bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence and correlates of severe social withdrawal (hikikomori) in Hong Kong: A cross-sectional telephone-based survey study
Authors: Wong Paul WC , Li Tim MH , Chan Melissa , Law YW , Chau Michael , Cheng Cecilia , Fu KW , Bacon-Shone John , Yip Paul SF 
Published: July 2014

Background: Severe social withdrawal behaviors among young people have been a subject of public and clinical concerns. Aims: This study aimed to explore the prevalence of social withdrawal behaviors among young people aged 12–29 years in Hong Kong. Methods: A cross-sectional telephone-based survey was conducted with 1,010 young individuals. Social withdrawal behaviors were measured with the proposed research diagnostic criteria for hikikomori and were categorized according to the (a) international proposed duration criterion (more than 6 months), (b) local proposed criterion (less than 6 months) and (c) with withdrawal behaviors but self-perceived as non-problematic. The correlates of social withdrawal among the three groups were examined using multinomial and ordinal logistic regression analyses. Results: The prevalence rates of more than 6 months, less than 6 months and self-perceived non-problematic social withdrawal were 1.9%, 2.5% and 2.6%, respectively. In terms of the correlates, the internationally and locally defined socially withdrawn youths are similar, while the self-perceived non-problematic group is comparable to the comparison group. Conclusions: The study finds that the prevalence of severe social withdrawal in Hong Kong is comparable to that in Japan. Both groups with withdrawal behaviors for more or less than 6 months share similar characteristics and are related to other contemporary youth issues, for example, compensated dating and self-injury behavior. The self-perceived non-problematic group appears to be a distinct group and the withdrawal behaviors of its members may be discretionary.
Fate of traumatic pulmonary pseudocyst: Factors of resolution
Authors: El-Hag-Aly Mohammed Ahmed , Allam Heba Khodari 
Published: July 2014

Background Traumatic pulmonary pseudocysts are rarely talked about, developing in less than 3% of patients with pulmonary parenchymal injuries. Resolution usually occurs within a few weeks to a few months. Method A prospective study was undertaken in 21 cases treated in Menouﬁa University Hospital, Egypt from August 2011 through August 2013. Results The overall mean time for complete resolution was 61.1 days. The mean time for resolution of simple traumatic pulmonary pseudocysts was 21 days ( n = 6), and the mean time for resolution of complicated (blood filled) traumatic pulmonary pseudocysts was 77.1 days ( n = 15). Mean resolution time was 26.3 days for small pulmonary pseudocysts ≤22 mm ( n = 11) and 99.4 days for those >22 mm ( n = 10). The resolution time was 42.6 days in patients 17-years old or younger ( n = 11) and 81.4 days in patients older than 17 years ( n = 10). Conclusion There was a highly significant difference in resolution time between simple and complicated pseudocysts. There was also a highly significant delay in the resolution time of pseudocysts larger than 22 mm and in patients older than 17 years.
Using continuous sedation until death for cancer patients: A qualitative interview study of physicians’ and nurses’ practice in three European countries
Authors: Seymour Jane , Rietjens Judith , Bruinsma Sophie , Deliens Luc , Sterckx Sigrid , Mortier Freddy , Brown Jayne , Mathers Nigel , van der Heide Agnes ,   on behalf of the UNBIASED consortium, Addington-Hall Julia , Anquinet Livia , Brown Jayne , Bruinsma Sophie , Deliens Luc , Mathers Nigel , Mortier Freddy , Payne Sheila , Raus Kasper , Rietjens Judith , Seale Clive , Seymour Jane , Smithson W. Henry , Sterckx Sigrid , Janssens Rien , van der Heide Agnes 
Published: July 2014

Background: Extensive debate surrounds the practice of continuous sedation until death to control refractory symptoms in terminal cancer care. We examined reported practice of United Kingdom, Belgian and Dutch physicians and nurses. Methods: Qualitative case studies using interviews. Setting: Hospitals, the domestic home and hospices or palliative care units. Participants: In all, 57 Physicians and 73 nurses involved in the care of 84 cancer patients. Results: UK respondents reported a continuum of practice from the provision of low doses of sedatives to control terminal restlessness to rarely encountered deep sedation. In contrast, Belgian respondents predominantly described the use of deep sedation, emphasizing the importance of responding to the patient’s request. Dutch respondents emphasized making an official medical decision informed by the patient’s wish and establishing that a refractory symptom was present. Respondents employed rationales that showed different stances towards four key issues: the preservation of consciousness, concerns about the potential hastening of death, whether they perceived continuous sedation until death as an ‘alternative’ to euthanasia and whether they sought to follow guidelines or frameworks for practice. Conclusion: This qualitative analysis suggests that there is systematic variation in end-of-life care sedation practice and its conceptualization in the United Kingdom, Belgium and the Netherlands.
Evaluation of adenoviral vascular endothelial growth factor-activated chitosan/hydroxyapatite scaffold for engineering vascularized bone tissue using human osteoblasts: In vitro and in vivo studies
Authors: Koç Aysel , Finkenzeller Günter , Elçin A Eser , Stark G Björn , Elçin Y Murat 
Published: July 2014

Bone tissue is dependent on an efficient blood supply to ensure delivery of nutrients and oxygen. One method to acquire a vascular-engineered bone tissue could be the use of an angiogenic gene-activated scaffold. In the current study, porous chitosan/hydroxyapatite (C/HA) scaffolds were fabricated via freeze-drying with desired pore size, and then combined with the adenoviral vector encoding vascular endothelial growth factor and green fluorescence protein (Ad-VEGF). Human osteoblasts were cultured and seeded on characterized scaffolds. The attachment, proliferation, and differentiation of cells on gene-activated and unactivated C/HA scaffolds were evaluated in vitro and in vivo by histo- and immunohistochemistry. Findings confirmed that human osteoblasts cultured on gene-activated C/HA scaffold secreted vascular endothelial growth factor, besides maintaining its characteristic phenotype with specific extracellular matrix production. In vivo experiments indicated that scaffolds were tissue biocompatible, and that gene-activated scaffold provided a suitable environment for neovessel formation by recruiting host endothelial cells into the newly forming ectopic bone-like tissue. This study revealed that the Ad-VEGF-activated C/HA composite scaffold has potential for vascular bone regeneration applications.
Predictors of Low Milk Volume among Mothers Who Delivered Preterm
Authors: Murase Masahiko , Nommsen-Rivers Laurie , Morrow Ardythe L. , Hatsuno Misato , Mizuno Katsumi , Taki Motohiro , Miyazawa Tokuo , Nakano Yuya , Aizawa Madoka , Itabashi Kazuo 
Published: July 2014

Background: Factors associated with successful provision of mother’s own milk (MOM) for premature infants in a Japanese neonatal intensive care unit (NICU) context are not well known. Objective: We determined the independent risk factors for low milk volume at day 4 postpartum and formula feeding at the time of NICU discharge. Methods: We reviewed the medical records of mothers who delivered at < 32 weeks’ gestation. We determined maternal, premature infant, and milk expression variables predictive of (1) day 4 postpartum milk volume being less than the cohort median and (2) formula feeding at the time of NICU discharge, reported as adjusted odds ratios (95% confidence interval). Results: Among 85 dyads, median (quartile range) milk volume on day 4 postpartum was 153 (34-255) mL. The rate of formula feeding at discharge was 42%. Mothers delivering by cesarean (vs vaginal) delivery had 4.3-fold (1.5-12.4) greater odds of day 4 milk volume < median ( P < .01). Pregnancy-induced hypertension, delayed milk expression initiation, and low pumping frequency were strongly associated with cesarean delivery. Subsequently, mothers with day 4 milk volume < median (vs ≥ median) had 7.1-fold (2.6-19.5) greater odds of formula feeding at discharge ( P < .01). Conclusion: Cesarean delivery is associated with lower milk volume on day 4 but may represent a composite of underlying risk factors for low milk volume in the early postpartum period. Further, low milk volume on day 4 is a strong correlate of lack of exclusive breast milk feeding at NICU discharge.
Tidal stream power in the Pentland Firth – long-term variability, multiple constituents and capacity factor
Authors: Adcock Thomas AA , Draper Scott , Houlsby Guy T , Borthwick Alistair GL , Serhadlıoğlu Sena 
Published: July 2014

The Pentland Firth, Scotland, is one of the World’s prime locations for the eventual installation of large farms of tidal stream turbines. This paper seeks to improve the upper bound estimate of available power output obtained by Adcock et al . (2013) who used a depth-integrated numerical model of the region containing the Pentland Firth with the outer boundary forced solely by M2 and S2 tidal constituents. Herein, the analysis is extended to include six additional tidal constituents and the model run for 11.5 years, more than half of the 18.6-year lunar nodal cycle, to allow variations over this to be analysed. The consequent increase in available power is estimated, and the variation in power output over an 11-year period is examined. Although further power could theoretically be extracted from the additional six tidal constituents, this would require the tidal turbine farm to have such a low capacity factor that it would probably be economically unfeasible.
Methylphenidate misuse in adult patients and the impact of therapeutic use
Authors: Jensen LS , Pagsberg AK , Dalhoff K 
Published: July 2014

Objective: Methylphenidate (MPH) prescription rates for adults increase, but the extent of a parallel rise in toxic exposures and their causes and distribution between different MPH trade names are unexplored. Method: We retrospectively analyzed adult MPH exposures reported to the Danish Poison Information Centre from January 2006 to July 2012 and the association with MPH sales and the number of patients prescribed MPH. Results: Of the 394 exposures (57% males, median age 27 years) reported, MPH status was available in 249 of whom 65.5% were prescribed MPH. Exposure was in 54% motivated by suicidal attempt and in 40% by recreational use (based on 375 cases). Exposure was dominated by one trade name and exposure incidence correlated significantly with sales (  p = 0.001) and prevalence of MPH-treated patients (  p = 0.0008). Conclusions: The increase in MPH exposures parallels the prescription rates (particularly Ritalin®/Ritalin® Uno). Most exposures were intentional and motivated by suicide attempts or recreational use.
Systematic Analysis of Bleeding Phenotype in PT-VWD Compared to Type 2B VWD Using an Electronic Bleeding Questionnaire
Authors: Kaur Harmanpreet , Ozelo Margareth , Scovil Stephen , James Paula D. , Othman Maha 
Published: July 2014

Objective: To investigate the utility of an electronic version of the condensed molecular and clinical markers for the diagnosis and management of type 1 von Willebrand disease (VWD) bleeding questionnaire (eBQ) in assessing the bleeding phenotype in platelet-type VWD (PT-VWD) and compare it to its closely similar disorder, type 2B VWD. Methods: Retrospective analysis of the clinical bleeding and laboratory phenotype of 13 patients with PT-VWD and 12 type 2B VWD. Results: Bleeding score (BS) was significantly lower in PT-VWD as compared to type 2B. Bleeding score correlated with platelet count and von Willebrand factor:Ristocetin cofactor activity in PT-VWD but not in type 2B with a significant reduction in platelet count in type 2B VWD compared to PT-VWD. The eBQ had sensitivity of 62% in PT-VWD and 92% in type 2B VWD. Conclusion: Objective analysis of bleeding symptoms further the understanding of the phenotype of 2 closely similar bleeding disorders for better diagnosis and follow-up. Larger international prospective studies are warranted to evaluate the utility of the eBQ in PT-VWD and other rare bleeding disorders.
Selection criteria for initiation and renewal of luteinizing hormone-releasing hormone agonist therapy in patients with prostate cancer: a French prospective observational study
Authors: Lebret Thierry , Davin Jean-Louis , Hennequin Christophe , Latorzeff Igor , Mignard Jean-Pierre , Moreau Jean-Luc , Rossi Dominique , Ruffion Alain , Zerbib Marc , Culine Stéphane 
Published: July 2014

Objectives: To define the profile of patients with prostate cancer (PCa) receiving a 3-month or 6-month formulation of luteinizing hormone-releasing hormone (LHRH) agonist in France and the reasons for choosing between formulations. Methods: This prospective 1-year observational study included patients with PCa starting LHRH agonist therapy in everyday practice. Reasons for prescription and patient preference were recorded at inclusion, 3 or 6 months, and 12 months. The percentage of patients with a renewed initial prescription was recorded during follow up. Results: A total of 1438 patients with PCa were included. Hormonotherapy was initiated more frequently with a 6-month ( n = 903; 62.8%) than with a 3-month formulation ( n = 535; 37.2%). The initial prescription was renewed in most patients after 3 or 6 months (86.1%) and 12 months (71%); 170 patients switched from a 3-month to a 6-month formulation during follow up. Presence of metastases influenced initial prescription (odds ratio 0.439; 95% confidence interval 1.095–1.892), with a 3-month formulation more often prescribed than a 6-month formulation to men with metastatic PCa at diagnosis (21.3% versus 15.8%, respectively). The most frequent reasons given by physicians for choosing the 6-month formulation were ‘simplification of therapeutic regimen’ (86.9%) or ‘fewer unnecessary visits’ (46.8%). Similar reasons were given for switching from a 3-month to a 6-month formulation during follow up. The most frequent reasons given by physicians to initiate therapy with a 3-month formulation were ‘usual practice/habit’ (55.5%) or ‘closer patient management’ (46.2%). ‘Closer patient management’ and ‘reassuring effect upon patient’ were the main reasons for switching from a 6-month to a 3-month formulation during follow up. Approximately 80% of patients were satisfied with the formulation they were prescribed and patients’ reasons for preferring one formulation over another were similar to the physicians’ reasons for prescribing these formulations. Conclusions: Slow-release formulations of LHRH agonists are useful therapies for physicians treating patients with PCa and there may be a preference for the 6-month formulation.
Implications of ventricular arrhythmia “bursts” with normal epicardial flow, myocardial blush, and ST-segment recovery in anterior ST-elevation myocardial infarction reperfusion: A biosignature of direct myocellular injury “downstream of downstream”
Authors: Majidi Mohamed , Kosinski Andrzej S , Al-Khatib Sana M , Smolders Lilian , Cristea Ecaterina , Lansky Alexandra J , Stone Gregg W , Mehran Roxana , Gibbons Raymond J , Crijns Harry J , Wellens Hein J , Gorgels Anton P , Krucoff Mitchell W 
Published: July 2014

Aims: Establishing epicardial flow with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is necessary but not sufficient to ensure nutritive myocardial reperfusion. We evaluated whether adding myocardial blush grade (MBG) and quantitative reperfusion ventricular arrhythmia “bursts” (VABs) surrogates provide a more informative biosignature of optimal reperfusion in patients with Thrombolysis in Myocardial Infarction (TIMI) 3 flow and ST-segment recovery (STR). Methods and results: Anterior STEMI patients with final TIMI 3 flow had protocol-blinded analyses of simultaneous MBG, continuous 12-lead electrocardiogram (ECG) STR, Holter VABs, and day 5–14 SPECT imaging infarct size (IS) assessments. Over 20 million cardiac cycles from >4500 h of continuous ECG monitoring in subjects with STR were obtained. IS and clinical outcomes were examined in patients stratified by MBG and VABs. VABs occurred in 51% (79/154) of subjects. Microcirculation (MBG 2/3) was restored in 75% (115/154) of subjects, of whom 53% (61/115) had VABs. No VABs were observed in subjects without microvascular flow (MBG of 0). Of 115 patients with TIMI 3 flow, STR, and MBG 2/3, those with VABs had significantly larger IS (median: 23.0% vs 6.0%, p=0.001). Multivariable analysis identified reperfusion VABs as a factor significantly associated with larger IS ( p=0.015). Conclusions: Despite restoration of normal epicardial flow, open microcirculation, and STR, concomitant VABs are associated with larger myocardial IS, possibly reflecting myocellular injury in reperfusion settings. Combining angiographic and ECG parameters of epicardial, microvascular, and cellular response to STEMI intervention provides a more predictive “biosignature” of optimal reperfusion than do single surrogate markers.
Yield of tuberculosis contact investigations in Amsterdam: opportunities for improvement
Authors: Sloot Rosa , Schim van der Loeff Maarten F. , Kouw Peter M. , Borgdorff Martien W. 
Published: July 2014

We aimed to determine the coverage and yield of tuberculosis contact investigation, and compliance with guidelines, and to identify opportunities for improvement.Data were extracted from records on contacts of pulmonary tuberculosis patients at the Public Health Service (Amsterdam, the Netherlands) from 2008 to 2011. Additional data were obtained from the national tuberculosis register.Among 3743 contacts of 235 pulmonary tuberculosis index patients, 2337 (62%) were screened for latent tuberculosis infection (LTBI). Those less likely to be screened for LTBI included contacts of sputum smear-negative index patients (adjusted odds ratio (aOR) 0.6, 95% CI 0.4–0.9) and bacille Calmette Guérin (BCG)-vaccinated contacts (aOR 0.06, 95% CI 0.04–0.09). Among BCG-vaccinated contacts, the proportion screened increased from 9% in 2008 to 43% in 2011 (p-value for trend <0.001). LTBI diagnosis among contacts screened was associated with non-Dutch nationality (aOR 2.8, 95% CI 1.9–4.1) and being a close contact (aOR 4.0, 95% CI 1.9–8.3). Of the 254 contacts with LTBI diagnosis, 142 (56%) started preventive treatment. Starting treatment was associated with Dutch nationality (aOR 2.6, 95% CI 1.2–5.4) and being a close contact (aOR 10.5, 95% CI 1.5–70.7). Treatment completion was achieved by 129 (91%) of the 142 contacts who started treatment.Two areas for improvement were identified: further expanding LTBI screening, particularly among BCG-vaccinated contacts and contacts of sputum smear-negative index patients, and expanding preventive treatment among contacts with LTBI.
Changes in physical activity and all-cause mortality in COPD
Authors: Vaes Anouk W. , Garcia-Aymerich Judith , Marott Jacob L. , Benet Marta , Groenen Miriam T.J. , Schnohr Peter , Franssen Frits M.E. , Vestbo Jørgen , Wouters Emiel F.M. , Lange Peter , Spruit Martijn A. 
Published: July 2014

Little is known about changes in physical activity in subjects with chronic obstructive pulmonary disease (COPD) and its impact on mortality. Therefore, we aimed to study changes in physical activity in subjects with and without COPD and the impact of physical activity on mortality risk.Subjects from the Copenhagen City Heart Study with at least two consecutive examinations were selected. Each examination included a self-administered questionnaire and clinical examination.1270 COPD subjects and 8734 subjects without COPD (forced expiratory volume in 1 s 67±18 and 91±15% predicted, respectively) were included. COPD subjects with moderate or high baseline physical activity who reported low physical activity level at follow-up had the highest hazard ratios of mortality (1.73 and 2.35, respectively; both p<0.001). In COPD subjects with low baseline physical activity, no differences were found in survival between unchanged or increased physical activity at follow-up. In addition, subjects without COPD with low physical activity at follow-up had the highest hazard ratio of mortality, irrespective of baseline physical activity level (p≤0.05).A decline to low physical activity at follow-up was associated with an increased mortality risk in subjects with and without COPD. These observational data suggest that it is important to assess and encourage physical activity in the earliest stages of COPD in order to maintain a physical activity level that is as high as possible, as this is associated with better prognosis.
Smoking-related idiopathic interstitial pneumonia
Authors: Flaherty Kevin R. , Fell Charlene , Aubry Marie-Christine , Brown Kevin , Colby Thomas , Costabel Ulrich , Franks Teri J. , Gross Barry H. , Hansell David M. , Kazerooni Ella , Kim Dong Soon , King Talmadge E. , Kitachi Masanori , Lynch David , Myers Jeff , Nagai Sonoko , Nicholson Andrew G. , Poletti Venerino , Raghu Ganesh , Selman Moises , Toews Galen , Travis William , Wells Athol U. , Vassallo Robert , Martinez Fernando J. 
Published: July 2014

Cigarette smoking is a key factor in the development of numerous pulmonary diseases.An international group of clinicians, radiologists and pathologists evaluated patients with previously identified idiopathic interstitial pneumonia (IIP) to determine unique features of cigarette smoking. Phase 1 (derivation group) identified smoking-related features in patients with a history of smoking (n=41). Phase 2 (validation group) determined if these features correctly predicted the smoking status of IIP patients (n=100) to participants blinded to smoking history. Finally, the investigators sought to determine if a new smoking-related interstitial lung disease phenotype could be defined.Phase 1 suggested that preserved forced vital capacity with disproportionately reduced diffusing capacity of the lung for carbon monoxide, and various radiographic and histopathological findings were smoking-related features. In phase 2, the kappa coefficient among clinicians was 0.16 (95% CI 0.11–0.21), among the pathologists 0.36 (95% CI 0.32–0.40) and among the radiologists 0.43 (95% CI 0.35–0.52) for smoking-related features. Eight of the 100 cases were felt to represent a potential smoking-related interstitial lung disease.Smoking-related features of interstitial lung disease were identified in a minority of smokers and were not specific for smoking. This study is limited by its retrospective design, the potential for recall bias in smoking history and lack of information on second-hand smoke exposure. Further research is needed to understand the relationship between smoking and interstitial lung disease.