bluuebunny/crossref_metadata_2025_split huggingface dataset:
What influences women with intellectual disabilities to attend breast screening? Experiences of women who have and have not participated
Authors: Willis Diane S. 
Published: January 2016

Accessible summary

This study looks at the experience of women with learning disabilities who go for breast screening (X‐ray of the breast)

Women with learning disabilities reported that there were many things that encouraged and discouraged them from going for breast screening.

Carers were very important in supporting women with learning disabilities through breast screening

AbstractBackground: Despite breast screening in Britain being free to all women within the allotted age range, uptake of this service is often poor in women with intellectual disabilities. Reasons put forward are numerous, including poor knowledge, pain and difficulty travelling to the centre. However, what influences the decision to attend is rarely discussed.Methods: Twelve semi‐structured interviews and three focused observation were undertaken with women with intellectual disabilities to explore what influenced them to participate in breast screening and their experience of having mammography. Data were analysed thematically using a blended framework.Results: Despite the experience of mammography being negative, high uptake of breast screening services was reported in this study. Pain and previous poor treatment in hospital were reasons for nonparticipation in breast screening. Although awareness about breast screening varied, those who had previous breast problems were more knowledgeable; however, there was poor awareness of the risks of hereditary breast cancer. Overall, paid‐carers were found to play a key role, as means of support, information and a potential influence in determining participation in breast screening.Conclusions: There was general equality of access but an inequality in the preparation and delivery of the service which was dependent on a complex range of issues and relationships. Key to participation was preparation with the paid‐carer facilitating discussions about breast screening were key to participating in mammography. This has implications on the future direction of funding and policy making. Risks associated with hereditary breast cancer and earlier presentation of breast tumours also needs highlighting.
The association of visceral adipose tissue and subcutaneous adipose tissue with metabolic risk factors in a large population of Chinese adults
Authors: Tang Lizhi , Zhang Fang , Tong Nanwei 
Published: January 2016

SummaryObjectiveAbdominal visceral (VAT) and subcutaneous (SAT) adipose tissues contribute to obesity, but may have different cardiometabolic risk profiles. We examined and compared the associations of abdominal VAT and SAT with metabolic risk factors in a large cohort of Chinese adults.MethodsThis study was based on cross‐sectional analysis of data from 1449 adults aged 40–65 years. VAT and SAT were assessed at L4–L5 level by magnetic resonance imaging. The associations of VAT and SAT with blood pressure, glucose and lipid were examined by linear regression stratified by sex and glucose tolerance status (normal glucose tolerance and prediabetes). Logistic regression was used to analyse the association of VAT and SAT with risk of hypertension, prediabetes and dyslipidaemia.ResultsVAT was more strongly associated with metabolic risk factors. Higher VAT was associated with higher blood pressure (βmen = 3·99, P = 0·0002; βwomen = 6·46, P = 0·0002), higher triglyceride (βmen = 0·45, P < 0·0001; βwomen = 0·6, P < 0·0001), higher total cholesterol (βmen = 0·15, P = 0·02; βwomen = 0·37, P = 0·0002) and higher 2‐h glucose levels (βmen = 0·68, P = 0·003; βwomen = 0·94, P < 0·0001). The association remained significant after subjects were stratified by glucose tolerance status. However, SAT was not associated with any additional risk factors. VAT was associated with increased risk of hypertension (OR = 1·97, P < 0·0001), prediabetes (OR = 1·53, P = 0·0007) and dyslipidaemia (OR = 2·40, P < 0·0001). These associations were not observed for SAT.ConclusionsVAT was more strongly associated with cardiometabolic risk factors than SAT in a large cohort of Chinese adults. Higher VAT was associated with increased risk of hypertension, dyslipidaemia and prediabetes.
Functional outcome and quality of life after a maxillectomy: a comparison between an implant supported obturator and implant supported fixed prostheses in a free vascularized flap
Authors: Wang Feng , Huang Wei , Zhang Chenping , Sun Jian , Qu Xingzhou , Wu Yiqun 
Published: January 2016

AbstractObjectiveDefects of the maxilla caused by tumor resection create high levels of psychological and physical trauma for patients. The application of osseointegrated dental implants using either an obturator prosthesis or a free vascularized flap has tremendously changed the retention and stability of the superstructure. However, no study has been performed to compare the function of the aforementioned two approaches and the quality of life using the subjective assessments of patients.Materials and methodsEligible patients who were treated with maxillary resection and rehabilitated with implant supported obturator prostheses (group 1) or those who received free vascularized flap transfers with implant supported fixed prostheses (group 2) were enrolled between March 2006 and May 2014. A questionnaire that included the indices of the Obturator Functioning Scale (OFS), EORTC Head and Neck 35 assessment and the Mental Health Inventory (MHI) was used to evaluate the functional rehabilitation and QOL of patients in the study.ResultsA total of 42 dental implants, including 25 zygomatic implants, were used in 18 patients (mean age: 56.2 ± 12.3 years) in the obturator prostheses in group 1. Twenty patients (mean age: 45.6 ± 14.1 years) who were treated with a vascularized free flap including the fibula (n = 15) and ilium (n = 5) combined with a total of 71 regular implants for fixed prostheses comprised group 2. No statistically significant median differences in the OFS, EORTC Head and Neck assessment and MHI global scale were observed between the groups. On the MHI subscales item‐levels, higher median subscale scores exhibited by group 1 than group 2 and had statistically significant difference between the groups (P = 0.024).ConclusionWithin the limitations of this study, it demonstrated no difference in oral function between patients with implant supported obturators and implant supported fixed prostheses in free vascularized flaps after a maxillectomy. However, patients who received obturator therapy seemed to have poorer mental health than did patients with fixed prostheses, but it should be interpreted prudently with the study's limitation.
Sidestream dark field imaging of the serosal microcirculation during gastrointestinal surgery
Authors: de Bruin A. F. J. , Kornmann V. N. N. , van der Sloot K. , van Vugt J. L. , Gosselink M. P. , Smits A. , Van Ramshorst B. , Boerma E. C. , Noordzij P. G. , Boerma D. , van Iterson M. 
Published: January 2016

AbstractAimThe study aimed to describe the serosal microcirculation of the human bowel using sidestream dark field imaging, a microscopic technique using polarized light to visualize erythrocytes through capillaries. We also compared its feasibility to the current practice of sublingual microcirculatory assessment.MethodIn 17 patients sidestream dark field measurements were performed during gastrointestinal surgery. Microcirculatory parameters like microvascular flow index (MFI), proportion of perfused vessels (PPV), perfused vessel density (PVD) and total vessel density (TVD) were determined for every patient, sublingually and on the bowel serosa.ResultsSixty measurements were done on the bowel of which eight (13%) were excluded, five owing to too much bowel peristalsis and three because of pressure artefacts. Image stability was in favour of sublingual measurements [pixel loss per image, bowel 145 (95% CI 126–164) vs sublingual 55 (95% CI 41–68); P < 0.001] and time to acquire a stable image [bowel 96 s (95% CI 63–129) vs sublingual 46 s (95% CI 29–64); P = 0.013]. No difference in the MFI was observed [bowel 2.9 (interquartile range 2.87–2.95) vs sublingual 3.0 (interquartile range 2.91–3.0); P = 0.081]. There was a difference in the PPV [bowel 95% (95% CI 94–96) vs sublingual 97% (95% CI 97–99); P < 0.001], PVD [bowel 12.9 mm/mm2 (95% CI 11.1–14.8) vs sublingual 17.4 mm/mm2 (95% CI 15.6–19.1); P = 0.003] and the TVD [bowel 13.6 mm/mm2 (95% CI 11.6–15.6) vs sublingual 17.7 mm/mm2 (95% CI 16.0–19.4); P = 0.008].ConclusionSidestream dark field imaging is a very promising technique for bowel microcirculatory visualization and assessment. It is comparable to sublingual assessment and the analysis produces a similar outcome with slightly differing anatomical features.
Brain magnetic resonance imaging helps to differentiate atypical multiple sclerosis with cavitary lesions and vanishing white matter disease
Authors: Ayrignac X. , Menjot de Champfleur N. , Menjot de Champfleur S. , Carra‐Dallière C. , Deverdun J. , Corlobe A. , Labauge P. 
Published: January 2016

Background and purposeMultiple sclerosis (MS) patients can present with atypical cavitary lesions mimicking vanishing white matter disease (VWMD). Our objective was to identify brain magnetic resonance imaging (MRI) findings that differentiate these two disorders.MethodsA cross‐sectional study was performed including 14 patients with MS with cavitary lesions and 14 patients with VWMD. Two neuroradiologists retrospectively reviewed the MRI including at least T1‐, T2‐ and fluid‐attenuated inversion recovery weighted images.ResultsThe main differences included ovoid lesions perpendicular to the lateral ventricle, punctate isolated juxtacortical lesions (both 100% in MS versus 0% in VWMD) and symmetrical infratentorial hyperintensities (0% in MS versus 50% in VWMD). Other statistically significant differences included midbrain (79% in MS versus 29% in VWMD) and thalamus lesions (71% vs. 7%) as well as extensive external capsule involvement (29% vs. 86%) and extensive corpus callosum lesions (64% vs. 100%). Cavitary lesions usually had periventricular predominance in MS (36% vs. 0%) whereas they were more frequently anterior in VWMD (0% in MS versus 57% in VWMD).ConclusionDespite many similar MRI findings, our results suggest that a careful analysis of the morphology and the location of the lesions is helpful to differentiate these distinct disorders.
Vascular plants promote ancient peatland carbon loss with climate warming
Authors: Walker Tom N. , Garnett Mark H. , Ward Susan E. , Oakley Simon , Bardgett Richard D. , Ostle Nicholas J. 
Published: January 2016

AbstractNorthern peatlands have accumulated one third of the Earth's soil carbon stock since the last Ice Age. Rapid warming across northern biomes threatens to accelerate rates of peatland ecosystem respiration. Despite compensatory increases in net primary production, greater ecosystem respiration could signal the release of ancient, century‐ to millennia‐old carbon from the peatland organic matter stock. Warming has already been shown to promote ancient peatland carbon release, but, despite the key role of vegetation in carbon dynamics, little is known about how plants influence the source of peatland ecosystem respiration. Here, we address this issue using in situ 14C measurements of ecosystem respiration on an established peatland warming and vegetation manipulation experiment. Results show that warming of approximately 1 °C promotes respiration of ancient peatland carbon (up to 2100 years old) when dwarf‐shrubs or graminoids are present, an effect not observed when only bryophytes are present. We demonstrate that warming likely promotes ancient peatland carbon release via its control over organic inputs from vascular plants. Our findings suggest that dwarf‐shrubs and graminoids prime microbial decomposition of previously ‘locked‐up’ organic matter from potentially deep in the peat profile, facilitating liberation of ancient carbon as CO2. Furthermore, such plant‐induced peat respiration could contribute up to 40% of ecosystem CO2 emissions. If consistent across other subarctic and arctic ecosystems, this represents a considerable fraction of ecosystem respiration that is currently not acknowledged by global carbon cycle models. Ultimately, greater contribution of ancient carbon to ecosystem respiration may signal the loss of a previously stable peatland carbon pool, creating potential feedbacks to future climate change.
Reterritorializing the global knowledge economy: an analysis of geopolitical assemblages of higher education
Authors: MOISIO SAMI , KANGAS ANNI 
Published: January 2016

AbstractIn this article, we analyse the geopolitics of higher education, which we understand as an assemblage through which the functioning of the ‘borderless’ and ‘deterritorializing’ dynamics of the global knowledge economy are respatialized. Discourses, objects and bodies constitute a geopolitical assemblage. We scrutinize in particular the geopolitical discourse of the knowledge economy, the construction of material and immaterial learning environments as one of its governmental technologies as well as the subjectification of individuals as specific kinds of professional citizens. We concretize this with an enquiry into the set of recent university reforms in Finland and the ways in which these contribute to the formation of transnational citizenship.
A profile of inactive information seekers on influenza prevention: a survey of health care workers in Central Kentucky
Authors: Kim Sujin , Real Kevin 
Published: January 2016

AbstractObjectiveThis study developed a profile of inactive information seekers by characterising how they are different from active seekers, identifying possible determinants of inactive seekers and understanding characteristics of frequently asked influenza‐related questions.MethodsA survey and follow‐up interviews were conducted between December 2010 and January 2011. A total of 307 health care workers in three hospitals in Central Kentucky (USA) are included.ResultsFour study groups were formed based on their information‐seeking and vaccination uptake status: (1) Inactive Seekers with Vaccination (N = 141); (2) Inactive Seekers without Vaccination (N = 49); (3) Active Seekers with Vaccination (N = 107); and (4) Active Seekers without Vaccination (N = 10).Inactive Seekers without Vaccination are found to be least responsive to health outcomes. Inactive Seeker groups do not prefer to use sources such as Internet or family/friends. In predicting inactive seekers, Information Needs and Knowledge Perception made significant contributions to prediction. The most frequently asked questions included information about survival duration of influenza virus (N = 25) followed by the incubation period for influenza (N = 24).ConclusionProfiling inactive seekers can serve as a way to better design customised influenza information sources and services for health care workers, thus giving hospitals through medical libraries additional tools to reduce the spread of influenza.
The Anti-Incumbent Effects of Conditional Cash Transfer Programs
Authors: Corrêa Diego Sanches , Cheibub José Antonio 
Published: January 2016

AbstractScholars concur that conditional cash transfer (CCT) programs have a strong proincumbent effect among beneficiaries. Although no study has properly focused on the overall effect of cash transfers on incumbents' national vote shares, most scholars have deduced that this effect is positive; i.e., that cash transfers lead to the expansion of incumbents' electoral bases. This article analyzes survey data from nearly all Latin American countries and confirms that beneficiaries of CCT programs are more likely to support incumbents. However, it also shows that CCT programs may induce many voters who were previously incumbent supporters to vote for the opposition. As a consequence, the overall impact of cash transfers on incumbents' vote shares is indeterminate; it depends on the balance between both patterns of behavioral changes among voters. This study is the first to report evidence that cash transfer programs may have significant anti-incumbent effects.
Explaining disjunct distributions in the flora of southern South America: evolutionary history and biogeography of Myrceugenia (Myrtaceae)
Authors: Murillo‐A José C. , Stuessy Tod F. , Ruiz Eduardo 
Published: January 2016

AbstractAimPast climatic and geological events can be used to interpret present distributions of organisms. We use chronological and spatial analyses of the species of Myrceugenia in southern South America to help explain their present distribution.LocationSouthern South America (Argentina, Brazil, Chile, Paraguay and Uruguay).MethodsChronological analyses were completed for the tribe Myrteae (Myrtaceae) using two nuclear DNA sequences and for the genus Myrceugenia using four chloroplast and two nuclear sequences. A biogeographical analysis of Myrceugenia was carried out. Based on calibration points from fossils and estimations, a relaxed molecular clock was used to estimate divergence times and rates of speciation within each lineage. Ancestral states were reconstructed through Bayesian analysis.ResultsThe chronogram implies that tribe Myrteae diversified at the end of the Cretaceous, but that the majority of the individual lineages originated more recently. Myrceugenia diverged into four lineages during the early Miocene. Three of these lineages diversified in Chile, with dispersal to the north and south of the country plus a recent dispersal to the Juan Fernández archipelago. The fourth lineage diversified through vicariant events in south‐eastern Brazil. The ancestors of Blepharocalyx, Myrceugenia fernandeziana and Luma are very ancient lineages that originated between the Palaeocene and Eocene, and which have remained stable with little or no subsequent diversification.Main conclusionsThe estimated age for diversification of tribe Myrteae is consistent with the known fossil evidence from southern South America. The distribution of Myrceugenia may be explained by a combination of three events occurring in the early–middle Miocene: uplift of the Andes, a rain‐shadow effect and a marine transgression. These events may also have led to disjunct distributions in several other genera in southern South America.
Staged versus Simultaneous Thoracoscopic Hybrid Ablation for Persistent Atrial Fibrillation Does Not Affect Time to Recurrence of Atrial Arrhythmia
Authors: RICHARDSON TRAVIS D. , SHOEMAKER M. BENJAMIN , WHALEN S. PATRICK , HOFF STEVEN J. , ELLIS CHRISTOPHER R. 
Published: January 2016

Staged versus Simultaneous Hybrid AF AblationIntroductionTotally thoracoscopic (TT) epicardial ablation combined with endocardial catheter ablation is an emerging treatment for persistent AF. The effects of timing of the TT and endocardial portion on AT/AF recurrence are not known.MethodsWe retrospectively analyzed patients undergoing TT staged versus simultaneous hybrid AF ablation at our institution. Arrhythmia‐free outcome was compared using time to recurrence (AF or AT greater than 30 seconds after a 3‐month blanking period from endocardial ablation) at 12 months. All subjects had continuous ILR or PM monitoring.ResultsEighty‐three patients (52 same‐day, 31 staged) underwent TT hybrid AF ablation. Recurrence was observed in 23 (29%) patients at a median time of 147 days (IQR 91,238). In univariate analysis, a staged approach significantly increased the likelihood of detecting incomplete PVI (OR 6 [95% CI 2–17] P = 0.001). However, only longstanding persistent AF (LSP‐AF) status predicted recurrence (HR 4 [95% CI 1.4–12] P = 0.01). Neither a staged approach (HR 1.0 [95% CI 0.4–2.4] P = 0.9), nor detection of incomplete PVI (HR 0.9 [95% CI 0.4–2.3] P = 0.8) predicted time to first AF/AT recurrence.ConclusionsStaged hybrid ablation of AF significantly increases the likelihood of discovering incomplete PVI at the time of endocardial mapping versus a same‐day procedure. However, the staged approach did not improve time to first AT/AF recurrence.
Spatial Relation Between Left Atrial Anatomical Contact Areas and Circular Activation in Persistent Atrial Fibrillation
Authors: NAKAHARA SHIRO , YAMAGUCHI TAKANORI , HORI YUICHI , ANJO NAOFUMI , HAYASHI AKIKO , KOBAYASHI SAYUKI , KOMATSU TAKAAKI , SAKAI YOSHIHIKO , FUKUI AKIRA , TSUCHIYA TAKESHI , TAGUCHI ISAO 
Published: January 2016

Atrial Anatomical Contact Area and Circular ActivationIntroductionAtrial low‐voltage zones (LVZs) may be related to maintenance of atrial fibrillation (AF). The influence of left atrial (LA) contact areas (CoAs) on reentrant or rotor‐like sources maintaining AF has not been investigated.Methods and ResultsForty patients with persistent AF (PsAF) were analyzed. Three representative CoA regions in the LA (ascending aorta: anterior wall; descending aorta: left inferior pulmonary vein; and vertebrae: posterior wall) were visualized by enhanced CT. Using circular catheters, the LVZs (<0.5 mV) were assessed after restoration of SR, and local activation mapping and frequency domain analyses were performed after induction of AF. Circular activation during AF was visually defined as sites with ≥2 rotations by serial electrograms encompassing >80% of the mean AF cycle length. A pivot was defined as the core of the localized circular activation. Anterior (39/40 patients, 98%), left pulmonary vein antrum (27/40, 68%), and posterior (19/40, 48%) CoAs were identified, and 80% (68/85) of those sites were overlapped by or close (<3 mm) to LVZs. Thirty‐six (90%) patients demonstrated circular activation (3.1±1.7 sites/patients) along with significantly higher organized dominant frequencies (6.3 ± 0.5 Hz, regularity‐index: 0.26 [0.23–0.41]) within the LA, and the average electrogram amplitude of those pivots was 0.30 mV (0.18–0.52). Of those sites, 55% (66/120) were located at or close to CoA regions. Catheter ablation including of LVZs neighboring CoAs terminated AF in 9 (23%) patients.ConclusionsExternal anatomical structures contacting the LA may be related to unique conduction properties in diseased myocardium necessary for PsAF maintenance.