bluuebunny/crossref_metadata_2025_split huggingface dataset:
Five‐year impact of catheter ablation for atrial fibrillation in patients with a prior history of stroke
Authors: Bunch T. Jared , May Heidi T. , Bair Tami L. , Crandall Brian G. , Cutler Michael J. , Day John D. , Jacobs Victoria , Mallender Charles , Osborn Jeffrey S. , Weiss J. Peter 
Published: November 2017

AbstractBackgroundCatheter ablation of atrial fibrillation (AF) is an established therapeutic rhythm approach. Patients with a prior history of a stroke (CVA) represent a unique high‐risk population for recurrent thromboembolic events. The role of antiarrhythmic treatment on the natural history of stroke recurrence in these patients is not fully understood.MethodsThree patient groups with a prior CVA and 5 years of follow‐up were matched 1:3:3 by propensity score (±0.01): AF ablation patients receiving their first ablation (n = 139), AF patients that did not receive an ablation (n = 416), and CVA patients without clinical AF (n = 416). Prior CVA was determined by medical chart review. Patients were followed for outcomes of recurrent CVA, heart failure, and death.ResultsThe average age of the population was 69 ± 11 years and 51% male. AF ablation patients had higher rates of hypertension and heart failure (P < 0.0001), but diabetes prevalence was similar between the groups (P = 0.5). Note that 5‐year risk of CVA (HR = 2.26, P < 0.0001) and death (HR = 2.43, P < 0.0001) were higher in the AF, no ablation group compared those that were ablated. When comparing AF, ablation to no AF patients, there was not a significant difference in 5‐year risk of for CVA (HR = 0.82, P = 0.39) and death (HR = 0.92, P = 0.70); however, heart failure risk was increased (HR = 3.08, P = 0.001).ConclusionIn patients with AF and a prior CVA, patients undergoing ablation have lower rates of recurrent stroke compared to AF patients not ablated. Although the full mechanisms of benefit are unknown, as CVA rates are similar to patients without AF these data are suggestive of a potential altering of the natural history of disease progression.
Deaths from Resident‐to‐Resident Aggression in Australian Nursing Homes
Authors: Murphy Briony , Bugeja Lyndal , Pilgrim Jennifer , Ibrahim Joseph E. 
Published: November 2017

ObjectivesTo describe the frequency and nature of deaths from resident‐to‐resident aggression (RRA) in nursing homes in Australia.DesignNational population‐based retrospective cohort study.SettingAccredited nursing homes in Australia.ParticipantsResidents whose deaths resulted from RRA and were reported to the coroner between July 1, 2000, and December 31, 2013.MeasurementsCases were identified using the National Coronial Information System, and data on individual, interpersonal, organizational, and societal factors were collected through review of the paper‐based coroners' files.ResultsThis research identified 28 deaths from RRA over a 14‐year study period (0.004 per 100,000 bed days). Most exhibitors of aggression were male (n = 24, 85.7%), and risk of death from RRA was twice as high for male as for female nursing home residents (relative risk (RR) = 2.13, 95% confidence interval (CI) = 0.93–4.80, P = .05). Almost 90% of residents involved in RRA had a diagnosis of dementia, and three‐quarters had a history of behavioral problems, including wandering and aggression. Dyad analysis showed that exhibitors of aggression were often younger and more recently admitted to the nursing home than targets. RRA incidents commonly occurred in communal areas and during the afternoon and involved a “push and fall.” Seven (25%) RRA deaths had a coronial inquest; criminal charges were rarely filed.ConclusionThis is the first national study in Australia, and the largest internationally, to examine RRA deaths using medicolegal data. This generates hypotheses for future research on the effect of environmental and organizational factors on the frequency and preventability of RRA.
Evaluation of the serum zinc level in adult patients with melasma: Is there a relationship with serum zinc deficiency and melasma?
Authors: Rostami Mogaddam Majid , safavi Ardabili Nastaran , Iranparvar Alamdari Manouchehr , Maleki Nasrollah , Aghabalaei Danesh Maryam 
Published: November 2017

SummaryBackgroundMelasma is a common acquired hypermelanosis of sun‐exposed skin, particularly on the face, which presents as symmetric, light‐ to gray‐brown‐colored macules and patches. There are several studies of serum zinc levels in cutaneous disorders. So far, no studies have been carried out to assess the serum zinc level in patients with melasma. The aim of this study is to determine the serum zinc level in patients with melasma compared to healthy subjects.Materials and methodsA total of 118 patients with melasma and 118 healthy controls were enrolled in this prospective cross‐sectional study. The two groups were matched for age and sex. Atomic absorption spectrophotometry was used to measure serum zinc levels. The statistical analysis was performed using SPSS software.ResultsThe mean serum level of zinc in melasma patients and controls was 77.4±23.2 μg/dL and 82.2±23.9 μg/dL, respectively (P‐value=.0001). Serum zinc deficiency was found in 45.8% and 23.7% of melasma patients and control subjects, respectively. A positive family history of melasma in first‐degree relatives was present in 46 (39%) of the cases, and a history of taking oral contraceptive pill was found in 95 (81%) of women with melasma. The aggravating factors for melasma were stated as: sun exposure (11.1%), pregnancy (15.3%), nutrition (2.5%), oral contraceptive pills (18.6%), and emotional stress (5.9%). The malar and centrofacial patterns were seen in 3.4% and 72% of cases, respectively, whereas 24.6% of the patients had both centrofacial distribution and malar distribution, and there was no patient with mandibular pattern. Among patients with melasma, 20.3% had thyroid dysfunction, while in the control subjects, 8.4% had thyroid dysfunction (P=.001).ConclusionThere is a significant relationship between low levels of zinc and melasma. Zinc deficiency may be involved in the pathogenesis of melasma. Also, treatment with oral zinc supplements can be tried in these patients to see the outcome. However, to make recommendations on screening for zinc deficiency in patients with melasma, future research of good methodological quality is needed.
Meaning for Radical Contextualists: Travis and Gadamer on Why Words Matter
Authors: Lynch Greg 
Published: November 2017

AbstractCharles Travis and Hans‐Georg Gadamer both affirm radical contextualism, the view that natural language is ineliminably context‐sensitive. However, they offer different accounts of the role linguistic meaning plays in determining the contents of utterances. I discuss the differences between Travis's and Gadamer's views of meaning and offer an argument in favour of the latter. I argue that Travis's view assumes a principled distinction between literal and figurative speech that is at odds with his wider contextualist commitments. By contrast, Gadamer's view, on which meaning is ‘fundamentally metaphorical,’ makes no such assumption and thus avoids the difficulty.
Immunological interaction between Giardia cyst extract and experimental toxoplasmosis
Authors: Ashour D. S. , Saad A. E. , Dawood L. M. , Zamzam Y. 
Published: November 2017

SummaryToxoplasmosis is mostly associated with other intestinal parasitic infections especially Giardia due to shared mode of peroral infection. Toxoplasma and Giardia induce a strong T‐helper 1‐ immune response. Our aim was to induce a protective immune response that results in significant impact on intestinal and extra‐intestinal phases of Toxoplasma infection. This study was conducted in experimental animals and assessment of Giardia cyst extract effect on Toxoplasma infection was investigated by histopathological examination of small intestine and brain, Toxoplasma cyst count and iNOS staining of the brain, measurement of IFN‐γ and TGF‐β in intestinal tissues. Results showed that the brain Toxoplasma cyst number was decreased in mice infected with Toxoplasma then received Giardia cyst extract as compared to mice infected with Toxoplasma only. This effect was produced because Giardia cyst extract augmented the immune response to Toxoplasma infection as evidenced by severe inflammatory reaction in the intestinal and brain tissues, increased levels of IFN‐γ and TGF‐β in intestinal tissues and strong iNOS staining of the brain. In conclusion, Giardia cyst extract generated a protective response against T. gondii infection. Therefore, Giardia antigen will be a suitable candidate for further researches as an immunomodulatory agent against Toxoplasma infection.
The prognostic significance of pneumothorax in patients with idiopathic pulmonary fibrosis
Authors: Nishimoto Koji , Fujisawa Tomoyuki , Yoshimura Katsuhiro , Enomoto Yasunori , Enomoto Noriyuki , Nakamura Yutaro , Inui Naoki , Sumikawa Hiromitsu , Johkoh Takeshi , Colby Thomas V. , Suda Takafumi 
Published: November 2017

ABSTRACTBackground and objectivePneumothorax is a co‐morbidity in patients with idiopathic pulmonary fibrosis (IPF). However, its incidence, risk factors and prognostic significance in IPF remain unclear. The aim of this study was to clarify the incidence and prognostic significance of pneumothorax in patients with IPF, and to further investigate the risk factors for its onset.MethodsEighty‐four consecutive patients with IPF based on the consensus guideline were included in this study. We retrospectively reviewed the medical records, pulmonary function tests and chest high‐resolution computed tomography images, and determined the incidence of pneumothorax. The prognostic significance of pneumothorax was evaluated using the Cox proportional hazards model analysis with time‐dependent covariates. We also assessed the cumulative incidence and the risk factors for pneumothorax.ResultsOf the 84 patients, 17 (20.2%) developed pneumothorax. The cumulative incidence of pneumothorax was 8.5%, 12.5% and 17.7% at 1, 2 and 3 years, respectively. Univariate analysis demonstrated that pneumothorax was significantly related to poor prognosis (hazards ratio, 2.99; P = 0.002). Multivariate analysis, adjusting for sex, age and forced vital capacity (% predicted), revealed that pneumothorax was an independent predictor of poor outcome in IPF (hazards ratio, 2.85; P = 0.006). Lower BMI and the presence of extensive reticular abnormalities were significantly associated with developing pneumothorax.ConclusionThese results confirm that patients with IPF often develop pneumothorax during their clinical course and that the onset of pneumothorax predicts a poor outcome.
Transformations between Nonlocal and Local Integrable Equations
Authors: Yang Bo , Yang Jianke 
Published: November 2017

AbstractRecently, a number of nonlocal integrable equations, such as the ‐symmetric nonlinear Schrödinger (NLS) equation and ‐symmetric Davey–Stewartson equations, were proposed and studied. Here, we show that many of such nonlocal integrable equations can be converted to local integrable equations through simple variable transformations. Examples include these nonlocal NLS and Davey–Stewartson equations, a nonlocal derivative NLS equation, the reverse space‐time complex‐modified Korteweg–de Vries (CMKdV) equation, and many others. These transformations not only establish immediately the integrability of these nonlocal equations, but also allow us to construct their Lax pairs and analytical solutions from those of the local equations. These transformations can also be used to derive new nonlocal integrable equations. As applications of these transformations, we use them to derive rogue wave solutions for the partially ‐symmetric Davey–Stewartson equations and the nonlocal derivative NLS equation. In addition, we use them to derive multisoliton and quasi‐periodic solutions in the reverse space‐time CMKdV equation. Furthermore, we use them to construct many new nonlocal integrable equations such as nonlocal short pulse equations, nonlocal nonlinear diffusion equations, and nonlocal Sasa–Satsuma equations.
Mental ill‐health among adult patients at healthcare centres in Sweden: district nurses experiences
Authors: Janlöv Ann‐Christin , Johansson Linda , Clausson Eva K. 
Published: November 2017

BackgroundMental ill‐health among the general population is increasing in Sweden. Primary Health Care (PHC) and Healthcare Centres (HCC), where district nurses (DNs) work, bear the basic responsibility for treatment of mental ill‐health, while severe mental ill‐health fall under the responsibility of psychiatric specialist care. The increased prevalence of mental ill‐health in the community means thatDNs increasingly encounter people with mental health problems – not least as a comorbidity. How wellDNs are equipped to deal with mental ill‐health is currently unclear.AimThe purpose of this study was to explore district nurses’ experience of encountering and dealing with mental ill‐health among adult patients at healthcare centres.DesignA qualitative explorative approach was used to capture the experiences of the phenomena under study.MethodsIndividual interviews were conducted with 10DNs working at sixHCCs. The interviews were transcribed and analysed by qualitative content analysis.ResultsThe result emerged as several subcategories captured by three categories: (i) having competence – a prerequisite for feeling confident; (ii) nursing mental ill‐health requires time and commitment; and (iii) working in an organisation without preparedness, encompassed by the synthesising theme; nursing mental ill‐health requires specific competence and organisational support.ConclusionWorking as aDNrequires formal and informal competence when encountering patients with complex health needs. The findings revealed that theDNs could feel insecure regarding how to deal with patients with mental ill‐health due to lack of knowledge. Assessment of patients with mental ill‐health is time‐ and energy‐consuming and calls for improved teamwork atHCCs as well as effective collaboration with psychiatric specialist care and other care givers. TheDNs responsibility to fulfil their work considering the increasing number of mental ill‐health among people that seeks help atHCCs needs to be acknowledged and met by thePHCorganisation.
CONSISTENCY OF FLY ASH QUALITY FOR MAKING HIGH VOLUME FLY ASH CONCRETE
Authors: Antoni Antoni , Krisnanta Widianto Alvin , Lakshmana Wiranegara Jerry , Hardjito Djwantoro 
Published: November 2017

Fly ash is a by-product of coal burning and is widely used as a substitute for cement material. The advantages of using fly ash in concrete include the improvement of workability and reduction of bleeding and segregation. The problem often encountered when using fly ash is the uncertainty of the fly ash quality. The quality is influenced by the coal origin, burning technique, mineral content, and capturing method. In this study, the consistency of fly ash from one power plant source was investigated for making a high-volume fly ash (HVFA) mortar. Variations in fly ash can be detected by applying rapid indicators as suggested in this paper; i.e., the pH of the fly ash in aqueous solution, the percentage of fly ash particles passing sieve #325 and the superplasticizer demand for the targeted slump flow. The fly ash replacement ratio was varied from 10–60% of cement, by mass. The results showed a large variation in the chemical content of the fly ash as shown by variation in pH, whereas only slight variation in the physical properties of the fly ash, i.e. particle size and shape. Superplasticizer demand for the same flow diameter was reduced with the increase of fly ash content, whereas the optimum fly ash replacement ratio for maximum strength varied among fly ash from different sampling periods. The compressive strength could reach that of control specimens at a replacement ratio of 20–30%, and mortar compressive strength of 42 MPa was still achievable at a replacement ratio of 50%.
Half-lives of PFOS, PFHxS and PFOA after end of exposure to contaminated drinking water
Authors: Li Ying , Fletcher Tony , Mucs Daniel , Scott Kristin , Lindh Christian H , Tallving Pia , Jakobsson Kristina 
Published: November 2017

BackgroundMunicipal drinking water contaminated with perfluorinated alkyl acids had been distributed to one-third of households in Ronneby, Sweden. The source was firefighting foam used in a nearby airfield since the mid-1980s. Clean water was provided from 16 December 2013.ObjectiveTo determine the rates of decline in serum perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS) and perfluorooctanoate (PFOA), and their corresponding half-lives.MethodsUp to seven blood samples were collected between June 2014 and September 2016 from 106 participants (age 4–84 years, 53% female).ResultsMedian initial serum concentrations were PFHxS, 277 ng/mL (range 12–1660); PFOS, 345 ng/mL (range 24–1500); and PFOA, 18 ng/mL (range 2.4–92). The covariate-adjusted average rates of decrease in serum were PFHxS, 13% per year (95% CI 12% to 15%); PFOS, 20% per year (95% CI 19% to 22%); and PFOA, 26% per year (95% CI 24% to 28%). The observed data are consistent with a first-order elimination model. The mean estimated half-life was 5.3 years (95% CI 4.6 to 6.0) for PFHxS, 3.4 years (95% CI 3.1 to 3.7) for PFOS and 2.7 years (95% CI 2.5 to 2.9) for PFOA. The interindividual variation of half-life was around threefold when comparing the 5th and 95th percentiles. There was a marked sex difference with more rapid elimination in women for PFHxS and PFOS, but only marginally for PFOA.ConclusionsThe estimated half-life for PFHxS was considerably longer than for PFOS and PFOA. For PFHxS and PFOS, the average half-life is shorter than the previously published estimates. For PFOA the half-life is in line with the range of published estimates.
Potential US Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline
Authors: Muntner Paul , Carey Robert M. , Gidding Samuel , Jones Daniel W. , Taler Sandra J. , Wright Jackson T. , Whelton Paul K. 
Published: November 2017

Background:
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults provides recommendations for the definition of hypertension, systolic and diastolic blood pressure (BP) thresholds for initiation of antihypertensive medication, and BP target goals.

Objectives:
This study sought to determine the prevalence of hypertension, implications of recommendations for antihypertensive medication, and prevalence of BP above the treatment goal among US adults using criteria from the 2017 ACC/AHA guideline and the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7).

Methods:
The authors analyzed data from the 2011 to 2014 National Health and Nutrition Examination Survey (N = 9 623). BP was measured 3 times following a standardized protocol and averaged. Results were weighted to produce US population estimates.

Results:
According to the 2017 ACC/AHA and JNC7 guidelines, the crude prevalence of hypertension among US adults was 45.6% (95% confidence interval [CI]: 43.6% to 47.6%) and 31.9% (95% CI: 30.1% to 33.7%), respectively, and antihypertensive medication was recommended for 36.2% (95% CI: 34.2% to 38.2%) and 34.3% (95% CI: 32.5% to 36.2%) of US adults, respectively. Nonpharmacological intervention is advised for the 9.4% of US adults with hypertension who are not recommended for antihypertensive medication according to the 2017 ACC/AHA guideline. Among US adults taking antihypertensive medication, 53.4% (95% CI: 49.9% to 56.8%) and 39.0% (95% CI: 36.4% to 41.6%) had BP above the treatment goal according to the 2017 ACC/AHA and JNC7 guidelines, respectively.

Conclusions:
Compared with the JNC7 guideline, the 2017 ACC/AHA guideline results in a substantial increase in the prevalence of hypertension, a small increase in the percentage of US adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.
Systematic Review for the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines
Authors: Reboussin David M. , Allen Norrina B. , Griswold Michael E. , Guallar Eliseo , Hong Yuling , Lackland Daniel T. , Miller Edgar (Pete) R. , Polonsky Tamar , Thompson-Paul Angela M. , Vupputuri Suma 
Published: November 2017

Objective—
To review the literature systematically and perform meta-analyses to address these questions: 1) Is there evidence that self-measured blood pressure (BP) without other augmentation is superior to office-based measurement of BP for achieving better BP control or for preventing adverse clinical outcomes that are related to elevated BP? 2) What is the optimal target for BP lowering during antihypertensive therapy in adults? 3) In adults with hypertension, how do various antihypertensive drug classes differ in their benefits and harms compared with each other as first-line therapy?

Methods—
Electronic literature searches were performed by Doctor Evidence, a global medical evidence software and services company, across PubMed and EMBASE from 1966 to 2015 using key words and relevant subject headings for randomized controlled trials that met eligibility criteria defined for each question. We performed analyses using traditional frequentist statistical and Bayesian approaches, including random-effects Bayesian network meta-analyses.

Results—
Our results suggest that: 1) There is a modest but significant improvement in systolic BP in randomized controlled trials of self-measured BP versus usual care at 6 but not 12 months, and for selected patients and their providers self-measured BP may be a helpful adjunct to routine office care. 2) systolic BP lowering to a target of <130 mm Hg may reduce the risk of several important outcomes including risk of myocardial infarction, stroke, heart failure, and major cardiovascular events. No class of medications (ie, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, calcium channel blockers, or beta blockers) was significantly better than thiazides and thiazide-like diuretics as a first-line therapy for any outcome.
Provision of Health-care Service over the Internet – the Legality of E-consultations in Estonia
Authors: Žmenja Marika 
Published: November 2017

The number of Web sites providing medical consultations is growing constantly. They offer common information and advice, patient education, and general and individualised consulting. In certain cases wherein Web sites offer consultations, the service is subject to the same legal regulation as conventional health-care provision. The article discusses when consulting via the Internet (i.e., e-consulting) can be considered provision of health-care service and which requirements it has to meet if so. The author concludes that what matters here is not how service providers present their service but whether the essence of e-consultation corresponds to the definition of a health-care service – if it does, e-consultation has to be considered one. Among the obstacles in providing e-consultations is fulfilling the requirement of having consultation premises at the time of applying for the necessary permit. Health-care providers are required to have a physical location where they can provide the services. Also addressed in the article is e-consultation as information-society service. It is concluded that if this is an intermediary service, then – if the design of the service so indicates – legal regulations applicable to health-care service provision do not apply. The author finds that, in general, e-consultations are possible and legitimate in the current legal framework.