs) were calculated using random or fixed-effects models. Results: In total, four case-control studies, two case-crossover studies, one case-case time control study, three cohort studies, and one self-controlled case series were included. The pooled OR (95% confidence interval (CI)) between any AP use and MI risk was 1.55 (1.33–1.79) compared with non-use: 1.39 (1.06–1.82) for atypical AP use and 1.57 (1.29–1.91) for typical AP use. Subgroup analyses indicated that male gender, schizophrenia diagnosis, and AP exposure periods ≤60 days were associated with higher risk of MI. Conclusion: Current evidence, based on 10 observational studies, suggested that AP use might be a potential risk factor of MI. However, we cannot conclude at this time due to significant heterogeneity among studies. We suggest that, instead of not using APs in fear of MI risk, careful cardiovascular monitoring before and during AP treatment in high-risk patients is needed. Additional high-quality prospective studies are required to evaluate the association between APs and the risk of MI.
Accuracy of [18Fluorine]-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography-Computed Tomography Response Assessment Following (Chemo)radiotherapy for Locally Advanced Laryngeal/Hypopharyngeal Carcinoma
Authors: Slevin Finbar , Ermiş Ekin , Vaidyanathan Sriram , Sen Mehmet , Scarsbrook Andrew F , Prestwich Robin JD 
Published: June 2017

Introduction: The accuracy of response assessment positron emission tomography (PET)-computed tomography (CT) following radiotherapy with or without chemotherapy for laryngeal/hypopharyngeal squamous cell carcinoma is uncertain. Methods: In all, 35 patients with laryngeal or hypopharyngeal squamous cell carcinoma who were treated between 2009 and 2014 with (chemo)radiotherapy were identified. The accuracy of response assessment PET-CT was made by correlation with clinical follow-up and pathological findings. Results: Of the 35 patients, 20 (57%) had an overall complete metabolic response. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for response assessment [18Fluorine]-fluoro-2-deoxy-d-glucose (FDG) PET-CT for primary and nodal sites, respectively, were 100%, 73%, 46%, and 100% and 83%, 95%, 83%, and 95%. Conclusions: Response assessment FDG PET-CT following (chemo)radiotherapy for laryngeal and hypopharyngeal carcinomas has a high NPV for both primary site and lymph nodes and can be used to guide treatment decisions. The PPV of residual FDG uptake at the primary tumour site is limited and requires examination and biopsy confirmation.
An evaluation of the relationship between traumatic injuries and the development of contrast-associated acute kidney injury
Authors: Bethea Audis , Keslar Lauren , Silhy Raquel , Samanta Damayanti , Chumbe Julton T 
Published: June 2017

Background Intravenous contrast media-enhanced computed tomography is vitally important in the early identification of traumatic injuries. Contrast media, however, has the propensity to promote nephrotoxicity. Age, injury severity score, renal dysfunction, and hypotension upon presentation are factors associated with contrast-associated acute kidney injury in current trauma literature. This study endeavors to expand upon these findings and evaluate the relationship between traumatic injuries and contrast-associated acute kidney injury. Methods This is a retrospective cohort study conducted at a Level 1 Trauma Center between January 2005 and August 2013. Patients identified by the institution’s Trauma Registry were divided into two groups: contrast-associated acute kidney injury-positive and negative based on previously published definitions. Results The analysis consisted of 831 intensive care patients; 161 contrast-associated acute kidney injury-positive and 670 contrast-associated acute kidney injury-negative. Logistic regression using significant findings from univariate comparisons between the study groups indicated that genitourinary (OR = 2.859, 95% CI 1.587–5.152, p = 0.000), arterial injuries (OR = 2.464, 95% CI 1.294–4.690, p = 0.006), and concomitant exposure to medications that are potentially nephrotoxic or alter renal hemodynamics (OR = 1.483, 95% CI 1.018–2.158, p = 0.040) were independent risk factors for contrast-associated acute kidney injury. Increasing revised trauma score (OR = 0.874, 95% CI 0.790–0.966, p = 0.009) and fluid administration prior to contrast (OR = 0.445, 95% CI 0.301–0.656, p = 0.000) were independently associated with decreased risk of contrast-associated acute kidney injury. Conclusion The risk of contrast-associated acute kidney injury increases with escalating injury severity. Unless contraindicated, fluids should be administered prior to contrast, and concomitant exposure to agents that may increase the potential for contrast-associated acute kidney injury should be limited. These practices are increasingly important in patients presenting with arterial or genitourinary trauma.
Impact of the implantable cardioverter defibrillator on confidence to undertake physical activity in inherited heart disease: A cross-sectional study
Authors: Sweeting Joanna , Ball Kylie , McGaughran Julie , Atherton John , Semsarian Christopher , Ingles Jodie 
Published: June 2017

Background: Physical activity is associated with improved quality of life. Patients with an implantable cardioverter defibrillator (ICD) face unique clinical and psychological challenges. Factors such as fear of ICD shock may negatively impact on physical activity, while a sense of protection gained from the ICD may instil confidence to be active. Aim: We aimed to examine the impact of an ICD on physical activity levels and factors associated with amount of activity. Methods: Two cross-sectional studies were conducted. Accelerometer data (seven-day) was collected in March–November 2015 for 63 consecutively recruited hypertrophic cardiomyopathy patients, with or without an ICD, aged ⩾18 years. A survey study was conducted in July–August 2016 of 155 individuals aged ⩾18 years with an inherited heart disease and an ICD in situ. Results: Based on the International Physical Activity Questionnaire, mean leisure time physical activity was 239 ± 300 min/week with 51% meeting physical activity guidelines. Accelerometry showed that mean moderate–vigorous physical activity was the same for patients with and without an ICD (254 ± 139 min/week versus 300 ± 150 min/week, p=0.23). Nearly half of survey participants ( n=73) said their device made them more confident to exercise. Being anxious about ICD shocks was the only factor associated with not meeting physical activity guidelines. Conclusions: Patients with inherited heart disease adjust differently to their ICD device, and for many it has no impact on physical activity. Discussion regarding the appropriate level of physical activity and potential barriers will ensure best possible outcomes in this unique patient group.
Perceived social support and self-care in patients hospitalized with heart failure
Authors: Chamberlain Lyne 
Published: June 2017

Background: Rehospitalization of heart failure patients is often considered the result of inadequate self-care yet only one study documents superior outcomes with better self-care. Aims: If inadequate self-care is related to hospitalizations, then hospitalized heart failure patients should have lower self-care skills than non-hospitalized patients. The purpose of this study was to evaluate perceived social support and self-care characteristics of patients hospitalized with an exacerbation of heart failure. The self-care of heart failure index (SCHFI) and medical outcomes study of social support (MOS-SS) were the key instruments used in the research. Methods and results: This descriptive study used t tests and multiple regression to analyze the data. Results were compared with non-hospitalized heart failure patients in another study. Perceived social support ( t=−4.007, df=211, P<0.001) and self-care maintenance ( t=−3.343, df=220, P<0.002) scores were lower in the hospitalized participants than the comparison group. Self-care confidence was the only variable significantly related to perceived social support ( β=0.210, t=2.210, P<0.30). Conclusions: This study supports the premise that heart failure rehospitalizations are related to inadequate self-care.
Budd–Chiari syndrome with upper gastrointestinal hemorrhage: Characteristic and long-term outcomes of endovascular treatment
Authors: Zhou Peng-Li , Wu Gang , Han Xin-Wei , Yan Lei , Zhang Wen-Guang 
Published: June 2017

Purpose To identify the characteristics and evaluate the long-term outcomes of endovascular treatment of Budd–Chiari syndrome with upper gastrointestinal hemorrhage. Methods Forty-seven consecutive Budd–Chiari syndrome patients with upper gastrointestinal hemorrhage were referred for the treatment with percutaneous transluminal balloon angioplasty, and subsequently underwent follow-up. Data were retrospectively collected and follow-up observations were performed at 1, 2, 2–5, and 5–8 years postoperatively. Results Cirrhosis was presented in 16 patients, and splenoportography reviewed obvious varices in 18 patients. Percutaneous transluminal balloon angioplasty was technically successful in all patients. Major procedure-related complications occurred in 3 of the 47 patients (6.38%). The cumulative 1, 2, 2–5, and 5–8 year primary patency rates were 100% (46/46), 93.2% (41/44), 90.9% (40/44), and 86.4% (19/22), respectively. The cumulative 1, 2, 2–5, and 5–8 year secondary patency rates were 100% (47/47), 100% (44/44), 100% (44/44), and 95.5% (21/22), respectively. Mean and median duration of primary patency was 65.17 ± 3.78 and 69.0 ± 5.69 months, respectively. No upper gastrointestinal hemorrhage recurred during follow-ups. The mean survival time was 66.97 ± 3.61 months and the median survival time was 69.0 ± 4.10 months. Conclusion PTBA was an effective treatment that can prevent recurrence of the life-threatening complications and ensured long-term satisfactory clinical outcomes for Budd–Chiari syndrome patients with upper gastrointestinal hemorrhage. Percutaneous transhepatic variceal embolization was not recommended for all Budd–Chiari syndrome patients with upper gastrointestinal hemorrhage.
Benefits of stroke treatment delivered using a mobile stroke unit trial
Authors: Yamal Jose-Miguel , Rajan Suja S , Parker Stephanie A , Jacob Asha P , Gonzalez Michael O , Gonzales Nicole R , Bowry Ritvij , Barreto Andrew D , Wu Tzu-Ching , Lairson David R , Persse David , Tilley Barbara C , Chiu David , Suarez Jose I , Jones William J , Alexandrov Andrei , Grotta James C 
Published: June 2017

Rationale Mobile stroke units speed treatment for acute ischemic stroke, thereby possibly improving outcomes. Aim To compare mobile stroke unit and standard management clinical outcomes, healthcare utilization, and cost-effectiveness in tissue plasminogen activator-eligible acute ischemic stroke patients calling 911. Sample size 693. Eighty percent power with 0.05 type I error rate to detect a difference of 0.09 in mean utility-weighted modified Rankin scale between groups. Design Phase III, multicenter, prospective cluster-randomized (mobile stroke unit versus standard management weeks) comparative effectiveness study in tissue plasminogen activator-eligible patients. Outcomes Primary: Ninety-day mean utility-weighted modified Rankin scale. Coprimary: cost-effectiveness based on EQ5D quality of life and one year poststroke costs. Analysis Two-sample t-test and linear regression adjusting for covariates; incremental cost-effectiveness ratio and net benefit regression. Results As of March 2017, 288 tissue plasminogen activator-eligible patients have been enrolled (173 in the mobile stroke unit arm and 115 in the standard management arm). Two new centers start in early 2017 with target end of recruitment September 2019. Conclusion This is the first randomized study to test for disability, healthcare utilization, and cost-effectiveness of a mobile stroke unit. The progress of the study suggests that it is feasible. Management of tissue plasminogen activator eligible acute ischemic stroke patients by a mobile stroke unit could potentially result in less disability and healthcare utilization, and be cost effective. Mobile stroke units are very costly. This trial may determine if the fixed cost can be justified by a reduction in disability and healthcare utilization. Clinical Trial Registration NCT02190500.
Outcomes of flexor tendon repairs in zone 2 subzones with early active mobilization
Authors: Moriya K. , Yoshizu T. , Tsubokawa N. , Narisawa H. , Matsuzawa S. , Maki Y. 
Published: June 2017

We report on the outcomes of flexor tendon repair in zone 2 subzones with early active mobilization in 102 fingers in 88 consecutive patients. There were 28, 53, 15, and six fingers with repairs in zones 2A to 2D, respectively. Rupture of the repair occurred in four fingers, all in zone 2B. Excluding those with repair ruptures, the mean total active motion was 230° (range 143°–286°). Evaluated with Tang’s criteria, the outcomes were ranked excellent in 39 fingers, good in 46, fair in ten, poor in three, and failure in four. The outcomes in zone 2C were significantly inferior to those in zones 2B and 2D ( p = 0.02). Our results suggest that the tendon laceration in the area covered by the A2 pulley (zone 2C) is the most difficult area to obtain satisfactory active digital motion and tendon repair in zone 2B is the area where the risk of rupture is highest. Level of evidence: IV
Parenting practices of Singaporean mothers of children with ADHD
Authors: Nomanbhoy Alefiya , Hawkins Russell 
Published: June 2017

Objectives: We wanted to determine: (1) whether ADHD symptoms were more common in mothers of children with ADHD; (2) whether mothers of children with ADHD differed in their parenting strategies; and (3) whether there was a difference in care-giving arrangements for children with ADHD and without ADHD. This was done by comparing mothers of children with ADHD with mothers of children without ADHD in Singapore. Methods: Mothers of children with ADHD ( n=46) and mothers of children without ADHD ( n=45) completed the Conners’ Parent Rating Scale-Revised, the Conners’ Adult ADHD Rating Scale-Self Report and the Alabama Parenting Questionnaire. Results: Mothers of children with ADHD did not report higher levels of current ADHD symptoms compared with the control group. However, they did use less adaptive parenting strategies. There were also no differences in the reported behaviours of children cared for by a paid worker and those cared for by mothers. Conclusions: Data support the Singapore Clinical Guidelines recommendations for the promotion of parenting skills, and referral to parenting programmes for parents of children with ADHD. The promotion of parenting skills and referral to parenting programmes for mothers of children with ADHD might include the option of electronic forms of programme delivery. The model of using paid help in the home, which is commonplace in Singapore, does not seem to disadvantage children with ADHD.
Frequent attenders at the emergency department: an analysis of characteristics and utilisation trends
Authors: Chan Joanna Shi-En , Tin Aung Soe , Chow Wai Leng , Tiah Ling , Tiru Mohan , Lee Chien Earn 
Published: June 2017

Background: Frequent attenders (FAs) place a disproportionate burden on emergency department (ED) resources. Objectives: Our study aimed to describe characteristics of ED visits by FAs to our hospital so as to identify potential strategies to better manage ED demand. Methods: This was a retrospective observational study. All visits to the ED from 1 January 2011 to 31 December 2011 were included. FAs were defined as patients with ⩾5 visits to the ED over the study period. They were further stratified by visit frequency. Results: FAs showed a bimodal age distribution, with visits by FAs aged 16–25 years old and the elderly aged 66 years and above accounting for the largest proportion of ED visits relative to the number of visits by their non-FA counterparts. Using the age group of 26–45 years as reference, the odds ratio (OR) of FAs being 16–25 years old was 3.037 (95% confidence interval (CI) 2.708–3.407, p < 0.001). Above the age of 65, the OR of FAs falling into a given age group increased for every additional decade of life, up to 3.118 (2.495–3.898, p <0.001) for the age group of 86 and above. FAs were more likely to be male. Diagnoses which accounted for a higher percentage of visits with increasing visit frequency were asthma, chronic obstructive pulmonary disease, upper respiratory tract infection and headache. Conclusions: FAs include the high-acuity chronic sick as well as young adults with low-acuity complaints. Disease optimisation programmes, case management, robust community-based healthcare and public education are possible avenues to optimise ED resources in an ageing society.
Hmga2 collaborates with JAK2V617F in the development of myeloproliferative neoplasms
Authors: Ueda Koki , Ikeda Kazuhiko , Ikezoe Takayuki , Harada-Shirado Kayo , Ogawa Kazuei , Hashimoto Yuko , Sano Takahiro , Ohkawara Hiroshi , Kimura Satoshi , Shichishima-Nakamura Akiko , Nakamura Yuichi , Shikama Yayoi , Mori Tsutomu , Mason Philip J. , Bessler Monica , Morishita Soji , Komatsu Norio , Shide Kotaro , Shimoda Kazuya , Koide Shuhei , Aoyama Kazumasa , Oshima Motohiko , Iwama Atsushi , Takeishi Yasuchika 
Published: June 2017

Key Points
In patients with MPNs, repression of MIRlet-7 and mutations in the polycomb genes EZH2 and ASXL1 correlate with HMGA2 overexpression. Hmga2 overexpression collaborates with JAK2V617F to promote lethal MPN in mice, highlighting the crucial role of Hmga2.
Effect of Age on the Efficacy and Safety of Lenvatinib in Radioiodine-Refractory Differentiated Thyroid Cancer in the Phase III SELECT Trial
Authors: Brose Marcia S. , Worden Francis P. , Newbold Kate L. , Guo Matthew , Hurria Arti 
Published: June 2017

PurposeIn the Study of (E7080) Lenvatinib in Differentiated Cancer of the Thyroid (SELECT), lenvatinib significantly prolonged progression-free survival (PFS) versus placebo in patients with radioiodine-refractory differentiated thyroid cancer (RR-DTC). This prespecified subanalysis investigated the effect of age on the efficacy and safety of lenvatinib.Patients and MethodsThis randomized, double-blind, phase III study enrolled patients with histologically confirmed RR-DTC stratified by age (≤ 65 or > 65 years). Patients (N = 392) received lenvatinib 24 mg/day (n = 261) or placebo (n = 131). The primary end point was PFS; secondary end points included overall survival (OS), objective response rate, and safety.ResultsIn both treatment arms, median ages were 56 (younger group) and 71 years (older group). PFS benefit was maintained with lenvatinib versus placebo in the younger and older age groups, with median PFS of 20.2 versus 3.2 months (hazard ratio [HR], 0.19; 95% CI, 0.13 to 0.27; P < .001) and 16.7 versus 3.7 months (HR, 0.27; 95% CI, 0.17 to 0.43; P < .001), respectively. PFS did not differ with age in either treatment arm. OS was improved in older lenvatinib-treated patients versus placebo (HR, 0.53; 95% CI, 0.31 to 0.91; P = .020). Younger lenvatinib-treated patients showed significantly higher ORR (72% v 55%; P = .0038), longer time to first dose reduction (3.7 v 1.5 months), and lower proportion of grade ≥ 3 treatment-related adverse events (67% v 89%; P < .001) compared with older patients.ConclusionThis subanalysis demonstrated improved PFS with lenvatinib treatment versus placebo in both age groups, although higher toxicity was observed in older patients. Despite the allowance of crossover after disease progression, the OS benefit was observed in older patients, suggesting that lenvatinib should be considered for treatment of patients of any age with RR-DTC.