bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep Disruption at Home As an Independent Risk Factor for Postoperative Delirium
Authors: Todd Oliver M. , Gelrich Lisa , MacLullich Alasdair M. , Driessen Martin , Thomas Christine , Kreisel Stefan H. 
Published: March 2017

ObjectivesTo determine whether sleep disruption at home or in hospital is an independent risk factor for postoperative delirium in older adults undergoing elective surgery.DesignProspective cohort study.SettingGerman teaching hospital.ParticipantsIndividuals aged 65 and older undergoing elective arthroplasty (N = 101).MeasurementsPreoperative questionnaires were used to assess sleep disruption at home (Pittsburgh Sleep Quality Index). Actigraphy was used to objectively measure sleep disruption in the hospital before and after surgery. Delirium was assessed daily after surgery using the Confusion Assessment Method and, if there was uncertainty, validated according to International Classification of Diseases, Tenth Revision (ICD‐10), criteria.ResultsTwenty‐seven participants developed postoperative delirium. Those with sleep disruption at home were 3.26 times as likely to develop postoperative delirium as those without (95% confidence interval (CI) = 1.34–7.92, P = .009). Participants with sleep disruption in hospital were 1.21 times as likely to develop postoperative delirium as those without (95% CI = 1.03–1.41, P = .02). When adjusting for other variables, risk remained significant for sleep disruption at home (risk ratio (RR) = 3.90, 95% CI = 2.14–7.11, P < .001) but not in the hospital (RR = 1.19, 95% CI = 0.69–2.07). Jointly modeling sleep disruption at home and in the hospital, adjusted for covariates, resulted in significant contributions of both (home: RR = 3.10, 95% CI = 1.34–7.17, P = .008; hospital: RR = 1.38 95% CI = 1.13–1.68, P = .002).ConclusionsOlder people with sleep disruption at home are at significantly higher risk of developing postoperative delirium than those without. Sleep disruption in the hospital may further heighten this risk.
How Common Are Pulmonary and Hepatic Adverse Effects in Older Adults Prescribed Nitrofurantoin?
Authors: Claussen Karin , Stocks Edward , Bhat Deepa , Fish Jason , Rubin Craig D. 
Published: March 2017

ObjectivesTo determine the frequency of serious pulmonary and hepatic adverse events (AEs) in persons aged 65 and older prescribed nitrofurantoin.DesignRetrospective electronic health record (EHR) audit of nitrofurantoin prescriptions and associated AEs.SettingUrban academic medical center.ParticipantsAll inpatients and outpatients aged 65 and older prescribed nitrofurantoin from January 1, 2010, to December 31, 2014.MeasurementsThe number of nitrofurantoin prescriptions and pulmonary and hepatic AEs associated with nitrofurantoin use was acquired by data extraction from EHRs.ResultsOf 3,400 individuals aged 65 and older prescribed nitrofurantoin during the study period, 641 were identified as possibly having one of five targeted symptoms or disease complications (pulmonary and hepatic) associated with nitrofurantoin. After a detailed chart audit, 89% were deemed to have no adverse reaction, 7% had a minor side effect or allergy, and 3.9% met criteria for suspicion of a nitrofurantoin‐induced AE, five of whom were rated as being highly suspicious for nitrofurantoin toxicity; four of the five were identified with pulmonary toxicity and one with hepatotoxicity. Four of five of these individuals used nitrofurantoin chronically.ConclusionNitrofurantoin was prescribed for 3,400 individuals aged 65 and older during the 5‐year study period. Serious side effects appeared to be uncommon, but chronic use appeared to be at greater risk.
Exclusion of Elderly People from Randomized Clinical Trials of Drugs for Ischemic Heart Disease
Authors: Bourgeois Florence T. , Orenstein Liat , Ballakur Sarita , Mandl Kenneth D. , Ioannidis John P. A. 
Published: March 2017

ObjectivesTo measure exclusion of elderly adults from randomized trials studying drug interventions for ischemic heart disease (IHD) and describe the characteristics of these trials.DesignCross‐sectional analysis.SettingInterventional clinical trials studying a drug intervention for IHD that started in 2006 and after were identified in ClinicalTrials.gov. Data were extracted on study features, including age‐based inclusion criteria. Data on participants and their age distribution were collected from trial publications, investigator inquiry, and result data in ClinicalTrials.gov.ParticipantsIndividuals aged 65 and older.MeasurementsProportion of trials excluding individuals based on age, mean age of trial participants, and proportion of enrolled participants aged 65 and older and 75 and older.ResultsOf 839 identified trials, 446 (53%) explicitly excluded elderly adults. The most‐frequent upper age limits were 80 (n = 164) and 75 (n = 114), with a median upper age limit of 80 (interquartile range 75–80). Trials with upper age limit exclusions tended to be smaller (median number of participants 100 vs 201, P < .001) and were more likely to be funded primarily by nonindustry sources (78.3% vs 70.0%, P = .006). The overall mean age of trial participants was 62.7 (mean maximum age 74). The estimated proportion of participants aged 65 and older was 42.5% and the estimated proportion aged 75 and older was 12.3%.ConclusionDespite the high burden of IHD in elderly adults, the majority of drug trials do not enroll participants reflective of age‐related prevalence of the disease.
Posttraumatic Stress Disorder, Antipsychotic Use and Risk of Dementia in Veterans
Authors: Roughead Elizabeth E. , Pratt Nicole L. , Kalisch Ellett Lisa M. , Ramsay Emmae N. , Barratt John D. , Morris Philip , Killer Graeme 
Published: March 2017

ObjectivesTo examine the risk of dementia associated with posttraumatic stress disorder (PTSD) and the contribution of antipsychotic use to this risk.DesignRetrospective cohort studySettingAustralia. Administrative claims data from the Australian Government Department of Veterans' Affairs were used.ParticipantsMale Vietnam veterans aged 55 to 65 at baseline (2001–02) with no preexisting dementia diagnosis (N = 15,612).MeasurementsThe association between PTSD and dementia was assessed over 12 years of follow‐up. Dementia was identified as a hospital diagnosis, dementia record in service disability data, or dispensing of medicines for dementia. Cox‐proportional hazards models were used, with age as the time‐scale. Results were stratified according to baseline antipsychotic use.ResultsNo greater risk of dementia was observed with PTSD. In veterans who received antipsychotics, dementia risk was significantly higher than in those who did not (hazard ratio (HR) = 2.1, 95% confidence interval (CI) = 1.4–3.3). Dementia risk was significantly greater in veterans hospitalized for PTSD who received antipsychotics (HR = 2.2, 95% CI = 1.1–4.6) and veterans without PTSD who received antipsychotics (HR = 4.3, 95% CI = 2.1–8.6) than in those without PTSD with no antipsychotic use.ConclusionAntipsychotic use may be a contributor to dementia risk. These findings should be interpreted with caution because the study design was observational. Further research using prospective study designs in settings where diagnostic data, cognitive function, and disease severity are available are required.
Protein Intake and Mobility Limitation in Community‐Dwelling Older Adults: the Health ABC Study
Authors: Houston Denise K. , Tooze Janet A. , Garcia Katelyn , Visser Marjolein , Rubin Susan , Harris Tamara B. , Newman Anne B. , Kritchevsky Stephen B. ,   the Health ABC Study
Published: March 2017

ObjectivesThe current Recommended Dietary Allowance (RDA) for protein is based on short‐term nitrogen balance studies in young adults and may underestimate the amount needed to optimally preserve physical function in older adults. We examined the association between protein intake and the onset of mobility limitation over 6 years of follow‐up in older adults in the Health ABC study.DesignProspective cohort study.SettingMemphis, Tennessee and Pittsburgh, Pennsylvania.ParticipantsCommunity‐dwelling, initially well‐functioning adults aged 70–79 years (n = 1998).MeasurementsProtein intake (g/kg body weight/d) was calculated using an interviewer‐administered 108‐item food frequency questionnaire at baseline. Mobility limitation was assessed semi‐annually and defined as reporting any difficulty walking one‐quarter of a mile or climbing 10 steps on 2 consecutive 6‐month contacts. The association between protein intake and incident mobility limitation was examined using Cox proportional hazard regression models adjusting for demographics, behavioral characteristics, chronic conditions, total energy intake, and height.ResultsMean (SD) protein intake was 0.91 (0.38) g/kg body weight/d, with 43% reporting intakes less than the RDA (0.8 g/kg body weight/d). During 6 years of follow‐up, 705 participants (35.3%) developed mobility limitations. Compared to participants in the upper tertile of protein intake (≥1.0 g/kg body weight/d), participants in the lower two tertiles of protein intake (<0.7 and 0.7 –<1.0 g/kg body weight/d) were at greater risk of developing mobility limitation over 6 years of follow‐up (RR (95% CI): 1.86 (1.41–2.44) and 1.49 (1.20–1.84), respectively).ConclusionLower protein intake was associated with increased risk of mobility limitation in community‐dwelling, initially well‐functioning older adults. These results suggest that protein intakes of ≥1.0 g/kg body weight/d may be optimal for maintaining physical function in older adults.
The Attributable Burden of Clostridium difficile Infection to Long‐Term Care Facilities Stay: A Clinical Study
Authors: Karanika Styliani , Grigoras Christos , Flokas Myrto E. , Alevizakos Michail , Kinamon Tori , Kojic Erna M. , Mylonakis Eleftherios 
Published: March 2017

BackgroundAdvanced age, history of hospitalization, and antibiotic consumption are associated with the pathogenesis of Clostridium difficile infection (CDI). Long‐term care facilities (LTCFs) represent a setting where CDI has been increasingly reported. We aimed to estimate the actual attributable burden of CDI to LTCF stay and determine the characteristics of the disease epidemiology in this setting.DesignIRB‐approved retrospective cohort study.SettingLTCF and community.ParticipantsOne thousand seven hundred and sixty‐one patients.Measurements/ResultsThe prevalence of CDI among LTCF residents was 22.4%, whereas the prevalence of CDI among community residents was 6.7% (P < .001). The prevalence of CDI among LTCF residents was significantly higher in both the 18–64 (P < .001) and the ≥65 age groups (P < .010). Measures of hospital exposure and antibiotic consumption between LTCF and community residents prior to CDI diagnosis were non‐significant. A strict matching (1:2) between LTCF and community residents adjusting for age, total number of hospital admissions and antibiotic consumption showed that the odds of CDI for an LTCF resident were 6.89 times larger than the odds for a community resident (OR = 6.89, 95%, 4.67–10.17). For an LTCF resident with CDI, the odds of manifesting severe disease were 3.25 times larger than the odds for a community resident with CDI (OR = 3.25, 95%, 1.81–5.86). LTCF residents were more frequently hospitalized (P = .002) required longer hospital stays for their CDI management (P = .03) and had more recurrent CDI cases than community residents (P = .04).ConclusionsOur study highlights the increased burden of CDI among LTCF residents independently of age, antibiotic, and hospitalization background. Severe CDI disease and recurrences are more frequent in LTCFs.
Psychiatric Diagnoses Among Older Recipients of Publicly Funded Mental Health Services
Authors: Stahl Sarah T. , Reynolds Charles F. , Whyte Ellen M. , Albert Steven M. 
Published: March 2017

ObjectivesTo compare the prevalence of psychiatric diagnoses among older recipients of publicly funded mental health services (county safety‐net base services and Medicaid) to psychiatric diagnoses in an insured population of older adults from the same county.DesignSecondary analysis of county human services claims data and claims from an insured population in the same county.SettingInpatient and outpatient clinics in Allegheny County, PA.ParticipantsAdults aged 65 and older in the county who received treatment for a psychiatric diagnosis in 2012 (county base services, n = 1,457; Medicaid, n = 641; Health plan insurance, n = 5,595).MeasurementsPsychiatric diagnoses were classified using the International Classification of Diseases, 9th revision (ICD‐9).ResultsEpisodic mood disorders and schizophrenia were more common among county‐funded and Medicaid recipients (50–54% vs 34%). Neurotic conditions were more common among older adults with health plan insurance (18% vs 8%). Nearly a quarter of older adults receiving county base services were classified as having “ill‐defined and unknown causes of morbidity and mortality,” compared <1% among insured and 6% among Medicaid recipients.ConclusionsThe prevalence of psychiatric conditions among older adults varies by insurance coverage, suggesting a role for social and economic factors associated with safety net coverage as well as system‐level differences in delivery of mental health services. Comparing the prevalence of psychiatric diagnoses across insurance types offers insight on social determinants of risk for mental disorders in late life.
Effect of Chronic Diseases and Multimorbidity on Survival and Functioning in Elderly Adults
Authors: Rizzuto Debora , Melis René J. F. , Angleman Sara , Qiu Chengxuan , Marengoni Alessandra 
Published: March 2017

ObjectivesTo determine the effect of chronic disorders and their co‐occurrence on survival and functioning in community‐dwelling older adults.DesignPopulation‐based cohort study.SettingKungsholmen, Stockholm, Sweden.ParticipantsIndividuals aged 78 and older examined by physicians four times over 11 years (N = 1,099).MeasurementsChronic diseases (grouped according to 10 organ systems according to the International Classification of Diseases, Tenth Revision, code) and multimorbidity (≥2 coexisting chronic diseases) were evaluated in terms of mortality, population attributable risk of death, median years of life lost, and median survival time with and without disability (need of assistance in ≥1 activities of daily living).ResultsApproximately one in four deaths were attributable to cardiovascular and one in six to neuropsychiatric diseases. Malignancy was the condition with the shortest survival time (2.5 years). Malignancies and cardiovascular disorders each accounted for approximately 5 years of life lost. In contrast, neurosensorial and neuropsychiatric conditions had the longest median survival time (>6 years), and affected people were disabled for more than half of this time. The most‐prevalent and ‐burdensome condition was multimorbidity, affecting 70.4% of the population, accounting for 69.3% of total deaths, and causing 7.5 years of life lost. Finally, people with multimorbidity lived 81% of their remaining years of life with disability (median 5.2 years).ConclusionSurvival in older adults differs in length and quality depending on specific conditions. The greatest negative effect at the individual (shorter life, greater dependence) and societal (number of attributable deaths, years spent with disability) level was from multimorbidity, which has made multimorbidity a clinical and public health priority.
WHY DO WE LIE? A PRACTICAL GUIDE TO THE DISHONESTY LITERATURE
Authors: Jacobsen Catrine , Fosgaard Toke Reinholt , Pascual‐Ezama David 
Published: March 2017

AbstractOver the last decade, a massive body of research has been devoted to uncovering human dishonesty. In the present paper, we review more than a hundred papers from this literature and provide a comprehensive overview by first listing the existing theoretical frameworks, and then covering the common empirical approaches, synthesizing the demographic and personal characteristics of those who cheat, identifying the behavioural mechanisms found that affect dishonesty and finally we finish by discussing how the empirical evidence fit theory. Overall, the review concludes that many people behave dishonestly, but also that it is a highly malleable behavior sensitive to elements such as decision contexts, behaviour of others, state of mind and depletion. The review can be used as an overview of the dishonesty literature or as a guide or work of reference for selected topics of interest.
An International Survey among Prosthodontists of the Use of Mandibular Implant‐Supported Dental Prostheses
Authors: Kronstrom Mats , Carlsson Gunnar E. 
Published: March 2017

AbstractPurposeTo evaluate the use of implant‐supported overdentures (IOD) and implant‐supported fixed dental prostheses (IFDP) in patients with edentulous mandibles among international prosthodontists.Materials and MethodsA questionnaire was sent by e‐mail to all clinically active prosthodontists in the International College of Prosthodontists with questions related to implant treatment of the edentulous mandible performed in 2015.ResultsOne hundred and sixteen prosthodontists from 33 countries responded to the questionnaire. The vast majority of the responding prosthodontists was faculty or worked in private practice, and the great majority had performed treatment with mandibular implant‐supported dental prostheses; however, two thirds of the respondents reported that <20% of the implant patients in their clinic had received treatment related to edentulous mandibles. The majority reported using 2 implants (84%), while 13% used 4 for overdenture retention. There were great variations regarding retention systems used for mandibular IODs; the most common was individual Locator attachments. Cost was considered the most common reason to choose mandibular IOD, There was a wide variation of materials used for mandibular IFDPs. The most common combination included milled titanium frameworks and acrylic resin teeth.ConclusionsThis survey, completed by 116 prosthodontists from 33 countries, showed that implant treatment for edentulous mandibles is common, but there was great variation among the respondents regarding amount of treatments performed, design, and materials used for the implant prostheses.
Simultaneous recording of ultrasound and polysomnography during natural sleep in patients with obstructive sleep apnea: a pilot study
Authors: Chen Jeng‐Wen , Huang Chih‐Chung , Weng Chi‐Kai , Chang Chun‐Hsiang , Wang Shou‐Jen 
Published: March 2017

SummaryTongue base deformation may play a critical role in the phenomenon of obstructive sleep apnea, but polysomnography provides limited information regarding the effect of tongue motion during natural sleep. We reported on preliminary results of combining a novel ultrasound system and polysomnography for simultaneous recordings during natural sleep in volunteers and patients with obstructive sleep apnea. All participants underwent time‐synchronized polysomnography and submental transcutaneous ultrasound examinations. The wearable ultrasound device detected the air–mucosal interface of the tongue surface and automatically determined the maximum tongue base thickness in real time. All participants reported no sensation of heat, no sign of skin allergy, and an average of mild disturbance after the ultrasound recordings. In the individual patient with obstructive sleep apnea, we demonstrated a significant difference (P < 0.001) between the ultrasonic tongue base thickness measured during eupnea and that measured during snoring, hypopnea and apnea. The ultrasonic tongue base thickness increased and remained before the occurrence of obstructive apnea. On average, increased tongue base thicknesses of 2.5 (4.1%), 6.0 (9.8%) and 7.7 mm (12.5%) are associated with snoring, hypopnea and apnea, respectively. Our present data demonstrate that simultaneous examination of ultrasonic tongue base thickness and polysomnography is feasible for prolonged recording during natural sleep. The proposed method also enables the detection of significant differences in ultrasonic tongue base thickness between eupnea and obstructive respiratory events evaluated using polysomnography. This novel technique can be used to generate hypotheses for subsequent investigations of the underlying mechanisms and individualized combined therapy for obstructive sleep apnea. Clinical trial registration: This study has been registered at the Chinese Clinical Trial Registry website with the registration number of ChiCTR‐DDT‐13003313. The date of registration was 13 July 2013.
Endothelial signaling and the dynamic regulation of arterial tone: A surreptitious relationship
Authors: Welsh Donald G. , Longden Thomas A. 
Published: March 2017

AbstractThe endothelium is an integrated layer of cells whose dynamic regulation governs arterial tone development and the matching of blood flow delivery to tissue energetic demand. Investigating the structural and electrical properties of native endothelial cells has been a challenging prospect, with efforts often restricted to traditional myographic techniques. Concerted experimental attention, along with recent technical advances, has broadened the investigative tool kit, deepening mechanistic insights. This overview in part of a STI centered on the endothelium and how key structural/electrical properties guide arterial tone development and integrated network behavior. Articles are written in a provocative, opinionated manner to provoke deeper thought and to highlight areas of investigative deficiency.
Influences of nationalisms on citizenship education: revealing a ‘dark side’ in Lebanon
Authors: Akar Bassel , Albrecht Mara 
Published: March 2017

AbstractThe development of education policies is in many aspects driven by nationalist aims, especially when demonstrating postcolonial autonomy. In the case of Lebanon, Arab and Lebanese forms of nationalism have framed education policy development when transitioning out of the French mandate to an independent republic and during pan‐Arab movements against colonialism. Following 15 years of armed conflict (1975–1990), the reformed national curriculum for citizenship drew on a negotiated compromise between advocates of Lebanese and Arab nationalism to foster a unifying national identity. The practices and outcomes of citizenship education, however, reveal degrees of social exclusion, barriers to learning active citizenship, infringement on intellectual freedoms and denial of thinking historically. Evidence is drawn from empirical studies, the state of affairs of history education and student registration figures in Lebanese and non‐Lebanese systems. The findings raise debates on the role of language in citizenship education and suggest a need to reconceptualise the implementation of nationalist aims in education policies, especially by incorporating elements of cosmopolitanism.