bluuebunny/crossref_metadata_2025_split huggingface dataset:
Statin Discontinuation in Nursing Home Residents with Advanced Dementia
Authors: Tjia Jennifer , Cutrona Sarah L. , Peterson Daniel , Reed George , Andrade Susan E. , Mitchell Susan L. 
Published: November 2014

ObjectivesTo describe patterns of, and factors associated with, statin use and discontinuation in nursing home (NH) residents progressing to advanced dementia and followed for at least 90 days.DesignRetrospective inception cohort using a dataset linking 2007 to 2008 Minimum Data Set (MDS) to Medicare denominator and Part D files.SettingAll NHs in five states (Minnesota, Massachusetts, Pennsylvania, California, Florida).ParticipantsNH residents with dementia.MeasurementsResidents who developed advanced dementia were observed from baseline (date of progression to very severe cognitive impairment with eating problems) and followed for at least 90 days to statin discontinuation or death. Logistic regression was used to identify baseline factors associated with statin use. Cox proportional hazard regression was used to identify factors associated with time to statin discontinuation.ResultsOf 10,212 residents, 16.6% (n = 1,699) used statins. Greater odds of statin use were associated with having diabetes mellitus (adjusted odds ratio (AOR) = 1.24, 95% confidence interval (CI) = 1.09–1.40), stroke (AOR = 1.31, 95% CI = 1.16–1.48), and hypertension (AOR = 1.35, 95% CI = 1.18–1.54); hospice enrollment was associated with lower odds (AOR = 0.75, 95% CI = 0.64–0.89). In follow‐up, 37.2% (n = 632) discontinued statins. Median time to discontinuation was 36 days (interquartile range 12–110 days). Shorter time to discontinuation was associated with hospitalization in past 30 days (adjusted hazard ratio (AHR) = 1.67, 95% CI = 1.40–1.99) and more daily medications (AHR = 1.02, 95% CI = 1.01–1.04). When statins were discontinued, 15.0% (n = 95) of residents stopped only statins, and 47.5% (n = 300) stopped at least one other medication.ConclusionMost NH residents who use statins at the time of progression to advanced dementia continue use in follow‐up.
Frailty Status Can Predict Further Lean Body Mass Decline in Older Adults
Authors: Jung Hee‐Won , Kim Sun‐Wook , Lim Jae‐Young , Kim Ki‐Woong , Jang Hak Chul , Kim Cheol‐Ho , Kim Kwang‐il 
Published: November 2014

ObjectivesTo assess whether frailty is a risk factor for skeletal muscle mass decline in community‐dwelling elderly people.DesignProspective observational cohort study.SettingSeongnam, Gyeongi Province, Korea.ParticipantsCommunity‐dwelling Koreans aged 65 and older (n = 341).MeasurementsBioimpedance analysis (BIA) was used to measure body composition at baseline and 5 years later. Laboratory examination and comprehensive geriatric assessment were performed at both times. Lean mass index (LMI) was defined as total body lean mass/height2. A decrease of more than 5% in the LMI was considered to be significant. Frailty status was defined using the Cardiovascular Health Study criteria.ResultsLMI decline occurred in 196 (54.1%) subjects during the follow‐up period (5.0 ± 0.7 years). Baseline LMI was highest in robust (17.6 ± 1.8 kg/m2, n = 126), lower prefrail (17.0 ± 1.7 kg/m2, n = 185), and lowest in frail (16.7 ± 1.3 kg/m2, n = 30) subjects (P < .001). Frailty status was associated with LMI decline at 5‐year follow‐up (robust 0.81 ± 0.78 kg/m2, prefrail 1.00 ± 0.92 kg/m2, frail 1.35 ± 0.85 kg/m2, P < .001). This effect of frailty on LMI decline persisted after adjusting for covariables (P = .02). The risk of significant LMI decline was 2.9 times as great in frail elderly adults as in those who were robust even after adjusting for covariates (95% confidence interval = 1.01–8.55).ConclusionFrailty status was found to be independently associated with subsequent LMI decline in community‐dwelling older adults.
Community‐Acquired Meningitis in Older Adults: Clinical Features, Etiology, and Prognostic Factors
Authors: Wang Amy Y. , Machicado Jorge D. , Khoury Nabil T. , Wootton Susan H. , Salazar Lucrecia , Hasbun Rodrigo 
Published: November 2014

ObjectivesTo investigate the epidemiology and outcomes of community‐acquired meningitis in older adults.DesignRetrospective study.SettingParticipants adults in Houston, Texas, with community‐acquired meningitis hospitalized between January 1, 2005, and January 1, 2010 (N = 619; n = 54, 8.7%, aged ≥65; n = 565 aged <65).MethodsAn adverse clinical outcome was defined as a Glasgow Outcome Scale score of 4 or less.ResultsOlder adults had higher rates of comorbidities, abnormal neurological and laboratory (serum white blood cell count >12,000/μL, and cerebrospinal fluid protein >100 mg/dL) findings (P < .001), abnormalities on computed tomography and magnetic resonance imaging of the head (P = .002), and adverse clinical outcomes (ACOs) (P < .001). The majority of participants (65.8%) had meningitis of unknown etiology. Bacterial meningitis was an infrequent cause of community‐acquired meningitis (7.4%). Of the known causes, bacterial meningitis and West Nile virus were more common in older than younger adults; younger participants more frequently had cryptococcal and viral meningitis. On logistic regression, female sex was predictive of a poor outcome in the older participants (P = .002), whereas abnormal neurological examination (P < .001), fever (P = .01), and a cerebrospinal fluid glucose level less than 45 mg/dL (P = .002) were significant poor prognostic factors in younger participants.ConclusionMost cases of community‐acquired meningitis are of unknown origin. Older adults are more likely than younger adults to have bacterial meningitis and West Nile virus infection when a cause can be identified. They also have more neurological abnormalities, laboratory and imaging abnormalities, and adverse clinical outcomes.
The Process of Translating Family Nursing Knowledge Into Clinical Practice
Authors: Svavarsdottir Erla Kolbrun , Sigurdardottir Anna Olafia , Konradsdottir Elisabet , Stefansdottir Anna , Sveinbjarnardottir Eydís Kristin , Ketilsdottir Audur , Blondal Katrin , Jónsdóttir Arndís , Bergs Dorothea , Guðmundsdottir Hlíf 
Published: November 2014

AbstractPurposeTo report on approaches that were used to assist with implementation of family systems nursing (FSN) at a university hospital level in Northern Europe.Design and MethodsA quasi‐experimental research design was used for the first phase of the study. For the second phase, a cross‐sectional research design was used. Data were collected in the first phase of the study from 457 nurses in all except one of the divisions of the hospital regarding their attitudes towards involving families into their care before and after having participated in the education and training intervention (ETI) program in FSN. Furthermore, in the second phase, data were collected from 812 nurses, after FSN had been implemented in all divisions at Landspitali University Hospital, regarding the nurses’ knowledge of FSN and their evaluation of the quality of the ETI program (i.e., theoretical lectures on FSN as well as the benefit of the skill lab training regarding applying FSN into their clinical practices). Graham and colleagues’ Knowledge to Action framework was used as the conceptual framework for the research.ResultsNurses who had taken a course in FSN reported a significantly more positive attitude towards involving families in their care after the ETI program compared to those who had not taken such a course. Furthermore, a majority of the nurses who participated in the ETI program reported that the program was a favorable experience and indicated readiness for applying FSN in clinical practice.ConclusionsFurther research is needed regarding the benefits of offering FSN at an institutional level, but focusing international attention on effective strategies to implement FSN into nursing practice may result in better health care for individuals and families around the globe.Clinical RelevanceProviding clinically meaningful education and training in family nursing through programs such as the ETI program for practicing nurses at a university hospital is essential in supporting nurses applying new knowledge, when providing evidence‐based health care services, to individuals and their family members. Such training can facilitate integration of new and needed information in clinical practice.
Nuclear fractal dimension in oral squamous cell carcinoma: a novel method for the evaluation of grading, staging, and survival
Authors: Mincione Gabriella , Di Nicola Marta , Di Marcantonio Maria Carmela , Muraro Raffaella , Piattelli Adriano , Rubini Corrado , Penitente Enrico , Piccirilli Marcello , Aprile Giuseppe , Perrotti Vittoria , Artese Luciano 
Published: November 2014

Fractal dimension (FD) in tissue specimens from patients with oral squamous cell carcinoma (OSCC) was evaluated. FD values in different stages of OSCC, and the correlations with clinicopathological variables and patient survival were investigated. Histological sections from OSCC and control non‐neoplastic mucosa specimens were stained with hematoxylin–eosin for pathological analysis and with Feulgen for nuclear evaluation. FD in OSCC groups vs. controls revealed statistically significant differences (P < 0.001). In addition, a progressive increase of FD from stage I and II lesions and stage III and IV lesions was observed, with statistically significant differences (P = 0.003). Moreover, different degrees of tumor differentiation showed a significant difference in the average nuclear FD values (P = 0.001). A relationship between FD and patients' survival was also detected with lower FD values associated to longer survival time and higher FD values with shorter survival time (P = 0.034). These data showed that FD significantly increased during OSCC progression. Thus, FD could represent a novel prognostic tool for OSCC, as FD values significantly correlated with patient survival. Fractal geometry could give insights into tumor morphology and could become an useful tool for analyzing irregular tumor growth patterns.
Cryogun cryotherapy for oral leukoplakia and adjacent melanosis lesions
Authors: Chen Hsin‐Ming , Cheng Shih‐Jung , Lin Hung‐Pin , Yu Chuan‐Hang , Wu Yang‐Che , Chiang Chun‐Pin 
Published: November 2014

BackgroundOur previous study has shown that cryogun cryotherapy is a good and effective treatment modality for oral leukoplakia.MethodsIn this study, we used cryogun cryotherapy to treat 72 oral leukoplakia and adjacent smoking‐induced melanosis (OLM) lesions on the buccal mucosae.ResultsOf 72 OLM lesions, 14 had epithelial hyperplasia with parakeratosis, 24 had epithelial hyperplasia with hyperkeratosis, 26 had mild dysplasia, seven had moderate dysplasia, and one had severe dysplasia. Complete regression was achieved in all 72 OLM lesions after a mean of 3.3 ± 1.3 cryogun cryotherapy treatments. We found that OLM lesions in patients without smoking habit, with the greatest diameter < 2.8 cm, with epithelial dysplasia, or with a surface keratin thickness ≤ 50 μm needed significantly fewer mean number of cryogun cryotherapy treatment to achieve complete regression than those OLM lesions in patients with smoking habit, with the greatest diameter ≥ 2.8 cm, without epithelial dysplasia, or with a surface keratin thickness > 50 μm (all P‐values < 0.001), respectively. Univariate logistic regression analyses showed that the greatest diameter, epithelial dysplasia, smoking habit, and surface keratin thickness were the factors influencing the cryogun cryotherapy treatment number (all P‐values < 0.001). However, only the greatest diameter < 2.8 cm (P < 0.001) was an independent factor influencing the number of cryogun cryotherapy treatment required to achieve complete regression of the OLM lesion by multivariate logistic regression analyses.ConclusionCryogun cryotherapy is an effective treatment modality for OLM lesions.
The calcium‐dependent protein kinase CPK7 acts on root hydraulic conductivity
Authors: LI GUOWEI , BOUDSOCQ MARIE , HEM SONIA , VIALARET JÉRÔME , ROSSIGNOL MICHEL , MAUREL CHRISTOPHE , SANTONI VÉRONIQUE 
Published: November 2014

AbstractThe hydraulic conductivity of plant roots (Lpr) is determined in large part by the activity of aquaporins. Mechanisms occurring at the post‐translational level, in particular phosphorylation of aquaporins of the plasma membrane intrinsic protein 2 (PIP2) subfamily, are thought to be of critical importance for regulating root water transport. However, knowledge of protein kinases and phosphatases acting on aquaporin function is still scarce. In the present work, we investigated the Lpr of knockout Arabidopsis plants for four Ca2+‐dependent protein kinases. cpk7 plants showed a 30% increase in Lpr because of a higher aquaporin activity. A quantitative proteomic analysis of wild‐type and cpk7 plants revealed that PIP gene expression and PIP protein quantity were not correlated and that CPK7 has no effect on PIP2 phosphorylation. In contrast, CPK7 exerts a negative control on the cellular abundance of PIP1s, which likely accounts for the higher Lpr of cpk7. In addition, this study revealed that the cellular amount of a few additional proteins including membrane transporters is controlled by CPK7. The overall work provides evidence for CPK7‐dependent stability of specific membrane proteins.
Hospital Admissions and Gestational Age at Birth: 18 Years of Follow Up in Western Australia
Authors: Slimings Claudia , Einarsdóttir Kristjana , Srinivasjois Ravisha , Leonard Helen 
Published: November 2014

AbstractBackgroundInfants born moderate to late preterm are twice as likely to be rehospitalised within the first few weeks following discharge from the birth admission. It is not understood how rehospitalisation risk changes with age or how risks have changed over time.MethodsA retrospective birth cohort study of all live, singleton births in Western Australia 1 January 1980–31 December 2010, without congenital anomalies, followed to 18 years of age. Rehospitalisation rates for gestational age categories (<28, 28–31, 32–33, 34–36, 37–38 and ≥42 weeks) were compared with term births (39–41 weeks) using negative binomial regression. To assess whether rehospitalisation risk changed with age or over time, analyses were conducted for different age intervals and for 5‐year birth cohorts.ResultsRehospitalisation rates were higher up to 18 years for all preterm and early term categories including early term (37–38 weeks) [130.2/1000 person‐years at risk (pyr); 95% confidence interval 129.1, 131.4]; late preterm (34–36 weeks) (164.2/1000 pyr; 161.1, 167.4), and post‐term (≥42 weeks) (115.3/1000 pyr; 111.7, 119.0) compared with term births (109.1/1000 pyr; 108.5, 109.7). The effect of gestational age on rehospitalisation was highest during the first year of life and declined by adolescence [e.g. 34–36 weeks: rate ratio = 2.10 (2.04, 2.15) for 29 days–1 year; 1.14 (1.11, 1.18) for 12–18 years]. The risk of rehospitalisation up to 1 year of age has declined since 1980, except for those born <32 weeks.ConclusionsRehospitalisation risk is greater for singleton children born at all gestational ages compared with those born full term. This effect of gestational age on rehospitalisation is highest in the first year post‐discharge, but has almost disappeared by adolescence.
Maternal HLA‐C2 and 14 bp insertion in HLA‐G is associated with recurrent implantation failure after in vitro fertilization treatment
Authors: Lashley L. E. E. L. O. , van der Westerlaken L. A. J. , Haasnoot G. W. , Drabbels J. J. M. , Spruyt‐Gerritse M. J. , Scherjon S. A. , Claas F. H. J. 
Published: November 2014

AbstractThe major rate‐limiting step in in vitro fertilization (IVF) success appears to be the implantation of the semi‐allogeneic embryo into the maternal endometrium. To determine possible risk factors of recurrent failure of embryos to implant, we investigated immunogenetic determinants as level of human leukocyte antigen (HLA) histocompatibility, frequency of killer‐cell immunoglobulin‐like receptors (KIR) and HLA‐C alleles and HLA‐G polymorphism. We DNA typed women with recurrent implantation failure (RIF) and their partners for classical HLA Class I, HLA Class II, HLA‐G and KIR alleles and compared these results with couples with successful embryo implantation after their first IVF and normal fertile couples. No association was found between RIF and the degree of histocompatibility between partners or sharing of a specific antigen. Also, no significant difference in KIR haplotype or combination of HLA‐C group and KIR was observed. We did find a higher frequency of HLA‐C2 and a higher frequency of 14 base pair (bp) insertion in HLA‐G in women with RIF. Therefore we conclude that the degree of histocompatibility between partners is not a determining factor for the occurrence of RIF. However, presence of the HLA‐C2 allotype and the HLA‐G allele with a 14 bp insertion is a significant risk factor.
Hepatitis C transmission from viremic donors in hematopoietic stem cell transplant
Authors: Hsiao H.‐H. , Liu Y.‐C. , Wang H.‐C. , Wu C.‐H. , Cho S.‐F. , Hsu J.‐F. , Tsai H.‐J. , Hsiao S.Y. , Chang C.‐S. , Lin S.‐F. , Liu T.‐C. , Chuang W.‐L. , Yu M.‐L. 
Published: November 2014

AbstractTransmission of hepatitis C virus (HCV) to recipients of hematopoietic stem cell transplant (HSCT) occurs frequently from HCV viremic donors and causes complications. Here, we report the outcomes of 3 cases from our 265 allogeneic HSCTs, whose donors had HCV infections. Successful prevention of HCV transmission was noted in 1 recipient by pretreatment of the donor with peginterferon/ribavirin to undetectable levels of HCV viremia before stem cell harvest. This case stressed the important role of effective antiviral therapy and HCV RNA seronegativity before cell harvest for prevention of HCV transmission in HSCT.
Prospective cohort study of a new vacuum delivery device to assist with complicated labour in low‐resource settings
Authors: Khan Mishal , Hashmani Farah Naz , Ahmed Sajjad , Ahmed Owais , Asim Shabnam S. , Wajahat Yasmin , Sobani Shoaib , Syed Shershah , Qazi Fahad 
Published: November 2014

AbstractObjectivesCurrently available vacuum devices used to assist women undergoing complicated labour are unsuitable for use in low‐resource settings. The objective of this study was to evaluate the safety and feasibility of a new low‐cost vacuum device, named Koohi Goth Vacuum Delivery System (KGVDS), designed for use in low‐resource settings.MethodsA hospital‐based, multicentre, prospective cohort study with no control group was conducted in Karachi, Pakistan. After training, KGVDS devices were made available for use by labour room staff at their discretion when instrumental delivery was indicated. Women to whom KGVDS was applied were followed from the start of labour until discharge. Feasibility was assessed in terms of successful expulsion of the foetal head following application of KGVDS and ease of use ratings. Safety was assessed by observing maternal and newborn post‐delivery outcomes prior to discharge.ResultsKoohi Goth Vacuum Delivery System was applied to 137 women requiring instrumental delivery, of whom 111 (81%; 95% CI = 74–88%) successfully expelled the foetal head assisted by KGVDS and 103 (75%) stated that they would agree to use KGVDS again. There were no serious maternal or neonatal injuries or infections related to KGVDS use. The mean score for ‘ease of use’ given by doctors and midwives using the device was 8 of 10.ConclusionsKoohi Goth Vacuum Delivery System was feasible and safe to use for assisting complicated deliveries in low‐resource hospitals in this initial evaluation. Our results indicate that this new device may have the potential to improve birth outcomes in settings where most mortality occurs and that further evaluations should be conducted.
Health policy for sickle cell disease in Africa: experience from Tanzania on interventions to reduce under‐five mortality
Authors: Makani Julie , Soka Deogratias , Rwezaula Stella , Krag Marlene , Mghamba Janneth , Ramaiya Kaushik , Cox Sharon E. , Grosse Scott D. 
Published: November 2014

AbstractTanzania has made considerable progress towards reducing childhood mortality, achieving a 57% decrease between 1980 and 2011. This epidemiological transition will cause a reduction in the contribution of infectious diseases to childhood mortality and increase in contribution from non‐communicable diseases (NCDs). Haemoglobinopathies are amongst the most common childhood NCDs, with sickle cell disease (SCD) being the commonest haemoglobinopathy in Africa. In Tanzania, 10 313 children with SCD under 5 years of age (U5) are estimated to die every year, contributing an estimated 7% of overall deaths in U5 children. Key policies that governments in Africa are able to implement would reduce mortality in SCD, focusing on newborn screening and comprehensive SCD care programmes. Such programmes would ensure that interventions such as prevention of infections using penicillin plus prompt diagnosis and treatment of complications are provided to all individuals with SCD.
Patterns of Objectively Measured Moderate-to-Vigorous Physical Activity in Preschool Children
Authors: O’Dwyer Mareesa , Fairclough Stuart J. , Ridgers Nicola Diane , Knowles Zoe Rebecca , Foweather Lawrence , Stratton Gareth 
Published: November 2014

Background:Identifying periods of the day which are susceptible to varying levels of physical activity (PA) may help identify key times to intervene and potentially change preschool children’s PA behaviors. This study assessed variability of objectively measured moderate-to-vigorous physical activity (MVPA) during weekdays and weekend days among preschool children.Methods:One hundred and eighty-eight children (aged 3 to 5 years; 53.2% boys) from a northwest English city wore uni-axial accelerometers for 7 consecutive days.Results:Higher levels of MVPA were recorded in boys, particularly those who attended preschool for a half day. Children who attended preschool for a full day engaged in 11.1 minutes less MVPA than children who attended for a half day. After-school hours were characterized by a decrease in activity for all groups. Patterns of activity during the weekend were smoother with less variability.Conclusion:This study identified discrete segments of the week, specifically afterschool and during the weekend, when preschoolers engage in low levels of PA. Higher levels of MVPA among children who attended preschool for less time each day suggests that the structured preschool environment is related to decreased activity. Consequently, there is a need for interventions in young children to focus on school and home environments.
Daily Physical Activity Behavior Patterns of Hispanic Adolescents in Puerto Rico
Authors: Vigo-Valentín Alexander , Bush Kimberly A. , Hodge Samuel R. 
Published: November 2014

Background:There is limited evidence on physical activity patterns among Hispanic adolescents in Puerto Rico. This restricts opportunities to implement effective interventions and policies to increase physical activity in schools. The purpose of this study was to examine the physical activity behaviors of adolescents attending middle and high schools in Puerto Rico based on a compendium of moderate to vigorous physical activities including walking, jogging or running, bicycling, sports and more. A secondary purpose was to examine group differences as a function of gender and school level.Method:A cross-sectional survey research design was used. Students (N = 637) attending public middle and high schools completed a Visual 7-Day Physical Activity Recall survey. Both descriptive and inferential analyses were conducted to describe the sample and to determine group differences.Results:Puerto Rican adolescents’ levels of physical activity decreased throughout the week. Only a small proportion of them reached at least 60 minutes everyday of the week. Differences were found between middle and high school students’ daily and weekly participation in physical activities.Conclusions:Most adolescents do not engage in sufficient physical activity.Implications:Implications of the results are discussed and recommendations are articulated for policy makers, educators, and other professionals.