bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Supported Discharge by Caregiver-Mediated Exercises and e-Health Support After Stroke
Authors: van den Berg Maayken , Crotty Maria , Liu Enwu , Killington Maggie , Kwakkel Gert , van Wegen Erwin 
Published: June 2016

Background and Purpose—
This proof-of-concept trial investigated the effects of an 8-week program of caregiver-mediated exercises commenced in hospital combined with tele-rehabilitation services on patient self-reported mobility and caregiver burden.

Methods—
Sixty-three hospitalized stroke patients (mean age 68.7, 64% female) were randomly allocated to an 8-week caregiver-mediated exercises program with e-health support or usual care. Primary outcome was the Stroke Impact Scale mobility domain. Secondary outcomes included length of stay, other Stroke Impact Scale domains, readmissions, motor impairment, strength, walking ability, balance, mobility, (extended) activities of daily living, psychosocial functioning, self-efficacy, quality of life, and fatigue. Additionally, caregiver’s self-reported fatigue, symptoms of anxiety, self-efficacy, and strain were assessed. Assessments were completed at baseline and at 8 and 12 weeks.

Results—

Intention-to-treat analysis showed no between-group difference in Stroke Impact Scale mobility (
P
=0.6); however, carers reported less fatigue (4.6, confidence interval [CI] 95% 0.3–8.8;
P
=0.04) and higher self-efficacy (−3.3, CI 95% −5.7 to −0.9;
P
=0.01) at week 12. Per-protocol analysis, examining those who were discharged home with tele-rehabilitation demonstrated a trend toward improved mobility (−9.8, CI 95% −20.1 to 0.4;
P
=0.06), significantly improved extended activities of daily living scores at week 8 (−3.6, CI 95% −6.3 to −0.8;
P
=0.01) and week 12 (3.0, CI 95% −5.8 to −0.3;
P
=0.03), a 9-day shorter length of stay (
P
=0.046), and fewer readmissions over 12 months (
P
<0.05).

Conclusions—
Caregiver-mediated exercises supported by tele-rehabilitation show promise to augment intensity of practice, resulting in improved patient-extended activities of daily living, reduced length of stay with fewer readmissions post stroke, and reduced levels of caregiver fatigue with increased feelings of self-efficacy. The current findings justify a larger definite phase III randomized controlled trial.

Clinical Trial Registration—

URL:
http://www.anzctr.org.au
. Unique identifier: ACTRN12613000779774.
Diet analysis indicates seasonal fluctuation in trophic overlap and separation between a native and an introduced shrimp species (Decapoda, Palaemonidae) in the tidal river Thames (U.K.)
Authors: Ashelby Christopher W. , De Grave Sammy , Johnson Magnus L. 
Published: June 2016

The diets of Palaemon longirostris and the non-native P. macrodactylus were investigated to explore their competitive interactions. Both species are largely carnivorous with amphipods being the dominant prey. Chironomid larvae were consumed in large numbers by both species in summer. Vacuity coefficients were higher for both species in winter than summer. A high degree of dietary overlap occurs in winter, with less overlap in summer suggesting that the two species compete for food on a seasonal basis, which may be partly attributed to the absence of chironomid larvae, and generally reduced prey availability, in the winter. If summer prey also become limited then competition for food may increase and P. macrodactylus may then have an adverse effect on P. longirostris. An introduction of P. macrodactylus in the summer, when there is less competition for food, may be more likely to lead to a successful colonisation than one in the winter.
Cloud Radiative Effects and Precipitation in Extratropical Cyclones
Authors: Polly James B. , Rossow William B. 
Published: June 2016

AbstractClouds associated with extratropical cyclones complicate the well-developed theory of dry baroclinic waves through feedback on their dynamics by precipitation and cloud-altered radiative heating. The relationships between cyclone characteristics and the diabatic heating associated with cloud radiative effects (CREs) and latent heat release remain unclear. A cyclone tracking algorithm [NASA’s Modeling, Analysis, and Prediction (MAP) Climatology of Midlatitude Storminess (MCMS)] is used to identify over 106 cyclones in 33 years of the ERA-Interim and collect the properties of each disturbance. Considering storm intensity as related to wind speeds, which depend on the pressure gradient, the distribution of cyclone properties is investigated using groups defined by their depth (local pressure anomaly) and the radius of the region within closed pressure contours to investigate variations with longitude (especially ocean and land), hemisphere, and season. Using global data products of cloud radiative effects on in-atmosphere net radiation [the ISCCP radiative flux profile dataset (ISCCP-FD)] and precipitation (GPCP), composites are assembled for each cyclone group and for “nonstormy” locations. On average, the precipitation rate and the CRE are approximately the same among all cyclone groups and do not strongly differ from nonstormy conditions. The variance of both precipitation and CRE increases with cyclone size and depth. In larger, deeper storms, maximum precipitation and CRE increase, but so do the amounts of nonprecipitating and clear-sky conditions.
Severe Weather Warning Communication: Factors Impacting Audience Attention and Retention of Information during Tornado Warnings
Authors: Drost Robert , Casteel Mark , Libarkin Julie , Thomas Stephen , Meister Matt 
Published: June 2016

AbstractWeather hazards in the United States inflict both personal and economic tolls on the public. Communicating warnings about weather hazards is an important duty of TV weathercasters. Televised weather warnings are typically conveyed through live radar, live coverage, and warning scrolls. However, these traditional approaches may not be entirely effective given the limited attention some members of the public pay to these warnings. A study comparing individual responses to a traditional warning, an animated warning, and an audio warning was undertaken to evaluate the impact of delivery methods on viewer attention, retention, and preferences during viewing of severe weather warnings. A Tobii T60 eye tracker was used to document visual interactions with on-screen warnings and surveys were used to collect evidence of warning retention and preference. Demographic variables were also collected to describe the study population. Results indicate that viewers of the animated warning retained more pertinent information about the tornado warning than viewers of the traditional warning, and retention during the traditional warning was equivalent to that of the audio warning. In addition, gaze patterns for the traditional warning were much more diffuse than for the animated warning, suggesting that attention was more focused on the animation than the live video. In addition, modifications to reduce visual complexity of traditional warnings may positively impact viewer attention to individual warning elements. Future studies will consider the effectiveness of a hybrid warning containing both traditional and animated components. The current research study can be used to advance current severe weather warning communication techniques and increase public awareness during severe weather events.
Effects of repeated freeze–thaw cycles on endocrine parameters in plasma and serum
Authors: Hillebrand JJ , Heijboer AC , Endert E 
Published: June 2016

Background Repeated freezing and thawing of plasma (or serum) may influence the stability of plasma (or serum) constituents. Despite the alarming warnings from commercial manuals that freeze–thaw cycles affect the stability of hormones in plasma (or serum), surprisingly little, consistent information about this concept is available in literature. Methods We studied the stability of 15 endocrine parameters (adrenocorticotropic hormone, osteocalcin, plasma renin activity, α-subunits, cortisol binding globulin, glucagon, inhibin B, fT4, TT4, TT3, rT3, TBG, TSH, chromogranin A and thyroglobulin upon repeated freeze–thaw cycles in plasma (or serum) samples from 10 volunteers. Blood was collected by venipuncture and after centrifugation and aliquoting, all samples were frozen at −20℃. Aliquots were thawed up to four times and changes in concentrations of endocrine parameters were compared to baseline condition. Results Repeated freeze–thaw cycling resulted in significant and relevant increases of plasma renin activity and a small decrease of adrenocorticotropic hormone. Conclusions For most of the analysed endocrine parameters, we found no effects of multiple freeze–thaw cycles despite alarming notifications in assay manuals. Plasma renin activity was the only endocrine parameter that showed significant and relevant changes following repeated freeze–thaw cycling.
Clinical, Psychosocial, and Demographic Factors Are Associated With Overweight and Obesity in Early Adolescent Girls With Type 1 Diabetes
Authors: Minges Karl E. , Whittemore Robin , Chao Ariana M. , Jefferson Vanessa , Murphy Kathryn M. , Grey Margaret 
Published: June 2016

Purpose The purpose of the study was to examine the differences in clinical, psychosocial, and demographic factors by sex and weight status. Methods Baseline data were analyzed from 318 adolescents (mean age = 12.3 ± 1.1 years, 55.0% female, 62.7% white) with type 1 diabetes (T1D) from a multisite clinical trial. Differences were examined between normal weight (body mass index ≥5th and <85th percentile) and overweight/obese (body mass index ≥85th percentile) boys and girls with T1D in clinical, psychosocial, and demographic factors. Descriptive and multiple logistic regression analyses were used. Results Overweight/obesity was prevalent (39.0%) and common in girls (42.6%) and boys (33.1%). In bivariate analyses, overweight/obese girls had parents with lower educational attainment, longer diabetes duration, and significantly worse self-management and psychosocial health as compared with normal weight girls. There were no differences between overweight/obese and normal weight girls in A1C, therapy type, race/ethnicity, or household income. No significant differences were found between normal weight and overweight/obese boys. In multivariate analysis, parental educational attainment (master or higher vs high school diploma or less) and perceived stress were significantly associated with overweight/obesity in girls. Longer duration of T1D bordered statistical significance. Conclusions Overweight/obesity is prevalent among adolescents with T1D. Clinical, psychosocial, and demographic factors are associated with overweight/obesity in girls but not boys. Greater attention to weight status and aspects of health that are germane to adolescents with T1D is warranted.
Obstructive Sleep Apnea Resolution in Hypopnea‐ versus Apnea‐Predominant Children after Adenotonsillectomy
Authors: Tang Alice L. , Cohen Aliza P. , Benke James R. , Stierer Kevin D. , Stanley James , Ishman Stacey L. 
Published: June 2016

ObjectiveGiven that 30% to 40% of children have persistent obstructive sleep apnea (OSA) after adenotonsillectomy, we evaluated whether children with hypopnea‐predominant OSA were more likely to have complete disease resolution after adenotonsillectomy than those with apnea‐predominant disease. We also identified risk factors that might modify the relationship between disease resolution and polysomnographic event type (ie, hypopnea vs apnea).Study DesignCase series with chart review.SettingTertiary pediatric hospital.Subjects/MethodsConsecutive 1‐ to 18‐year‐old typically developing children diagnosed with OSA from March 2011 to December 2012 underwent adenotonsillectomy and completed pre‐ and postoperative polysomnography within 1 year of surgery.ResultsFifty‐eight children were included (27 female; mean ± SD: age, 5.6 ± 3.1 years; body mass index z score, 1.1 ± 1.7). Overall, adenotonsillectomy resulted in significant improvement in obstructive apnea‐hypopnea index (oAHI) from 23.3 ± 40.0 to 4.3 ± 8.2 events per hour (P <. 001), obstructive apnea index (5.1 ± 7.4 to 0.4 ± 0.8, P <. 001), and obstructive hypopnea index (oHI; 18.1 ± 37.5 to 3.7 ± 8.1, P <. 001). There was complete response (oAHI <1.0 event/h) in 24 of 58 patients (41%) but no difference by event type (P =. 11). On univariate analysis, only race, sex, oxygen saturation nadir, and oHI were predictive of response to adenotonsillectomy, while multivariate analysis found that prematurity, age, oxygen saturation nadir, oHI, obstructive apnea index, and oAHI were predictive. Event type was not significant, even in a model controlling for age, race, sex, prematurity, asthma, body mass index, and baseline polysomnographic variables.ConclusionThis small study demonstrated no difference in disease resolution between children with hypopnea‐ and apnea‐predominant OSA who underwent adenotonsillectomy. Additionally, adenotonsillectomy significantly improved OSA in most children, and high preoperative oAHI was associated with persistent postoperative OSA.
Electrophysiologic Evaluation of the Facial Nerve and Blink Reflex Pathways in Asymptomatic Cochlear Implant Users
Authors: Edizer Deniz Tuna , Adatepe Turgut , Uzun Nurten , Yigit Ozgur , Gunduz Aysegul , Yildiz Muhammet , Celebi Ozlem Onerci 
Published: June 2016

ObjectiveTo evaluate the functional integrity of the facial nerve and blink reflex (BR) pathways in asymptomatic patients who underwent cochlear implantation (CI).Study DesignCase series with planned data collection.SettingTertiary referral center.Subjects and MethodsTwenty‐four deafened patients with unilateral CI who had no complications were enrolled. Bilateral compound muscle action potentials (CMAPs) of the facial nerve were recorded over the nasalis and occipitalis muscles, whereas BR responses were recorded over the orbicularis oculi after supraorbital nerve stimulation. All recordings were performed when the external part of the implant was in place (CIp) and after its removal (CIr), except occipitalis recordings, which were performed only after removal. The amplitude and latency of CMAP were measured to evaluate the axonal integrity of the zygomatic and posterior branches of the facial nerve. Latency, amplitude, and duration of the BR were measured to investigate the integrity of trigeminofacial connections.ResultsThe amplitude and latency of CMAP over the nasalis muscle were bilaterally normal, and the difference between CIp and CIr was not statistically significant. No CMAP of the occipitalis muscle was recorded in 4 (16.7%) patients, and low‐amplitude responses were recorded on the implant side of 20 (83.3%). Amplitudes of the contralateral R2 response were higher in the CIp condition versus the CIr condition (P =. 031). There were no differences among other BR components.ConclusionDuring functioning of the CI system, excitability of the facial circuit may increase either through the facial motor nucleus or through removal of the inhibitory effect of the descending pathway.
Diet-induced obesity alters dural CGRP release and potentiates TRPA1-mediated trigeminovascular responses
Authors: Marics Balázs , Peitl Barna , Varga Angelika , Pázmándi Kitti , Bácsi Attila , Németh József , Szilvássy Zoltán , Jancsó Gábor , Dux Mária 
Published: June 2016

Background Clinical studies suggest a link between obesity and the primary headache disorder migraine. In our study we aimed to reveal the effect of obesity on meningeal nociceptor function in rats receiving a high-fat, high-sucrose diet. Methods Transient receptor potential ankyrin 1 (TRPA1) receptor activation-induced changes in meningeal blood flow, release of calcitonin gene-related peptide (CGRP) from trigeminal afferents and TRPA1 protein expression in the trigeminal ganglia were measured in control and obese rats. Metabolic parameters of the animals were assessed by measuring glucose and insulin homeostasis as well as plasma cytokine concentrations. Results The present experiments revealed an enhanced basal and TRPA1 receptor agonist-induced CGRP release from meningeal afferents of obese insulin-resistant rats and an attenuated CGRP release to potassium chloride. Obesity was also associated with an augmented vasodilatation in meningeal arteries after dural application of the TRPA1 agonist acrolein, a reduction in TRPA1 protein expression in the trigeminal ganglia and elevations in circulating proinflammatory cytokines IL-1β and IL-6 in addition to increased fasting blood glucose and insulin concentrations. Conclusions Our results suggest trigeminal sensitisation as a mechanism for enhanced headache susceptibility in obese individuals after chemical exposure of trigeminal nociceptors.
Ethical competency of nurse leaders: A qualitative study
Authors: Barkhordari-Sharifabad Maasoumeh , Ashktorab Tahereh , Atashzadeh-Shoorideh Foroozan 
Published: June 2016

Background: Ethics play an important role in activating the manpower and achieving the organizational goals. The nurse leaders’ ethical behavior can promote the care quality by affecting the nurses’ performance and bringing up several positive consequences for the organization. Objectives: The aim of this study was to identify and describe the ethical competency of nurse leaders in cultural domains and the working conditions of the Iranian healthcare setting to arrive at a more comprehensive and specific perspective. Methods: This was a qualitative conventional content analysis study conducted with the participation of 14 nurse leaders at various levels. The participants were selected using the purposive sampling method, and the required data were collected using deep interview and also semi-structured interview. A deductive method of content analysis was applied in data analysis. Ethical considerations: This study was conducted in accord with the principles of research ethics and national rules and regulations relating to informed consent and confidentiality. Findings: Data analysis resulted in 17 subcategories that were subsequently grouped into three major categories including empathetic interactions, ethical behavior, and exalted manners. Discussion: Our findings are consistent with previous ones, yet presenting a more complete knowledge about aspects of ethical competency of nurse leaders. The nurse leaders can provide a proper behavioral model for the work environment through the use of new information. Conclusion: The nurse leaders introduced various aspects of ethical competency, so the leaders’ ethical competency could be promoted via planning and managing some ethical development programs. More future research is needed regarding the experiences of the subordinates and other related parties.
An Evaluation of the Modified Diagnostic Criteria for DIC Established by the Japanese Society of Thrombosis and Hemostasis
Authors: Aota Takumi , Wada Hideo , Yamashita Yoshiki , Matsumoto Takeshi , Ohishi Kohshi , Suzuki Kei , Imai Hiroshi , Usui Masanobu , Isaji Shuji , Asakura Hidesaku , Okamoto Kohji , Katayama Naoyuki 
Published: June 2016

Objective: We evaluated the modified diagnostic criteria for disseminated intravascular coagulation (DIC), which was published by the Japanese Society of Thrombosis and Hemostasis (JSTH) in 108 patients with suspected infectious DIC. Material and methods: The diagnoses of the patients were as follows: DIC (n = 63), pre-DIC (n = 22), and non-DIC (n = 45). The efficacy of the diagnostic criteria for DIC was evaluated using a receiver–operating characteristic analysis. Results: Although the area under the curve for global coagulation test (GCT) scores in the diagnosis of “DIC” was high that for the diagnosis of “DIC and pre-DIC” was low, suggesting that the addition of antithrombin (AT), soluble fibrin (SF)/thrombin–AT complex (TAT), and reduced platelet count (PLT) values was required to diagnose “DIC and pre-DIC.” Using GCT score with the AT, SF/TAT, and reduced PLT values, the cutoff value of the DIC score for the diagnosis of “DIC and pre-DIC” was 5 points. Discussion and conclusion: The modified JSTH’s diagnostic criteria for DIC, which used the GCT score and the reduced PLT, AT, and TAT/SF values, were useful for diagnosing “DIC and pre-DIC.”
Planning Ahead or Living a Day at a Time? A Family History of AD and Retirement Planning
Authors: Zick Cathleen D. , Smith Ken R. , Mayer Robert N. 
Published: June 2016

Background: We assess whether a family history of Alzheimer’s disease (AD) is associated with the odds that healthy family members’ engage in retirement planning activities. Methods: This is a cross-sectional study utilizing individual-level data from the Utah Population Database that have been linked to Medicare records and to responses from a retirement planning survey. Engagement in 3 retirement planning activities was estimated as a function of the number of parents and grandparents diagnosed with AD along with a set of fundamental socioeconomic and demographic covariates. Results: Adults who had a parent with AD were 86% more likely to have seen a professional financial advisor and 40% less likely to plan to retire before age 65. Conclusions: Caregiving costs and/or knowledge of the familial risk of developing AD may provide adult children with a forewarning of their own future financial needs that, in turn, motivates them to engage in retirement planning.
The Effect of Undiagnosed Diabetes on the Association Between Self-Reported Diabetes and Cognitive Impairment Among Older Mexican Adults
Authors: Downer Brian , Kumar Amit , Mehta Hemalkumar , Al Snih Soham , Wong Rebeca 
Published: June 2016

Purpose: To study the effect of undiagnosed diabetes on the relationship between self-reported diabetes and cognitive impairment. Methods: Data were from 1033 participants aged ≥60 from Wave III (2012) of the Mexican Health and Aging Study. Participants were classified as nondiabetic (n = 589), undiagnosed diabetic (n = 201), and self-reported diabetic (n = 243). Multivariate logistic regression models were used to estimate the relationship between self-reported diabetes and severity of cognitive impairment (nonimpaired, moderate impaired, severe impaired). Results: Self-reported diabetes was associated with significantly higher odds for severe, but not moderate, cognitive impairment (odds ratio [OR] = 2.70, 95% confidence interval [CI] = 1.39-5.32). The association between self-reported diabetes and severe cognitive impairment decreased by 6.3% when undiagnosed diabetics were included in the nondiabetic category and by 30.4% when undiagnosed diabetics were included in the self-reported diabetes category. Discussion: The association between self-reported diabetes and severe cognitive impairment is underestimated when undiagnosed diabetics are not differentiated from self-reported diabetics and nondiabetics.