bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors of age‐related cataract in a Chinese adult population: the Taizhou Eye Study
Authors: Tang Yating , Wang Xiaofeng , Wang Jiucun , Jin Li , Huang Wei , Luo Yi , Lu Yi 
Published: August 2017

AbstractImportanceCataract risk factors data will provide epidemic evidence for cataract prevention.BackgroundThis study aimed to study the risk factors for age‐related cataract in a Chinese adult population.DesignThis is a population‐based, cross‐sectional study.ParticipantsA total of 10 234 eligible subjects ≥45 years old (response rate: 78.1%) were included in the study.MethodsWe conducted detailed eye examinations including presenting visual acuity, best‐corrected visual acuity, slit lamp examination of lens opacities and fundus examination. Questionnaires about lifestyle were administered. Measurements of blood pressure, heart rate and body mass index were collected. Serological metabolic indicators, including fasting blood glucose, triglycerides, cholesterol, lipoprotein, were also evaluated. We used stepwise multivariate logistic regression model to evaluate the association of these risk factors with any cataract and subtypes of cataract.Main Outcome MeasuresOdds ratios of risk factors for cataract were calculated.ResultsFor any cataract, we found age, gender (female), increased outdoor activity, no outdoor eye protection, high myopia, high low‐density lipoprotein, low high‐density lipoprotein, lower education level and increased pickled food intake were independent risk factors. When further examined the risk factors of different subtypes of cataract, we found that these risk factors also existed, but there were slight differences among different subtypes. In addition, for cortical cataract, lower annual family income and high diastolic pressure were additional independent risk factors.Conclusions and RelevanceReduced outdoor activity, outdoor eye protection, prevention of high myopia, higher education level, controlled blood pressure, improved high‐density lipoprotein and low‐density lipoprotein levels and reduced pickled food intake may help to reduce the risk of age‐related cataract development.
The impact of pediatric obesity on hospitalized children with lower respiratory tract infections in the United States
Authors: Okubo Yusuke , Nochioka Kotaro , Testa Marcia A. 
Published: August 2017

AbstractObjectiveObesity is the most common public health problem and is a clinically complicating risk factor among hospitalized children. The impact of pediatric obesity on the severity and morbidity of lower respiratory tract infections remains unclear.Materials and MethodsWe conducted a retrospective cohort study of bronchitis and pneumonia among children aged 2‐20 years using hospital discharge records. The data were obtained from the Kid's Inpatient Database in 2003, 2006, 2009, and 2012, and were weighted to estimate the number of hospitalizations in the United States. We used the International Classification of Diseases, Ninth Revision, Clinical Modification code (278.0×) to classify whether the patient was obese or not. We investigated the associations between pediatric obesity and use of mechanical ventilation using multivariable logistic regression model. In addition, we ascertained the relationships between pediatric obesity, comorbid blood stream infections, mean healthcare cost, and length of hospital stay.ResultsWe estimated a total of 133 602 hospitalizations with pneumonia and bronchitis among children aged between 2 and 20 years. Obesity was significantly associated with use of mechanical ventilation (adjusted OR 2.90, 95% CI 2.15‐3.90), comorbid bacteremia or septicemia (adjusted OR 1.58, 95% CI 1.03‐2.44), elevated healthcare costs (adjusted difference $383, 95%CI $276‐$476), and prolonged length of hospital stay (difference 0.32 days, 95%CI 0.23‐0.40 days), after adjusting for patient and hospital characteristics using multivariable logistic regression models.ConclusionsPediatric obesity is an independent risk factor for severity and morbidity among pediatric patients with lower respiratory tract infections. These findings suggest the importance of obesity prevention for pediatric populations.
Anxiety and depression in adult outpatients with bronchiectasis: Associations with disease severity and health‐related quality of life
Authors: Gao Yong‐Hua , Guan Wei‐Jie , Zhu Ya‐Nan , Chen Rong‐Chang , Zhang Guo‐Jun 
Published: August 2017

AbstractBackgroundAnxiety and depression might frequently affect bronchiectasis patients, but data in Chinese patients, including their association with disease severity assessed with Bronchiectasis Severity Index (BSI) and FACED score, are limited.ObjectiveTo investigate the rate, risk factors, association with disease severity and impact of anxiety and depression on health‐related quality of life (HRQoL) in adult outpatients with steady‐state bronchiectasis.MethodsThis cross‐sectional study included 163 outpatients (102 females; mean age, 45.8 years) and 80 healthy subjects (47 females; mean age, 47.1 years). Demographic, clinical indices, radiology, spirometry, aetiology, sputum bacteriology, Hospital Anxiety and Depression Scales (HADS), Pittsburgh Sleep Quality Index (PSQI) and St. George's Respiratory Questionnaire (SGRQ) were assessed.ResultsPatients with steady‐state bronchiectasis had a higher rate of depression (HADS‐depression >7) (30.1% vs 10.0%, P = .001) and anxiety (HADS‐anxiety >7; 39.9% vs 6.3%, P < .001) compared with healthy subjects. Notably, no significant differences in the rate of anxiety and depression were found across different disease severity, assessed with BSI and FACED score (all P > .05). In multivariate model, factors associated with anxiety included younger age (OR = 1.05), education below college graduate (OR = 4.55) and sleep disturbance (PSQI ≥ 6; OR = 2.95); whereas sleep disturbance was the sole factor associated with depression (OR = 5.98). Patients with either depression or anxiety had more markedly impaired HRQoL affecting most domains than those without.ConclusionsAnxiety and depression are common in bronchiectasis and can negatively affect HRQoL, but not related to disease severity. Prompt assessment and treatment of these mental disorders, regardless of bronchiectasis severity, are advocated and might improve HRQoL.
Pleuroparenchymal fibroelastosis in heterogeneous clinical conditions: Clinicopathologic analysis of 7 cases
Authors: Cha Yoon Jin , Han Joungho , Chung Man Pyo , Kim Tae Jung , Shin Sumin 
Published: August 2017

AbstractBackground and AimsPleuroparenchymal fibroelastosis (PPFE) is classified as a rare idiopathic interstitial pneumonia, and its clinicopathologic features remain unclear. We sought to investigate the clinical, radiologic, and pathologic features of patients with histologically proven PPFE.MethodsSeven patients who had histologic features of PPFE that were definitive or consistent with PPFE were included. Clinical data and radiologic findings of chest computed tomography were obtained. Histologic evaluation was performed by 2 pathologists.ResultsFour patients had elevated serum autoantibodies, 3 had a history of organ transplantation, and 1 had acute Aspergillus infection. All patients had various degrees of restrictive patterns on pulmonary function tests. Histologic examination revealed a variable extent of PPFE. Fibroblastic foci, patchy lymphocytic infiltration, and pneumothorax were observed, but these findings were nonspecific. Radiologically, PPFE lesions were distributed diffusely, rather than being limited to the upper lungs.ConclusionsPPFE seems to be a histologic finding that may partly overlap with other chronic lung diseases. There can be various underlying clinical states.
Contracting out of basic health facilities in Pakistan: Are the lessons generalizable?
Authors: Bano Masooda 
Published: August 2017

AbstractAmid growing support within international development agencies for the privatization of health facilities in developing countries, contracting out of the Basic Health Units (BHUs) in Pakistan has been presented as a success. This article argues for caution in generalizing results from this model. It shows that the model improved service delivery because the organization taking over the BHUs was itself a government‐owned QUANGO (Quasi‐Autonomous NGO); similar concessions would not have been granted to a private provider. Further, the article shows that, given the strong resistance that the model continues to receive from administrators within the state system, development agencies must consider whether models that try to sidestep the bureaucracy instead of working towards installing good practice within the state system, can be viewed as a success.
Plant water stress and previous herbivore damage affect insect performance
Authors: HAHN PHILIP G. , MARON JOHN L. 
Published: August 2017

1. Short‐term changes in plant resistance traits can be affected by abiotic factors or damage by herbivores, although how the combined effects of abiotic factors and previous damage affect subsequent insect larval development is not well understood.2. Complementary glasshouse and field experiments were conducted to evaluate whether plant water stress and previous herbivore damage influenced monarch (Danaus plexippus) larval development on common milkweed, Asclepias syriaca.3. In the glasshouse, water stress altered a suite of A. syriaca functional traits but did not affect nutrient content, whereas herbivore damage increased leaf nitrogen (N) and reduced the carbon:nitrogen (C:N) ratio. A bioassay experiment showed that monarch larval survival was lower on well‐watered plants that were previously damaged by monarch larva than on damaged and drought‐stressed plants. Bioassay larvae consumed less leaf tissue of previously damaged plants, whereas monarch larval mass was affected additively by water stress and previous damage, after correcting for the amount of leaf tissue consumed.4. In a 2‐year field experiment, monarch larval performance was higher on previously damaged A. syriaca plants that received experimentally reduced rainfall, relative to plants receiving ambient rainfall.5. Collectively, these results from glasshouse and field experiments suggest that insect performance was highest on previously damaged plants under water stress and highlight the additive and interactive roles of abiotic and biotic factors on herbivore performance.
Migraine Prophylaxis and Acute Treatment Patterns Among Commercially Insured Patients in the United States
Authors: Woolley J. Michael , Bonafede Machaon M. , Maiese Brett A. , Lenz Robert A. 
Published: August 2017

ObjectivesTo describe prophylactic and acute medication treatment patterns, including timing, medication type, and duration of use in migraine patients initiating prophylaxis.BackgroundPatients with migraine can be treated with acute and prophylactic therapies. Current treatment options for migraine prophylaxis are associated with poor tolerability and low adherence and persistence.MethodsThis retrospective cohort study used the Truven Health Analytics MarketScan® Research Databases to identify adults in the United States with a migraine diagnosis who initiated migraine prophylactic medication (index event) between January 1, 2008, and December 31, 2011. Prescribed prophylactic medications evaluated included topiramate, beta‐blockers, and tricyclic antidepressants. Patients were required to have 12 months of pre‐ and post‐index continuous enrollment. Patient characteristics, migraine‐specific prescribed prophylactic treatment patterns (including gaps in therapy, treatment switches, and additions of index medications), and prescribed acute medication utilization were assessed.ResultsThe study population comprised 107,122 patients, with 52,275 (49%) initiating topiramate, 22,658 (21%) initiating beta‐blockers, and 32,189 (30%) initiating tricyclic antidepressants. Mean (SD) age was 41 (12) years and 83% were female. Persistence with migraine prophylactic medication was low; 81% of patients had gaps of >90 days in their migraine prophylaxis in the first year. The gap in therapy occurred early in treatment (mean, 95 days), and only 10% of patients restarted prophylactic therapy within that year. Switching from index medication to another prophylactic medication or adding prophylaxis was uncommon (13% and 5%, respectively). One year after initiating prophylaxis, 65% of patients were not receiving any prophylactic therapies. Most patients initiating migraine prophylaxis also utilized acute treatments (81%); opioid use was more frequent than triptan use (53% vs 48%) and was common (40%) among patients without other chronic pain conditions (eg, arthritis, fibromyalgia, and lower back pain).ConclusionPatients with migraine who initiated prophylactic therapy had poor persistence with early gaps in therapy, were unlikely to switch prophylactic treatments, and most discontinued prophylaxis by the end of the first year.
Economics of Inhaled Oxygen Use as an Acute Therapy for Cluster Headache in the United States of America
Authors: O'Brien Megan , Ford Janet H. , Aurora Sheena K. , Govindan Sriram , Tepper Deborah E. , Tepper Stewart J. 
Published: August 2017

BackgroundCluster headache (CH) is a primary headache disorder associated with low levels of diagnosis and high unmet medical need. The pain attacks, associated anxiety, and fear in anticipation of the attacks are extremely debilitating to a patient with CH. For acute therapy, treatment guidelines recommend inhalation of high flow oxygen during the period of an attack. However, the use of oxygen for treatment of CH remains largely underutilized.ObjectivesThe objectives of the study, which covered each of the US states, were to map the current market landscape of medical grade oxygen for use in CH and to develop a cost simulator based on a patient's needs and geography.MethodsDesk research was undertaken to obtain price lists and product catalogs from wholesale and retail suppliers of medical grade oxygen across all US states. Base case scenarios for chronic and episodic forms of CH were assumed. A cost simulator was used to calculate the cost of oxygen use using inputs including the state in USA, tank size and price, exacerbations per year, duration of exacerbation, attacks per day, flow rate and duration of flow. Information was also collected to determine if healthcare insurers covered the costs of home oxygen use for CH.ResultsOut of the 42 US states where pricing information of medical grade oxygen was available from suppliers, in 38 states the annual cost of high‐flow oxygen for a patient with episodic CH was estimated to be <$1000. In 39 states, the annual cost of high‐flow oxygen for a patient with chronic CH was estimated to be <$5000. Most of the home oxygen suppliers were familiar with CH and stocked the special non‐rebreather masks and regulators necessary for this condition. It was found that many of the private commercial healthcare insurance providers reimbursed the cost of oxygen use for CH. However, the US Centers for Medicare and Medicaid Services (CMS) maintains there is insufficient evidence for coverage and continues to deny coverage for US Medicare and Medicaid patients.ConclusionsResults from our study showed that the current costs for oxygen use as an acute therapy in CH are not prohibitively expensive for patients and healthcare insurance providers. Apart from CMS, many insurers do reimburse the cost of oxygen use for CH. Our study suggests that further research is needed to determine if a lack of physician awareness about treatments and ways to prescribe are barriers for patients to access the high‐flow oxygen treatment.
Dl‐3‐n‐butylphthalide attenuates acute inflammatory activation in rats with spinal cord injury by inhibiting microglial TLR4/NF‐κB signalling
Authors: He Zili , Zhou Yulong , Lin Li , Wang Qingqing , Khor Sinan , Mao Yuqin , Li Jiawei , Zhen Zengming , Chen Jian , Gao Zhenzhen , Wu Fenzan , Zhang Xie , Zhang Hongyu , Xu Hua‐Zi , Wang Zhouguang , Xiao Jian 
Published: August 2017

AbstractIn this study, we examined the neuroprotective effects and anti‐inflammatory properties of Dl‐3‐n‐butylphthalide (NBP) in Sprague‐Dawley (SD) rats following traumatic spinal cord injury (SCI) as well as microglia activation and inflammatory response both in vivo and in vitro. Our results showed that NBP improved the locomotor recovery of SD rats after SCI an significantly diminished the lesion cavity area of the spinal cord, apoptotic activity in neurons, and the number of TUNEL‐positive cells at 7 days post‐injury. NBP inhibited activation of microglia, diminished the release of inflammatory mediators, and reduced the upregulation of microglial TLR4/NF‐κB expression at 1 day post‐injury. In a co‐culture system with BV‐2 cells and PC12 cells, NBP significantly reduced the cytotoxicity of BV‐2 cells following lipopolysaccharide (LPS) stimulation. In addition, NBP reduced the activation of BV‐2 cells, diminished the release of inflammatory mediators, and inhibited microglial TLR4/NF‐κB expression in BV‐2 cells. Our findings demonstrate that NBP may have neuroprotective and anti‐inflammatory properties in the treatment of SCI by inhibiting the activation of microglia via TLR4/NF‐κB signalling.
Risk prediction of post‐hepatectomy liver failure in patients with perihilar cholangiocarcinoma
Authors: Lee Eung Chang , Park Sang‐Jae , Han Sung‐Sik , Shim Jae Ryong , Park Hyeong Min , Lee Seung Duk , Kim Seong Hoon 
Published: August 2017

AbstractBackground and AimIn most patients with perihilar cholangiocarcinoma (PHCC), major hepatectomy and extrahepatic bile duct resection are needed for surgical radicality, and a high risk of hepatic insufficiency exists. This study aims to develop a prediction model for post‐hepatectomy liver failure (PHLF) in patients with PHCC.MethodsA total of 143 patients who underwent major liver resection and extrahepatic bile duct resection for PHCC between October 2001 and December 2013 were included. Clinically relevant PHLF was defined as liver failure corresponding to grade B or C of the International Study Group of Liver Surgery criteria. Multivariate logistic regression was used to develop the PHLF risk model. Model performance was evaluated internally using the area under the curve analysis (discrimination) after 1000 bootstrap resampling and the Hosmer–Lemeshow goodness‐of‐fit test (calibration).ResultsPost‐hepatectomy liver failure occurred in 43.4% of patients (n = 62). In multivariate analysis, PHLF was significantly associated with future liver remnant ratio (odds ratio [OR] per 10% = 0.68, 95% confidence interval [CI] 0.51–0.88), intraoperative blood loss (OR per 1 L = 1.82, 95% CI 1.11–3.17), and preoperative prothrombin time > 1.20 (OR = 3.22, 95% CI 1.15–9.97). The PHLF risk score model showed good discrimination (area under the curve = 0.708, 95% CI 0.623–0.793) and calibration (P = 0.227).ConclusionsThe risk model proposed in this study accurately predicted PHLF in patients with PHCC. This offers surgeons a practical guide to quantitative risk assessment of hepatic insufficiency and aids decision‐making in surgical treatment and perioperative management.
Environmental and Economic Implications of Distributed Additive Manufacturing: The Case of Injection Mold Tooling
Authors: Huang Runze , Riddle Matthew E. , Graziano Diane , Das Sujit , Nimbalkar Sachin , Cresko Joe , Masanet Eric 
Published: August 2017

SummaryAdditive manufacturing (AM) holds great potentials in enabling superior engineering functionality, streamlining supply chains, and reducing life cycle impacts compared to conventional manufacturing (CM). This study estimates the net changes in supply‐chain lead time, life cycle primary energy consumption, greenhouse gas (GHG) emissions, and life cycle costs (LCC) associated with AM technologies for the case of injection molding, to shed light on the environmental and economic advantages of a shift from international or onshore CM to AM in the United States. A systems modeling framework is developed, with integrations of lead‐time analysis, life cycle inventory analysis, LCC model, and scenarios considering design differences, supply‐chain options, productions, maintenance, and AM technological developments. AM yields a reduction potential of 3% to 5% primary energy, 4% to 7% GHG emissions, 12% to 60% lead time, and 15% to 35% cost over 1 million cycles of the injection molding production depending on the AM technology advancement in future. The economic advantages indicate the significant role of AM technology in raising global manufacturing competitiveness of local producers, while the relatively small environmental benefits highlight the necessity of considering trade‐offs and balance techniques between environmental and economic performances when AM is adopted in the tooling industry. The results also help pinpoint the technological innovations in AM that could lead to broader benefits in future.
The Influence of State‐Ownership on Eco‐Innovations in Russian Manufacturing Firms
Authors: Roud Vitaliy , Thurner Thomas Wolfgang 
Published: August 2017

SummaryThis paper studies drivers for eco‐innovation in Russian manufacturing firms on a sample of 2,212 innovative firms, of which over 600 introduced eco‐innovations. The companies in our sample specifically mention environmental regulation as a reason for engaging in eco‐innovations. Furthermore, we show that those firms who engage in eco‐innovations are motivated even stronger by the desire to increase resource efficiency. Companies under state ownership are especially prone to a higher likelihood to invest. We conclude that regulations are mostly relevant to the late comers who are obliged to follow minimum standards. On the other hand, the state uses its controlling influence to press companies under their control to exceed these minimum standards. Thus, we argue, state ownership does indeed have an influence on both the likelihood to eco‐innovate and on the levels of spending. Eco‐innovative state‐owned companies are only prone to invest in eco‐innovations, if they get additional money.
Closing the Loop on E‐waste: A Multidisciplinary Perspective
Authors: Bridgens Ben , Hobson Kersty , Lilley Debra , Lee Jacquetta , Scott Janet L. , Wilson Garrath T. 
Published: August 2017

SummaryThis paper describes the challenges faced, and opportunities identified, by a multidisciplinary team of researchers developing a novel closed loop system to recover valuable metals and reduce e‐waste, focusing on mobile phones as a case study. This multidisciplinary approach is contrasted with current top‐down approaches to making the transition to the circular economy (CE). The aim of the research presented here is to develop a product service system (PSS) that facilitates the recovery of valuable functional components and metals from mobile phone circuit boards. To create a holistic solution and limit unintended consequences, in addition to technological solutions, this paper considers appropriate component lifetimes; the (often ignored) role of the citizen in the circular economy; customer interaction with the PSS; environmental life cycle assessment; and social impacts of the proposed PSS. Development of enabling technologies and materials to facilitate recovery of components and metals and to provide an emotionally durable external enclosure is described. This research also highlights the importance of understanding value in the CE from a multifaceted and interdisciplinary perspective.