bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between physical activity levels in mid-life with physical activity in old age: a 20-year tracking study in a prospective cohort
Authors: Aggio Daniel , Papacosta Olia , Lennon Lucy , Whincup Peter , Wannamethee Goya , Jefferis Barbara J 
Published: September 2017

ObjectivesThis study aims to examine the tracking and predictability of physical activity in old age from overall physical activity and participation in sport, recreational activity and walking in mid-life.DesignProspective population-based cohort study.SettingBritish Regional Heart Study participants recruited from primary care centres in the UK in 1978–1980.Participants and outcome measuresMen (n=3413) self-reported their physical activity at baseline, 12, 16 and 20-year follow-ups and were categorised as inactive or active and having high or low participation in sport, walking and recreational activities. Tracking was assessed using kappa statistics and random effects models. Logistic regression estimated the odds of being active at 20-year follow-up according to physical activity participation in mid-life.ResultsAmong 3413 men (mean age at baseline 48.6±5.4 years) with complete data, tracking of overall physical activity was moderate (kappa: 0.23–0.26). Tracking was higher for sports participation (kappa: 0.35–0.38) compared with recreational activity (kappa: 0.16–0.24) and walking (kappa: 0.11–0.15). Intraclass correlation coefficients demonstrated similar levels of stability and only marginally weakened after controlling for covariates. Compared with inactive men, being active at baseline was associated with greater odds of being active at 20-year follow-up (OR 2.7, 95% CI 2.4 to 3.2) after adjusting for sociodemographic, health and lifestyle variables. Playing sport in mid-life was more strongly associated with being active at 20-year follow-up than other domains, particularly when sport participation began earlier in life.ConclusionBeing physically active in mid-life increases the odds of being active in old age. Promoting physical activity in later life might be best achieved by promoting sport participation earlier in the life course.
Health education intervention promoting infant safe sleep in paediatric primary care: randomised controlled trial
Authors: McDonald Eileen M , Davani Amanda , Price Akisha , Mahoney Patricia , Shields Wendy , Musci Rashelle J , Solomon Barry S , Stuart Elizabeth A , Gielen Andrea C 
Published: September 2017

BackgroundFew randomised controlled trials (RCTs) have been conducted to improve infant sleep practices. There is limited research on how best to integrate safe sleep information into routine paediatric anticipatory guidance delivered at well child visits (WCVs). This protocol paper describes the design of the Safe Start Study, which aims to evaluate the impact of safe sleep interventions on parents’ knowledge, beliefs and behaviours related to creating and maintaining a safe sleep environment for their infants.MethodsSafe Start is a three-group RCT comparing a safe sleep health education intervention delivered as part of the 2-week WCV, an attention-matched control group that receives a scald burn prevention intervention, and a standard of care group. A baseline survey is completed at the 2-week WCV; follow-up surveys and observations are completed in the home at 2–4 weeks and 2–3 months. Participants include mother–baby dyads attending a large urban paediatric primary care practice and their paediatricians. Primary outcomes are self-reported behaviours (baby sleeps alone, on back, in crib and in a smoke-free environment), observations of the sleep environment, paediatricians’ anticipatory guidance counselling about safe sleep and participants’ reported exposure to an existing city-wide safe sleep campaign.DiscussionProviding a theory-driven and evidenced-based safe sleep intervention is both a research and a clinical practice priority. This study will advance the application of educational and environmental interventions in the primary care setting to improve the safety of infant sleep environments in high-risk families.Trial registration numberNCT03070639; Pre-results.
Cultural crossings of care: An appeal to the medical humanities
Authors: Kristeva Julia , Moro Marie Rose , Ødemark John , Engebretsen Eivind 
Published: September 2017

Modern medicine is confronted with cultural crossings in various forms. In facing these challenges, it is not enough to simply increase our insight into the cultural dimensions of health and well-being. We must, more radically, question the conventional distinction between the ‘objectivity of science’ and the ‘subjectivity of culture’. This obligation creates an urgent call for the medical humanities but also for a fundamental rethinking of their grounding assumptions.Julia Kristeva (JK) has problematised the biomedical concept of health through her reading of the anthropogony of Cura (Care), who according to the Roman myth created man out of a piece of clay. JK uses this fable as an allegory for the cultural distinction betweenhealthconstrued as a ‘definitive state’, which belongs to biological life (bios), andhealingas a durative ‘process with twists and turns in time’ that characterises human living (zoe). A consequence of this demarcation is that biomedicine is in constant need of ‘repairing’ and bridging the gap between bios and zoe, nature and culture. Even in radical versions, the medical humanities are mostly reduced to such an instrument of repairment, seeing them as what we refer to as a soft, ‘subjective’ and cultural supplement to a stable body of ‘objective’, biomedical and scientific knowledge. In this article, we present a prolegomenon to a more radical programme for the medical humanities, which calls the conventional distinctions between the humanities and the natural sciences into question, acknowledges the pathological and healing powers of culture, and sees the body as a complex biocultural fact. A key element in such a project is the rethinking of the concept of ‘evidence’ in healthcare.
A comparison between the new Low-profile Visualized Intraluminal Support (LVIS Blue) stent and the Flow Redirection Endoluminal Device (FRED) in bench-top and cadaver studies
Authors: Matsuda Yoshikazu , Chung Joonho , Keigher Kiffon , Lopes Demetrius 
Published: September 2017

ObjectThe aim of this study is to demonstrate the differences between the new Low-profile Visualized Intraluminal Support (LVIS Blue) stenting device and the Flow Redirection Endoluminal Device (FRED) using a series of bench-top evaluations and optical coherence tomography (OCT) images in a cadaveric preparation of the basilar artery.MethodsThe first part of the evaluation was bench-top microscopic documentation of metal coverage for LVIS Blue and FRED stents. OCT images of the cerebral vessels and deployed stents were acquired using OCT intravascular imaging. The stents were deployed from the left posterior cerebral artery to the basilar artery in a fresh frozen cadaver. Wall apposition and the relationship to jailed perforators were evaluated.ResultsThe metal coverage along the inner curves of the LVIS Blue stent was similar to that along the outer curves of the FRED stent. The LVIS Blue stent cell size was compatible for crossing with the tested microcatheters after deployment of the stent. The LVIS Blue stent showed better wall apposition and less coverage of the perforator than the FRED stent in the cadaver experiment.ConclusionsLVIS Blue has a good crossing profile for microcatheters, better wall apposition, and less perforator coverage than FRED. These are desirable features in territories with high densities of perforators such as the posterior circulation.
Cervical Cancer Screening among Women from Muslim-Majority Countries in Ontario, Canada
Authors: Lofters Aisha K. , Vahabi Mandana , Kim Eliane , Ellison Lisa , Graves Erin , Glazier Richard H. 
Published: September 2017

Abstract
Background: Immigrant women are less likely to be screened for cervical cancer in Ontario. Religion may play a role for some women. In this population-based retrospective cohort study, we used country of birth as a proxy for religious affiliation and examined screening uptake among foreign-born women from Muslim-majority versus other countries, stratified by region of origin.
Methods: We linked provincial databases and identified all women eligible for cervical cancer screening between April 1, 2012, and March 31, 2015. Women were classified into regions based on country of birth. Countries were classified as Muslim-majority or not.
Results: Being born in a Muslim-majority country was significantly associated with lower likelihood of being up-to-date on Pap testing, after adjustment for region of origin, neighborhood income, and primary care–related factors [adjusted relative risk (ARR), 0.93; 95% (confidence interval) CI, 0.92–0.93]. Sub-Saharan African women from Muslim-majority countries had the highest prevalence of being overdue (59.6%), and the lowest ARR for screening when compared with women from non–Muslim-majority Sub-Saharan African countries (ARR, 0.77; 95% CI, 0.76–0.79). ARRs were lowest for women with no primary care versus those in a capitation-based model (ARR, 0.28; 95% CI, 0.27–0.29 overall).
Conclusions: We have shown that being born in a Muslim-majority country is associated with a decreased likelihood of being up-to-date on cervical screening in Ontario and that access to primary care has a sizeable impact on screening uptake.
Impact: Screening efforts need to take into account the background characteristics of population subgroups and to focus on increasing primary care access for all. Cancer Epidemiol Biomarkers Prev; 26(10); 1493–9. ©2017 AACR.
Retrograde Type A Aortic Dissection After Thoracic Endovascular Aortic Repair: A Systematic Review and Meta‐Analysis
Authors: Chen Yanqing , Zhang Simeng , Liu Lei , Lu Qingsheng , Zhang Tianyi , Jing Zaiping 
Published: September 2017

Background

Retrograde type A aortic dissection (
RTAD
) is a potentially lethal complication after thoracic endovascular aortic repair (
TEVAR
). However, data are limited regarding the development of
RTAD
post‐
TEVAR
. This systematic review aims to define the incidence, mortality, and potential risk factors of
RTAD
post‐
TEVAR
.

Methods and Results

Multiple electronic searches were performed. Fifty publications with a total of 8969 patients were analyzed. Pooled estimates for incidence and mortality of
RTAD
were 2.5% (95% confidence interval [
CI]
, 2.0–3.1) and 37.1% (95%
CI
, 23.7–51.6), respectively. Metaregression analysis evidenced that
RTAD
rate was associated with hypertension (
P
=0.043), history of vascular surgery (
P
=0.042), and American Surgical Association (
P
=0.044). The relative risk of
RTAD
was 1.81 (95%
CI,
1.04–3.14) for acute dissection (relative to chronic dissection) and 5.33 (95%
CI,
2.70–10.51) for aortic dissection (relative to a degenerative aneurysm). Incidence of
RTAD
was significantly different in patients with proximal bare stent and nonbare stent endografts (relative risk
[RR]
=2.06; 95%
CI,
1.22–3.50).
RTAD
occurrence rate in zone 0 was higher than other landing zones.

Conclusions

The pooled
RTAD
rate after
TEVAR
was calculated at 2.5% with a high mortality rate (37.1%). Incidence of
RTAD
is significantly more frequent in patients treated for dissection than those with an aneurysm (especially for acute dissection), and when the proximal bare stent was used. Rate of
RTAD
after
TEVAR
varied significantly according to the proximal Ishimaru landing zone. The more‐experienced centers tend to have lower
RTAD
incidences.
Cardiac Events During Competitive, Recreational, and Daily Activities in Children and Adolescents With Long QT Syndrome
Authors: Chambers Kristina D. , Beausejour Ladouceur Virginie , Alexander Mark E. , Hylind Robyn J. , Bevilacqua Laura , Mah Douglas Y. , Bezzerides Vassilios , Triedman John K. , Walsh Edward P. , Abrams Dominic J. 
Published: September 2017

Background
The 2005 Bethesda Conference Guidelines advise patients with long QT syndrome against competitive sports. We assessed cardiac event rates during competitive and recreational sports, and daily activities among treated long QT syndrome patients.

Methods and Results
Long QT syndrome patients aged ≥4 years treated with anti‐adrenergic therapy were included. Demographics included mechanism of presentation, corrected QT interval pretreatment, symptom history, medication compliance, and administration of QT‐prolonging medications. Corrected QT interval ≥550 ms or prior cardiac arrest defined high risk. Sports were categorized by cardiovascular demand per the 2005 Bethesda Conference Guidelines. Each was classified as recreational or competitive. One hundred seventy‐two patients (90; 52% female) with median age 15.2 years (interquartile range 11.4, 19.4) were included. Evaluation was performed for family history (102; 59%), incidental finding (34; 20%), and symptoms (36; 21%). Median corrected QT interval was 474 ms (interquartile range 446, 496) and 14 patients (8%) were deemed high risk. Treatment included β‐blockers (171; 99%), implantable cardioverter‐defibrillator (27; 16%), left cardiac sympathetic denervation (7; 4%), and pacemaker (3; 2%). Sports participation was recreational (66; 38%) or competitive (106; 62%), with 92 (53%) exercising against the Bethesda Conference Guidelines. There were no cardiac events in competitive athletes and no deaths. There were 13 cardiac events in 9 previously symptomatic patients during either recreational exercise or activities of daily life.

Conclusions
In this cohort of appropriately managed children with long QT syndrome, cardiac event rates were low and occurred during recreational but not competitive activities. This study further supports the need for increased assessment of arrhythmia risk during exercise in this patient population.
Professional Medical Interpreters Influence the Quality of Acute Ischemic Stroke Care for Patients Who Speak Languages Other than English
Authors: Luan Erfe Betty M. , Siddiqui Khawja A. , Schwamm Lee H. , Kirwan Chris , Nunes Anabela , Mejia Nicte I. 
Published: September 2017

Background
The inability to communicate effectively in a common language can jeopardize clinicians’ efforts to provide quality patient care. Professional medical interpreters (PMIs) can help provide linguistically appropriate health care, in particular for the >25 million Americans who identify speaking English less than very well. We aimed to evaluate the relationship between use of PMIs and quality of acute ischemic stroke care received by patients who preferred to have their medical care in languages other than English.

Methods and Results

We analyzed data from 259 non–English‐preferring acute ischemic stroke patients who participated in the American Heart Association Get With The Guidelines–Stroke program at our hospital from January 1, 2003, to April 30, 2014. We used descriptive statistics and logistic regression models to examine associations between involvement of PMIs and patients’ receipt of defect‐free stroke care. A total of 147 of 259 (57%) non–English‐preferring patients received PMI services during their hospital stays. Multivariable analyses adjusting for other socioeconomic factors showed that acute ischemic stroke patients who did not receive PMIs had lower odds of receiving defect‐free stroke care (odds ratio: 0.52;
P
=0.04).

Conclusions
Our findings suggest that PMIs may influence the quality of acute ischemic stroke care.
Thrombolysis in Postoperative Stroke
Authors: Voelkel Nicolas , Hubert Nikolai Dominik , Backhaus Roland , Haberl Roman Ludwig , Hubert Gordian Jan 
Published: September 2017

Background and Purpose—
Intravenous thrombolysis (IVT) is beneficial in reducing disability in selected patients with acute ischemic stroke. There are numerous contraindications to IVT. One is recent surgery. The aim of this study was to analyze the safety of IVT in patients with postoperative stroke.

Methods—
Data of consecutive IVT patients from the Telemedical Project for Integrative Stroke Care thrombolysis registry (February 2003 to October 2014; n=4848) were retrospectively searched for keywords indicating preceding surgery. Patients were included if surgery was performed within the last 90 days before stroke. The primary outcome was defined as surgical site hemorrhage. Subgroups with major/minor surgery and recent/nonrecent surgery (within 10 days before IVT) were analyzed separately.

Results—

One hundred thirty-four patients underwent surgical intervention before IVT. Surgery had been performed recently (days 1–10) in 49 (37%) and nonrecently (days 11–90) in 85 patients (63%). In 86 patients (64%), surgery was classified as major, and in 48 (36%) as minor. Nine patients (7%) developed surgical site hemorrhage after IVT, of whom 4 (3%) were serious, but none was fatal. One fatal bleeding occurred remotely from surgical area. Rate of surgical site hemorrhage was significantly higher in recent than in nonrecent surgery (14.3% versus 2.4%, respectively, odds ratio
adjusted
10.73; 95% confidence interval, 1.88–61.27). Difference between patients with major and minor surgeries was less distinct (8.1% and 4.2%, respectively; odds ratio
adjusted
4.03; 95% confidence interval, 0.65–25.04). Overall in-hospital mortality was 8.2%. Intracranial hemorrhage occurred in 9.7% and was asymptomatic in all cases.

Conclusions—
IVT may be administered safely in postoperative patients as off-label use after appropriate risk–benefit assessment. However, bleeding risk in surgical area should be taken into account particularly in patients who have undergone surgery shortly before stroke onset.
Dispute Settlement in the Law of the Sea: Survey for 2015, Part ii and 2016
Authors: Churchill Robin 
Published: September 2017

Abstract
This is the latest in a series of annual surveys reviewing dispute settlement in the law of the sea, both under the un Convention on the Law of the Sea and outside the framework of the Convention. It covers developments concerning the International Tribunal for the Law of the Sea in 2016 and concerning all other law of the sea dispute settlement bodies for both 2015 and 2016. The developments covered include: the awards in Chagos Marine Protected Area (Mauritius v. United Kingdom), South China Sea (Philippines v. China), Arctic Sunrise (Netherlands v. Russia) and Duzgit Integrity cases; the judgments in the jurisdictional phases of the Norstar and Nicaragua/Colombia cases; the prescription of provisional measures by the arbitral tribunal in the Enrica Lexie case; and the first ever use of the compulsory conciliation procedures of the un Convention on the Law of the Sea.
Infants’ Processing of Prosodic Cues: Electrophysiological Evidence for Boundary Perception beyond Pause Detection
Authors: Holzgrefe-Lang Julia , Wellmann Caroline , Höhle Barbara , Wartenburger Isabell 
Published: September 2017

Infants as young as six months are sensitive to prosodic phrase boundaries marked by three acoustic cues: pitch change, final lengthening, and pause. Behavioral studies suggest that a language-specific weighting of these cues develops during the first year of life; recent work on German revealed that eight-month-olds, unlike six-month-olds, are capable of perceiving a prosodic boundary on the basis of pitch change and final lengthening only. The present study uses Event-Related Potentials (ERPs) to investigate the neuro-cognitive development of prosodic cue perception in German-learning infants. In adults’ ERPs, prosodic boundary perception is clearly reflected by the so-called Closure Positive Shift (CPS). To date, there is mixed evidence on whether an infant CPS exists that signals early prosodic cue perception, or whether the CPS emerges only later—the latter implying that infantile brain responses to prosodic boundaries reflect acoustic, low-level pause detection. We presented six- and eight-month-olds with stimuli containing either no boundary cues, only a pitch cue, or a combination of both pitch change and final lengthening. For both age groups, responses to the former two conditions did not differ, while brain responses to prosodic boundaries cued by pitch change and final lengthening showed a positivity that we interpret as a CPS-like infant ERP component. This hints at an early sensitivity to prosodic boundaries that cannot exclusively be based on pause detection. Instead, infants’ brain responses indicate an early ability to exploit subtle, relational prosodic cues in speech perception—presumably even earlier than could be concluded from previous behavioral results.
Shed-blood-separation and cell-saver: an integral Part of MiECC? Shed-blood-separation and its influence on the perioperative inflammatory response during coronary revascularization with minimal invasive extracorporeal circulation systems – a randomized controlled trial
Authors: Bauer Adrian , Hausmann Harald , Schaarschmidt Jan , Scharpenberg Martin , Troitzsch Dirk , Johansen Peter , Nygaard Hans , Eberle Thomas , Hasenkam J. Michael 
Published: September 2017

Objective: The postoperative systemic inflammatory response after cardiopulmonary bypass (CPB) is still an undesirable side-effect after cardiac surgery. It is most likely caused by blood contact with foreign surfaces and by the surgical trauma itself. However, the recirculation of activated shed mediastinal blood is another main cause of blood cell activation and cytokine release. Minimal invasive extracorporeal circulation (MiECC) comprises a completely closed circuit, coated surfaces and the separation of suction blood. We hypothesized that MiECC, with separated cell saved blood, would induce less of a systemic inflammatory response than MiECC with no cell-saver. The aim of this study was, therefore, to investigate the impact of cell washing shed blood from the operating field versus direct return to the ECC on the biomarkers for systemic inflammation. Material and methods: In the study, patients with MiECC and cell-saver were compared with the control group, patients with MiECC and direct re-transfusion of the drawn blood shed from the surgical field. Results: High amounts of TNF-α (+ 120% compared to serum blood) were found in the shed blood itself, but a significant reduction was demonstrated with the use of a cell-saver (TNF-α ng/l post-ECC 10 min: 9.5±3.5 vs. 19.7±14.5, p<0.0001). The values for procalcitonin were not significantly increased in the control group (6h: 1.07±3.4 vs. 2.15±9.55, p=0.19) and lower for C-reactive protein (CRP) (24h: 147.1±64.0 vs.134.4±52.4 p=0.28). Conclusion: The use of a cell-saver and the processing of shed blood as an integral part of MiECC significantly reduces the systemic cytokine load. We, therefore, recommend the integration of cell-saving devices in MiECC to reduce the perioperative inflammatory response.