bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neuromyelitis optica spectrum disorders: long-term safety and efficacy of rituximab in Caucasian patients
Authors: Radaelli M , Moiola L , Sangalli F , Esposito F , Barcella V , Ferrè L , Rodegher M , Colombo B , Fazio R , Martinelli V , Comi G 
Published: July 2015

Objective: To assess the long-term benefit-risk profile of repeated courses of rituximab in Caucasian patients affected by neuromyelitis optica (NMO) and related disorders, in everyday clinical practice. Methods: This is a prospective observational study performed at San Raffaele Hospital, Milan, Italy. From February 2006, we recruited 21 patients affected by NMO and NMO spectrum of disorders (NMOSD) whom underwent at least one cycle of intravenous (i.v.) rituximab and then were followed for at least 2 years. Results: At a mean follow-up time of 48 months, we observed a significant reduction of the annualized relapse rate (ARR), from 2.0 to 0.16 ( p < 0.01); and of the median Expanded Disability Status Scale (EDSS), from 5.5 to 4.0 ( p < 0.013). There were 12 patients (57%) who remained disease free during the follow-up period. Five patients (24%) reported mild hematological adverse events. Serious infectious adverse events were reported by another four patients: These were all wheelchair bound at the beginning of their rituximab treatment. Conclusions: A fixed treatment scheme of rituximab, with re-treatment every 6 months, was efficacious for NMO and NMOSD, with a good safety profile; however, to obtain an even better benefit-risk ratio, close monitoring of CD19+ B cells should be performed before the re-treatment of patients with high-level disability, concomitant leukopenia and hypogammaglobulinemia.
Participant experiences in a smartphone-based health coaching intervention for type 2 diabetes: A qualitative inquiry
Authors: Pludwinski Sarah , Ahmad Farah , Wayne Noah , Ritvo Paul 
Published: July 2015

Introduction We investigated the experience of individuals diagnosed with type 2 diabetes mellitus (T2DM) who participated in an intervention in which the key elements were the provision of a smartphone and self-monitoring software. The interviews focused on use of a smartphone and the effects on motivation for health behavior change. Methods This was a qualitative evaluation of participants in a larger T2DM self-management randomized controlled trial (RCT) conducted at the Black Creek Community Health Centre (BCCHC) in Toronto, Canada (ClinicalTrials.gov Identifier: NCT02036892). The study is based on semi-structured interviews ( n = 11) that were audio taped and analyzed with a thematic analytic approach. The RCT compared the effectiveness of six months of smartphone-based self-monitoring and health coaching with a control group who received health coaching without internet or smartphone-based assistance. Results Qualitative data analyses resulted in derivation of four major themes that describe participant experience: (a) ‘smartphone and software’, describes smartphone use in relation to health behavior change; (b) ‘health coach’ describes how client/health coach relationships were assisted by smartphone use; (c) ‘overall experience’ describes perceptions of the overall intervention; and (d) ‘frustrations in managing chronic conditions’ describes difficulties with the complexities of T2DM management from a patient perspective. Discussion Findings suggest that interventions with T2DM assisted by smartphone software and health coaches actively engage individuals in improved hemoglobin A1c (HbA1c) control.
Speed and accuracy of mobile BlackBerry Messenger to transmit chest radiography images from a small community emergency department to a geographically remote referral center
Authors: Scheuermeyer Frank , Grunau Brian , Cheyne Jay , Grafstein Eric , Christenson Jim , Ho Kendall 
Published: July 2015

Background Small emergency departments (EDs) may rely on radiologists at remote centers for interpretations of chest radiographs (CXRs). We investigated systematic transmission of CXR images from a small ED to a geographically remote referral center using the mobile BlackBerry Messenger (BBM) application. Methods Investigators obtained de-identified CXR images of consecutive ED patients via mobile phone camera. Each CXR image, along with a brief clinical history, was sent via BBM to an emergency physician located at a remote referral site, and the receiving physician replied via BBM to confirm reception. All communications, image generation, and image analysis was conducted on mobile phones. The primary outcome was the proportion of BBMs received within two minutes of sending; the secondary outcome was the proportion of BBM replies to the sending physician within five minutes. Image accuracy—comparing the radiologist’s interpretation with the receiving emergency physician’s interpretation—was estimated using predefined criteria. Results Of 1281 consecutive ED patients, 231 (18.0 %) had CXRs obtained, 320 CXRs were analyzed and 611 BBMs sent. All BBMs (100.0%, 95% confidence interval (CI) 99.4–00.0) arrived within two minutes; 595 BBMs (97.4%, 95% CI 95.8–98.4) were replied to within five minutes. Of the 58 CXRs with abnormalities requiring intervention, there were 55 concordances (overall agreement 94.2%, 95% CI 85.9–98.3; kappa 0.95, 95% CI 0.89–1.0) Conclusion Systematic transmission of CXR images from a small ED to a remote large center using mobile phones may be a safe and effective strategy to rapidly communicate important patient information.
Testing the CIE system for mesopic photometry in a threshold detection experiment
Authors: Bodrogi P , Schiller Ch , Khanh TQ 
Published: July 2015

Results from a mesopic threshold detection experiment using static, quasi-monochromatic, 2° incremental detection targets were used to test the International Commission on Illumination (CIE) recommended system for mesopic photometry based on visual performance. An experimental apparatus was built to produce different mesopic backgrounds (four different spectral compositions at two different luminances, 0.1 cd/m2 and 1.0 cd/m2) on which the targets were projected at different eccentricities (2.65° and 10°). The CIE system was tested by two methods, variability of mesopic threshold contrast for different target chromaticities and trend analysis for mesopic threshold contrast plotted against background mesopic luminance. The mesopic threshold contrast did not remain constant among the different target centroid wavelengths within a given viewing condition. The inter-observer variability of the mesopic contrast threshold dataset was considerable.
The Impact of Simulated Nature on Patient Outcomes
Authors: Pati Debajyoti , Freier Patricia , O’Boyle Michael , Amor Cherif , Valipoor Shabboo 
Published: July 2015

Objective: To examine whether incorporation of simulated nature, in the form of ceiling mounted photographic sky compositions, influences patient outcomes. Background: Previous studies have shown that most forms of nature exposure have a positive influence on patients. However, earlier studies have mostly focused on wall-hung nature representations. The emergence of simulated nature products has raised the question regarding the effects of the new product on patient outcomes. Methods: A between-subject experimental design was adopted, where outcomes from five inpatient rooms with sky composition ceiling fixture were compared to corresponding outcomes in five identical rooms without the intervention. Data were collected from a total of 181 subjects on 11 outcomes. Independent sample tests were performed to identify differences in mean outcomes. Result: Significant positive outcomes were observed in environmental satisfaction and diastolic blood pressure (BP). Environmental satisfaction in the experimental group was 12.4% higher than the control group. Direction of association for diastolic BP, nausea/indigestion medication, acute stress, anxiety, pain, and environmental satisfaction were consistent with a priori hypothesis. A post hoc exploratory assessment involving patients who did not self-request additional pain and sleep medication demonstrated confirmatory directions for all outcomes except Systolic BP, and statistically significant outcomes for Acute Stress and Anxiety—Acute Stress and Anxiety levels of the experimental group subjects was 53.4% and 34.79% lower, respectively, than that of the control group subjects. Conclusion: Salutogenic benefits of photographic sky compositions render them better than traditional ceiling tiles and offer an alternative to other nature interventions.
Extrapleural Pneumonectomy
Authors: Qadri Syed S. A. , Cale Alex , Loubani Mahmoud , Chaudhry Mubarak , Cowen Michael 
Published: July 2015

Background: Malignant pleural mesothelioma is a rare but complicated disease associated with very poor prognosis, despite all forms of treatment and almost 100% mortality after diagnosis. Objectives: The use of extrapleural pneumonectomy (EPP) in the management of malignant mesothelioma has become controversial recently and appears to be a dying modality. This retrospective study aimed to review and compare our results with available literature. Methods: Consecutive patients were reviewed from March 1999 to April 2011 who underwent EPP for malignant mesothelioma. Short- and long-term outcomes were analyzed retrospectively until February 2013. Results: There were 30 consecutive patients who underwent EPP in 13 years. The majority of them were male (29 patients) with a mean age of 61 years (34-71 years). There was no in-hospital or 30-day mortality in this cohort, although Thoracoscore predicted 7.9% risk of in-hospital mortality. The overall median survival was 20 ± 24 months, which prolonged to 47.5 ± 24 months in patients who received trimodality treatment. Thirty-one percent of patients survived ≥4 years and 2 patients are still alive at 6 and 7 years postoperatively. Survival was significantly longer in epitheloid versus biphasic mesothelioma, right versus left pneumonectomy, age below 65 years, and with no N2 disease. Survival at 6, 12, and 18 months was 80%, 65%, and 55% in comparison with 65%, 52%, and 34%, respectively, in the Mesothelioma and Radical Surgery trial. Conclusions: Epitheloid mesothelioma, right pneumonectomy, negative extrapleural lymph nodes, and age below 65 years are associated with prolonged survival. Extrapleural pneumonectomy has a role in the management of malignant mesothelioma in selected patients by experienced surgeons.
Linear accelerator-based stereotactic radiosurgery in 140 brain metastases from malignant melanoma
Authors: Hauswald Henrik , Stenke Alina , Debus Jürgen , Combs Stephanie E. 
Published: July 2015

Abstract
Background
To retrospectively access outcome and prognostic parameters of linear accelerator-based stereotactic radiosurgery in brain metastases from malignant melanoma.

Methods
Between 1990 and 2011 140 brain metastases in 84 patients with malignant melanoma (median age 56 years) were treated with stereotactic radiosurgery. At initial stereotactic radiosurgery 48 % of patients showed extracerebral control. The median count of brain metastases in a single patient was 1, the median diameter was 12 mm. The median dose applied was 20 Gy/80 % isodose enclosing.

Results
The median follow-up was 7 months and the median overall survival 9 months. The 6-, 12- and 24 month overall survival rates were 71 %, 39 % and 25 % respectively. Cerebral follow-up imaging showed complete remission in 20 brain metastases, partial remission in 39 brain metastases, stable disease in 54 brain metastases, progressive disease in 24 brain metastases and pseudo-progression in 3 brain metastases. Median intracerebral control was 5.3 months and the 6- and 12-month intracerebral progression-free survival rates 48 % and 38 %, respectively. Upon univariate analysis, extracerebral control (log-rank, p < 0.001), the response to stereotactic radiosurgery (log-rank, p < 0.001), the number of brain metastases (log-rank, p = 0.007), the recursive partitioning analysis class (log-rank, p = 0.027) and the diagnosis-specific graded prognostic assessment score (log-rank, p = 0.011) were prognostic for overall survival. The most common clinical side effect was headache common toxicity criteria grade I. The most common radiological finding during follow-up was localized edema within the stereotactic radiosurgery high dose region.

Conclusion
Stereotactic radiosurgery is a well-tolerated and effective treatment option for brain metastases in malignant melanoma and was able to achieve local remissions in several cases. Furthermore, especially patients with controlled extracerebral disease and a low count of brain metastases seem to benefit from this treatment modality. Prospective trials analysing the effects of combined stereotactic radiosurgery and new systemic agents are warranted.
Foot problems in people with gout in primary care: baseline findings from a prospective cohort study
Authors: Roddy Edward , Muller Sara , Rome Keith , Chandratre Priyanka , Hider Samantha L. , Richardson Jane , Blagojevic‐Bucknall Milisa , Mallen Christian D. 
Published: July 2015

AbstractBackgroundFoot problems are common in people with gout yet the prevalence of current foot problems in people with gout and the burden they present to healthcare systems is not known. This cross‐sectional study aimed to determine the prevalence and associations of hallux valgus, foot pain and disability in people with gout, and to assess the frequency with which foot problems lead to consultation with healthcare professionals.MethodsAdults registered with 20 general practices who had consulted their GP about gout or been prescribed allopurinol or colchicine in the preceding two years were mailed a questionnaire. Prevalence of hallux valgus, foot pain in the last month, and disabling foot pain in the mailed population were ascertained using validated instruments and estimated by inverse‐weighted logistic regression. Associations with socio‐demographic, comorbid and gout‐specific factors were examined using logistic regression. Participants were asked if they had seen health care professionals for foot problems within the preceding 12 months.ResultsOne thousand one hundred eighty‐four questionnaires were received (response 66 %). Prevalence of hallux valgus was 36.3 %, foot pain in the last month 22.3 % and disabling foot pain 14.5 %. Hallux valgus associated with age (adjusted OR 1.47 per 10‐year increase, 95 % CI 1.26, 1.72) and female gender (2.03; 1.31, 3.15). Foot pain in the last month associated with age (1.24; 1.00, 1.55), obesity (BMI 30.0–34.9 2.67; 1.32, 5.38; BMI ≥ 35.0 3.16; 1.44, 6.93), mild depression (2.04; 1.09, 3.81) and polyarticular gout attacks (1.86; 1.18, 2.95). Disabling foot pain associated with age (1.42; 1.08, 1.87), obesity (BMI 30.0–34.9 3.73; 1.54, 9.09; BMI ≥ 35.0 4.36; 1.64, 11.64), depression (mild 2.63; 1.25, 5.53; moderate 3.53; 1.11, 11.26) and ischaemic heart disease (2.45; 1.32, 4.53). In the previous 12 months, 495 (42.8 %) reported consulting their GP about their feet and 281 (23.7 %) a podiatrist/chiropodist.ConclusionsFoot problems are common in people with gout and frequently lead to healthcare consultation. Hallux valgus has similar associations to those seen in the general population, whereas foot pain associates with obesity and gout characteristics, and disabling foot pain with obesity and comorbidity. Patient assessment should consider foot problems and offer specific treatment where relevant.
Adverse events associated with poor neurological outcome during targeted temperature management and advanced critical care after out-of-hospital cardiac arrest
Authors: Kim Young-Min , Youn Chun Song , Kim Soo Hyun , Lee Byung Kook , Cho In Soo , Cho Gyu Chong , Jeung Kyung Woon , Oh Sang Hoon , Choi Seung Pill , Shin Jong Hwan , Cha Kyoung-Chul , Oh Joo Suk , Yim Hyeon Woo , Park Kyu Nam ,   on behalf of the Korean Hypothermia Network Investigators
Published: July 2015

AbstractIntroductionThe aim of this study was to investigate the association of adverse events (AEs) during targeted temperature management (TTM) and other AEs and concomitant treatments during the advanced critical care period with poor neurological outcome at hospital discharge in adult out-of-hospital cardiac arrest (OHCA) patients.MethodsThis was a retrospective study using Korean Hypothermia Network registry data of adult OHCA patients treated with TTM in 24 teaching hospitals throughout South Korea from 2007 to 2012. Demographic characteristics, resuscitation and post-resuscitation variables, AEs, and concomitant treatments during TTM and the advanced critical care were collected. The primary outcome was poor neurological outcome, defined as a cerebral performance category (CPC) score of 3–5 at hospital discharge. The AEs and concomitant treatments were individually entered into the best multivariable predictive model of poor neurological outcome to evaluate the associations between each variable and outcome.ResultsA total of 930 patients, including 704 for whom a complete dataset of AEs and covariates was available for multivariable modeling, were included in the analysis; 476 of these patients exhibited poor neurological outcome [CPC 3 = 50 (7.1 %), CPC 4 = 214 (30.4 %), and CPC 5 = 212 (30.1 %)]. Common AEs included hyperglycemia (45.6 %), hypokalemia (31.3 %), arrhythmia (21.3 %) and hypotension (29 %) during cooling, and hypotension (21.6 %) during rewarming. Bleeding (5 %) during TTM was a rare AE. Common AEs during the advanced critical care included pneumonia (39.6 %), myoclonus (21.9 %), seizures (21.7 %) and hypoglycemia within 72 hours (23 %). After adjusting for independent predictors of outcome, cooling- and rewarming-related AEs were not significantly associated with poor neurological outcome. However, sepsis, myoclonus, seizure, hypoglycemia within 72 hours and anticonvulsant use during the advanced critical care were associated with poor neurological outcome [adjusted odds ratios (95 % confidence intervals) of 3.12 (1.40–6.97), 3.72 (1.93–7.16), 4.02 (2.04–7.91), 2.03 (1.09–3.78), and 1.69 (1.03–2.77), respectively]. Alternatively, neuromuscular blocker use was inversely associated with poor neurological outcome (0.48 [0.28–0.84]).ConclusionsCooling- and rewarming-related AEs were not associated with poor neurological outcome at hospital discharge. Sepsis, myoclonus, seizure, hypoglycemia within 72 hours and anticonvulsant use during the advanced critical care period were associated with poor neurological outcome at hospital discharge in our study.
Fixed points of conditionally F-contractions in complete metric-like spaces
Authors: Karapınar Erdal , Kutbi Marwan A , Piri Hossein , O’Regan Donal 
Published: July 2015

AbstractIn this paper, we introduce the notion of a conditionally F-contraction in the setting of complete metric-like spaces and we investigate the existence of fixed points of such mappings. Our results unify, extend, and improve several results in the literature.
Snake constriction rapidly induces circulatory arrest in rats
Authors: Boback Scott M. , McCann Katelyn J. , Wood Kevin A. , McNeal Patrick M. , Blankenship Emmett L. , Zwemer Charles F. 
Published: July 2015

ABSTRACTAs legless predators, snakes are unique in their ability to immobilize and kill their prey through the process of constriction, and yet how this pressure incapacitates and ultimately kills the prey remains unknown. In this study, we examined the cardiovascular function of anesthetized rats before, during and after being constricted by boas (Boa constrictor) to examine the effect of constriction on the prey's circulatory function. The results demonstrate that within 6 s of being constricted, peripheral arterial blood pressure (PBP) at the femoral artery dropped to 1/2 of baseline values while central venous pressure (CVP) increased 6-fold from baseline during the same time. Electrocardiographic recordings from the anesthetized rat's heart revealed profound bradycardia as heart rate (fH) dropped to nearly half of baseline within 60 s of being constricted, and QRS duration nearly doubled over the same time period. By the end of constriction (mean 6.5±1 min), rat PBP dropped 2.9-fold, fH dropped 3.9-fold, systemic perfusion pressure (SPP=PBP−CVP) dropped 5.7-fold, and 91% of rats (10 of 11) had evidence of cardiac electrical dysfunction. Blood drawn immediately after constriction revealed that, relative to baseline, rats were hyperkalemic (serum potassium levels nearly doubled) and acidotic (blood pH dropped from 7.4 to 7.0). These results are the first to document the physiological response of prey to constriction and support the hypothesis that snake constriction induces rapid prey death due to circulatory arrest.
Examining Factors Influencing Colorectal Cancer Screening of Rural Nebraskans Using Data from Clinics Participating in an Accountable Care Organization: A Study Protocol
Authors: Young Lufei , Kim Jungyoon , Wang Hongmei , Chen Li-Wu 
Published: July 2015

Background: Although mortality rates of colorectal cancer (CRC) can be significantly reduced through increased screening, rural communities are still experiencing lower rates of screening compared to urban counterparts. Understanding and eliminating barriers to cancer screening will decrease cancer burden and lead to substantial gains in quality and quantity of life for rural populations. However, existing studies have shown inconsistent findings and fail to address how contextual and provider-level factors impact CRC screening in addition to individual-level factors. Purpose: The purpose of the study is to examine multi-level factors related to CRC screening, and providers’ perception of barriers and facilitators of CRC screening in rural patients cared for by accountable care organization (ACO) clinics.Methods/Design: This is a convergent mixed method design. For the quantitative component, multiple data sources, such as electronic health records (EHRs), Area Resource File (ARF), and provider survey data, will be used to examine patient-, provider-, clinic-, and county-level factors. About 21,729 rural patients aged between 50 and 75 years who visited the participating ACO clinics in the past 12 months are included in the quantitative analysis. The qualitative methods include semi-structured in-depth interviews with healthcare professionals in selected rural clinics. Both quantitative and qualitative data will be merged for result interpretation. Quantitative data identifies “what” factors influence CRC screening, while qualitative data explores “how” these factors interact with CRC screening. The study setting is 10 ACO clinics located in nine rural Nebraska counties.Discussion: This will be the first study examining multi-level factors related to CRC screening in the new healthcare delivery system (i.e., ACO clinics) in rural communities. The study findings will enhance our understanding of how the ACO model, particularly in rural areas, interacts with provider- and patient-level factors influencing the CRC screening rate of rural patients.