bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Multistate Model Predicting Mortality, Length of Stay, and Readmission for Surgical Patients
Authors: Clark David E. , Ostrander Kaitlin R. , Cushing Brad M. 
Published: October 2015

ObjectiveSimultaneously evaluate postoperative mortality, length of stay (LOS), and readmission.Data SourceNational Surgical Quality Improvement Program (NSQIP).DesignRetrospective cohort.MethodsData from elective general surgical patients were obtained from the 2012 NSQIP Participant Use File. For each postoperative day, each patient's state was classified as index hospitalization, discharged home, discharged to long‐term care (LTC), readmitted, or dead. Transition rates were estimated using exponential regression, assuming constant rates for specified time periods. These estimates were combined into a multistate model, simulated results of which were compared to observed outcomes.FindingsAge, comorbidities, more complex procedures, and longer index LOS were associated with lower rates of discharge home and higher rates of death, discharge to LTC, and readmission. The longer patients had been discharged, the less likely they were to die or be readmitted. The model predicted 30‐day mortality 0.38 percent (95 percent CI: 0.36–0.41), index LOS 2.85 days (95 percent CI: 2.83–2.86), LTC discharge 2.76 percent (95 percent CI: 2.69–2.82), and readmissions 5.53 percent (95 percent CI: 5.43–5.62); observed values were 0.39 percent, 2.82 days, 2.87 percent, and 5.70 percent, respectively.ConclusionsMultistate models can simultaneously predict postoperative mortality, LOS, discharge destination, and readmissions, which allows multidimensional comparison of surgical outcomes.
Hospital Readmission Rates in U.S. States: Are Readmissions Higher Where More Patients with Multiple Chronic Conditions Cluster?
Authors: Basu Jayasree , Avila Rosa , Ricciardi Richard 
Published: October 2015

Research ObjectiveThis study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions.Study DesignThe study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to contextual and provider data from Health Resources and Services Administration. A multivariate cross sectional design at primary care service area (PCSA) level is used.Principal FindingsAdjusting for area characteristics, the readmission rates were significantly higher in PCSAs having higher proportions of patients with 2–3 chronic conditions and those with 4+ chronic conditions, compared with areas with a higher concentration of patients with 0–1 chronic conditions.ConclusionsUsing small area analysis, the study shows that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.
Adulteration of Dietary Supplements by the Illegal Addition of Synthetic Drugs: A Review
Authors: Rocha Tiago , Amaral Joana S. , Oliveira Maria Beatriz P.P. 
Published: October 2015

AbstractIn the last few years, the consumption of dietary supplements, especially those having plants as ingredients, has been increasing due to the common idea that they are natural products posing no risks to human health. In the European Union and the United States, dietary supplements are legally considered as foods/special category of foods, thus are not being submitted to any safety assessment prior to their commercialization. Among the issues that can affect safety, adulteration by the illegal addition of pharmaceutical substances or their analogs is of major concern since unscrupulous producers can falsify these products to provide for quick effects and to increase sales. This review discusses the various classes of synthetic drugs most frequently described as being illegally added to dietary supplements marketed for weight loss, muscle building/sport performance and sexual performance enhancement. Information regarding regulation and consumption is also presented. Finally, several conventional and advanced analytical techniques used to detect and identify different adulterants in dietary supplements and therefore also in foods, with particular emphasis on plant food supplements, are critically described. This review demonstrates that dietary supplement adulteration is an emerging food safety problem and that an effective control by food regulatory authorities is needed to safeguard consumers.
Effects of Long‐Term Erythropoiesis‐Stimulating Agents on Iron Metabolism in Patients on Hemodialysis
Authors: Onuma Shoko , Honda Hirokazu , Kobayashi Yasuna , Yamamoto Toshinori , Michihata Tetsuo , Shibagaki Keigo , Yuza Toshitaka , Hirao Keiichi , Tomosugi Naohisa , Shibata Takanori 
Published: October 2015

AbstractContinuous erythropoietin receptor activator (CERA) and darbepoetin‐α (DA) might differently affect iron metabolism and erythropoiesis in patients on hemodialysis (HD). This prospective study examined a cohort of patients on HD who had received either intravenous CERA every 2 or 4 weeks (N = 25) or DA once each week (N = 47). Blood was sampled before HD sessions on days 0, 2, 4, 7 and 14, and on days 0, 3, 5, 7 and 14 from patients who were injected with ESA at the beginning and end of the dialysis week, respectively. Changes in factors indicating erythropoiesis and biomarkers of iron metabolism were examined. Hemoglobin levels were maintained in the target range between 10.0 and 11.0 g/dL and ferritin levels at baseline and during the study period were similar between the DA and CERA groups. Levels of hepcidin 25 decreased from days 2–3 to day 5 and returned to the baseline at day 7 in the DA group, whereas those and transferrin saturation were serially suppressed from days 2–3 to day 14 in the CERA group. Levels of soluble transferrin receptor and reticulocyte counts were significantly elevated from days 4–5 to day 14 by CERA. Both DA and CERA stabilized erythropoiesis, but CERA might mobilize iron from body stores more effectively than DA in patients on HD.
Ursodeoxycholic Acid for Treatment of Enlarged Polycystic Liver
Authors: Iijima Takashi , Hoshino Junichi , Suwabe Tatsuya , Sumida Keiichi , Mise Koki , Kawada Masahiro , Imafuku Aya , Hayami Noriko , Hiramatsu Rikako , Hasegawa Eiko , Sawa Naoki , Takaichi Kenmei , Ubara Yoshifumi 
Published: October 2015

AbstractPatients with autosomal dominant polycystic kidney disease and polycystic liver disease (PLD) often have elevated serum levels of alkaline phosphatase (ALP) and gamma‐glutamyl transpeptidase (GGT). Ursodeoxycholic acid (UDCA) is used to treat biliary tract diseases, but its effect on PLD remains unclear. UDCA was administered for 1 year at a dose of 300 mg daily to seven PLD patients with elevated ALP or GGT levels who were selected for this treatment by experienced clinicians. Laboratory data and liver volumes were compared among three time points: 1 year before UDCA treatment, at the start of UDCA therapy, and 1 year after the start of therapy. Median GGT did not show a significant change between 1 year before UDCA (180 IU/L) and the start of UDCA therapy (209 IU/L), but it decreased significantly to 98 IU/L after 1 year of UDCA therapy (P = 0.015 vs. the start of therapy). ALP showed a significant increase from 1 year before UDCA (456 IU/L) to the start of UDCA therapy (561 IU/L), and then decreased significantly after 1 year of UDCA therapy (364 IU/L). Median liver volume did not show any significant changes among these three time points of assessment. UDCA may be effective for reducing biliary enzyme levels and inhibiting the growth of liver cysts in patients with PLD.
Clinical and laboratory 2‐year outcome of oral immunotherapy in patients with cow's milk allergy
Authors: Elizur A. , Appel M. Y. , Goldberg M. R. , Yichie T. , Levy M. B. , Nachshon L. , Katz Y. 
Published: October 2015

AbstractStudies examining the long‐term effect of oral immunotherapy in food‐allergic patients are limited. We investigated cow's milk‐allergic patients, >6 months after the completion of oral immunotherapy (n = 197). Questionnaires, skin prick tests, and basophil activation assays were performed. Of the 195 patients contacted, 180 (92.3%) were consuming milk protein regularly. Half experienced adverse reactions, mostly mild. Thirteen patients (6.7%) required injectable epinephrine. Higher reaction rate after immunotherapy was associated with more anaphylactic episodes before treatment and a lower starting dose (OR = 2.1, P = 0.035 and OR = 2.3, P = 0.035, respectively). Reaction rate in patients who were 6–15 months, 15–30 months, or >30 months post‐treatment decreased from 0.28/month to 0.21/month to 0.15/month, respectively (P < 0.01). Milk‐induced %CD63 and %CD203c expression was significantly lower in patients >24 months vs in patients <24 months post‐treatment (P = 0.038 and P = 0.047, respectively). In conclusion, many patients experience mild adverse reactions after completing oral immunotherapy and some require injectable epinephrine. Progressive desensitization, both clinically and in basophil reactivity, occurs over time.
Real‐time Responsiveness for Ethics Oversight During Disaster Research
Authors: Eckenwiler Lisa , Pringle John , Boulanger Renaud , Hunt Matthew 
Published: October 2015

AbstractDisaster research has grown in scope and frequency. Research in the wake of disasters and during humanitarian crises – particularly in resource‐poor settings – is likely to raise profound and unique ethical challenges for local communities, crisis responders, researchers, and research ethics committees (RECs). Given the ethical challenges, many have questioned how best to provide research ethics review and oversight. We contribute to the conversation concerning how best to ensure appropriate ethical oversight in disaster research and argue that ethical disaster research requires of researchers and RECs a particular sort of ongoing, critical engagement which may not be warranted in less exceptional research. We present two cases that typify the concerns disaster researchers and RECs may confront, and elaborate upon what this ongoing engagement might look like – how it might be conceptualized and utilized – using the concept of real‐time responsiveness (RTR). The central aim of RTR, understood here as both an ethical ideal and practice, is to lessen the potential for research conducted in the wake of disasters to create, perpetuate, or exacerbate vulnerabilities and contribute to injustices suffered by disaster‐affected populations. Well cultivated and deployed, we believe that RTR may enhance the moral capacities of researchers and REC members, and RECs as institutions where moral agency is nurtured and sustained.
Changes in Japanese eyes after laser peripheral iridotomy: an anterior segment optical coherence tomography study
Authors: Ang Bryan CH , Nongpiur Monisha E , Aung Tin , Mizoguchi Takanori , Ozaki Mineo 
Published: October 2015

AbstractBackgroundThe aim was to investigate the changes in anterior segment parameters, as assessed by anterior segment optical coherence tomography in Japanese subjects after laser peripheral iridotomy (LPI).DesignThis was a prospective observational study.ParticipantsThe participants include 72 subjects with angle closure including primary angle closure suspect (PACS), primary angle closure (PAC), and primary angle closure glaucoma (PACG).MethodsAnterior segment optical coherence tomography parameters was measured by customized software. Complete data of 51 subjects were available for final analysis.Main Outcome MeasuresThese were the following parameters: angle opening distance, trabecular‐iris space area, anterior chamber depth, width, area and volume (iris thickness, curvature, and area, and lens vault (LV).ResultsA total of 25 PACS, 17 PAC and 9 PACG were included. Mean age was 74.7 ± 6.7 years, and majority were women (80.4%). Following LPI, there was a significant increase in mean gonioscopic angle width (1.16 vs. 1.93, P < 0.001) and a corresponding increase in angle opening distance, trabecular‐iris space area, and angle recess area (all P < 0.001). The anterior chamber area (P < 0.001), anterior chamber volume (P < 0.001) and anterior chamber depth (P = 0.003) increased significantly; and iris curvature (P < 0.001) was significantly reduced. There were no significant changes in anterior chamber width, LV, iris thickness and area. Age‐adjusted and gender‐adjusted analysis for predictors of percentage change in angle opening distance 750 showed significant association with greater baseline LV (β = 0.32, P = 0.03). No significant differences were noted in the mean percentage change in parameters between the PACS and PAC‐PACG.ConclusionsAn increase in anterior chamber dimensions, angle widening and iris flattening; with a constant LV, iris thickness and iris area after LPI was demonstrated in Japanese eyes with angle closure.
Follow‐Up of the Sinus Membrane Elevation Technique for Maxillary Sinus Implants without the Use of Graft Material
Authors: Riben Christopher , Thor Andreas 
Published: October 2015

AbstractBackgroundThere is a limited amount of studies evaluating long‐term results of the sinus membrane elevation technique for bone formation around implants in the maxillary sinus floor without the use of bone graft material.PurposeTo investigate the long‐term results of this technique with regard to implant survival and bone gain in the maxillary sinus floor.Materials and MethodsA retrospective study was conducted on patients who had undergone the surgical procedure from November 2001 to August 2008. Thirty‐six patients with a total of 87 implants (ASTRA TECH Implant System™) in 53 sinuses were examined. After a submerged healing period of 6 months and at least 12 months of loading, the patients were examined clinically and radiologically. Implant stability was measured using resonance frequency analysis (RFA).ResultsThe mean follow‐up time was 4.6 years (range 1.5–7 years). Five implants were lost giving a survival rate of 94.3%.Subantral preoperative vertical bone levels were in the range of 1 to 10 mm. The average bone gain at the sinus floor was 6 mm. The 55 fixtures eligible for RFA displayed a mean implant stability quotient of 77 (range 56–85.5).ConclusionThe present study illustrates the long‐term reliability of the technique.
Perception of Sentence Stress in Speech Correlates With the Temporal Unpredictability of Prosodic Features
Authors: Kakouros Sofoklis , Räsänen Okko 
Published: October 2015

AbstractNumerous studies have examined the acoustic correlates of sentential stress and its underlying linguistic functionality. However, the mechanism that connects stress cues to the listener's attentional processing has remained unclear. Also, the learnability versus innateness of stress perception has not been widely discussed. In this work, we introduce a novel perspective to the study of sentential stress and put forward the hypothesis that perceived sentence stress in speech is related to the unpredictability of prosodic features, thereby capturing the attention of the listener. As predictability is based on the statistical structure of the speech input, the hypothesis also suggests that stress perception is a result of general statistical learning mechanisms. To study this idea, computational simulations are performed where temporal prosodic trajectories are modeled with an n‐gram model. Probabilities of the feature trajectories are subsequently evaluated on a set of novel utterances and compared to human perception of stress. The results show that the low‐probability regions of F0 and energy trajectories are strongly correlated with stress perception, giving support to the idea that attention and unpredictability of sensory stimulus are mutually connected.
Exploring culturally competent primary care diabetes services: a single‐city survey
Authors: Zeh P. , Sandhu H. K. , Cannaby A. M. , Warwick J. , Sturt J. A. 
Published: October 2015

AbstractAimsTo determine the cultural competence of diabetes services delivered to minority ethnic groups in a multicultural UK city with a diabetes prevalence of 4.3%.MethodsA semi‐structured survey comprising 35 questions was carried out across all 66 general practices in Coventry between November 2011 and January 2012. Data were analysed using descriptive statistics. The cultural competence of diabetes services reported in the survey was assessed using a culturally competent assessment tool (CCAT).ResultsThirty‐four general practices (52%) responded and six important findings emerged across those practices. (1) Ninety‐four per cent of general practices reported the ethnicity of their populations. (2) One in three people with diabetes was from a minority ethnic group. (3) Nine (26.5%) practices reported a diabetes prevalence of between 55% and 96% in minority ethnic groups. (4) The cultural competences of diabetes services were assessed using CCAT; 56% of practices were found to be highly culturally competent and 26% were found to be moderately culturally competent. (5) Ten practices (29%) reported higher proportionate attendance at diabetes annual checks in the majority white British population compared with minority ethnic groups. (6) Cultural diversity in relation to language and strong cultural traditions around food were most commonly reported as barriers to culturally competent service delivery.ConclusionsSeven of the eight cultural barriers identified in the global evidence were present in the city. Use of the CCAT to assess existing service provision and the good baseline recording of ethnicity provide a sound basis for commissioning culturally competent interventions in the future.
Reimagining Critical Race Theory in Education: Mental Health, Healing, and the Pathway to Liberatory Praxis
Authors: McGee Ebony O. , Stovall David 
Published: October 2015

AbstractLong‐standing theoretical education frameworks and methodologies have failed to provide space for the role mental health can play in mediating educational consequences. To illustrate the need for such space, Ebony McGee and David Stovall highlight the voices of black undergraduates they have served in the capacities of teacher, researcher, and mentor. Building from the theoretical contributions of intellectual giants like Frantz Fanon and W. E. B. Du Bois, the authors attempt to connect oppressive social systems to the psyche of the oppressed in a way that is relevant to black students. McGee and Stovall pose a challenge to the current research trend of attributing the survival of black students at traditionally white institutions primarily to grit, perseverance, and mental toughness, noting that research on the aforementioned qualities often fails to properly acknowledge multiple forms of suffering. Utilizing the lens of Critical Race Theory (CRT), the authors also challenge the construct of grit to consider the extent to which the mental health concerns of black students go undetected. Although critical race theorists have unmasked and attacked the racial trauma experienced at all levels of the educational system, the connection of CRT to mental health and wellness research is in its embryonic stages. For these reasons, McGee and Stovall argue that CRT scholars need to incorporate praxis to address mental health and wellness in order to address a fuller spectrum of black students' racialized worlds. Ultimately, they seek interdisciplinary perspectives that can help identify and foster strategies to support black students in the project and process of healing from multiple forms of racialized trauma they experience within and beyond their educational encounters.
Pedagogy of the Impossible: Žižek in the Classroom
Authors: McMillan Chris 
Published: October 2015

AbstractIf knowledge is socially constructed, then students' discursive attachments should be eminently malleable. Students' radical openness to change, however, is not the defining characteristic of a university classroom. Instead, learners appear to desire coherence of knowledge over revelations of contingency, and pedagogical acts that disrupt existing formations are as likely to produce reactionary responses as revolutionary reorganizations of the self. In this article Chris McMillan argues that neither the constructivist nor the social constructionist readings of critical pedagogy are able to account for this fixity of knowledge. In response he contends that Slavoj Žižek's Lacanian‐inspired theory of subjectivity and of the Real can effectively respond to the limitations of these approaches by insisting upon the pedagogical value of the lack within subjectivity. A Žižekian conception of subjectivity is able to respond to this lacuna by positing the negativity of the subject as the agent of transformation and to produce a “pedagogy of the impossible” that evokes the moments of impossibility within discourse embodied by the subject qua the Lacanian Real.
Erectile dysfunction and cardiovascular risk factors in a Mediterranean diet cohort
Authors: Ramírez R. , Pedro‐Botet J. , García M. , Corbella E. , Merino J. , Zambón D. , Corbella X. , Pintó X. ,   the Xarxa de Unitats de Lípids i Arteriosclerosi (XULA) Investigators Group
Published: October 2015

AbstractBackgroundErectile dysfunction affects more than 100 million men worldwide, with a wide variability in prevalence. An overall association of cardiovascular risk factors, lifestyle and diet in the context of ED in a Mediterranean population is lacking.AimTo assess ED prevalence and associated factors in a Mediterranean cohort of non‐diabetic patients with cardiovascular risk factors.MethodsObservational, cross‐sectional study of patients aged over 40 treated at cardiovascular risk units in Catalonia. Anthropometric data, risk factors, lifestyle and diet habits were recorded. ED was assessed using the International Index of Erectile Function.ResultsFour hundred and forty patients included, 186 (42.3%) with ED (24.8% mild, 6.8% moderate and 10.7% severe). ED presence and severity were associated with age, obesity, waist circumference, hypertension, antihypertensive treatment and ischaemic disease. Patients with ED were more frequently smokers, sedentary and consumed more alcohol. In multivariate analysis, consumption of nuts (> twice a week) (OR 0.41 (95% CI 0.25 to 0.67) and vegetables (≥ once a day) (OR 0.47 (95% CI 0.28–0,77)), were inversely related to ED. Obesity (as BMI ≥ 30 kg/m2) (OR 2.49 (95% CI 1.48–4.17)), ischaemic disease (OR 2.30 (95% CI 1.22 to 4.33), alcohol consumption (alcohol‐units a day) (OR 1.14 (95% CI 1.04 to 1.26), and age (year) (OR = 1.07 (95% CI 1.04–1.10) were directly related to ED.ConclusionErectile dysfunction is a common disorder in patients treated in lipid units in Catalonia for cardiovascular risk factors. This condition is associated with age, obesity, ischaemic disease and unhealthy lifestyle habits.