bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self‐Help Treatment for Insomnia Symptoms Associated with Chronic Conditions in Older Adults: A Randomized Controlled Trial
Authors: Morgan Kevin , Gregory Pamela , Tomeny Maureen , David Beverley M. , Gascoigne Claire 
Published: October 2012

ObjectivesTo evaluate the effectiveness of a self‐help cognitive behavioral intervention in improving sleep quality in older adults reporting insomnia symptoms associated with chronic disease.DesignA pragmatic two‐arm randomized controlled trial comparing supported self‐help with treatment as usual (TAU).SettingPrimary care.ParticipantsOne hundred ninety‐three self‐referred individuals aged 55 to 87 with long‐term conditions and chronic insomnia symptoms (as defined according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition).InterventionSelf‐help participants received six consecutive booklets, at weekly intervals, providing structured advice on important components of cognitive behavioral therapy for insomnia (CBT‐I, including self‐monitoring, sleep restriction, stimulus control procedures, and cognitive strategies), plus access to a telephone helpline. Control group participants received a single sheet of advice detailing standard sleep hygiene measures.MeasurementsThe primary outcome was sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes were the Insomnia Severity Index (ISI), the subjective sleep efficiency index, and the Fatigue Severity Scale.ResultsIn the self‐help group, sleep outcomes showed significant improvements after treatment (PSQI, P < .001; ISI, P < .001; sleep efficiency, P < .001) and at 3‐month (PSQI, P = .002; ISI, P = .006; sleep efficiency, P = .001) and 6‐month (PSQI, P = .003; ISI, P = .003; sleep efficiency, P = .001) follow‐up. Effect sizes were moderate (range of adjusted Cohen d = 0.51–0.75). Treatment had no effect on levels of daytime fatigue. Most treated participants (73%) said they would recommend the self‐help program to others.ConclusionSelf‐help CBT‐I offers a practical first‐line response to individual reporting insomnia symptoms associated with chronic disease in primary care settings. In these individuals, symptoms of daytime fatigue may be more closely associated with disease processes than with sleep quality.
Resistance of a subset of red blood cells to clearance by antibodies in a mouse model of incompatible transfusion
Authors: Liepkalns Justine S. , Cadwell Chantel M. , Stowell Sean R. , Hod Eldad A. , Spitalnik Steven L. , Zimring James C. 
Published: October 2012

BackgroundAlloimmunization to antigens on transfused red blood cells (RBCs) represents a major barrier to chronic transfusion. In extreme cases of multiple alloimmunization, clinicians may be faced with the decision of transfusing incompatible RBCs or risking death from lack of transfusion. The disastrous results of hemolytic transfusion reactions are well understood, and major pathways of clearance have been described. However, well described but poorly understood is the survival of a subset of incompatible donor RBCs during hemolysis, despite antibody binding.Study Design And MethodsWe utilize a tractable murine model of incompatible transfusion in which RBCs from transgenic donor mice expressing human glycophorin A (hGPA) are transfused into recipients passively immunized with anti‐hGPA.ResultsAs in humans, the majority of RBCs are cleared but a subset of incompatible donor RBCs persist in circulation, despite being bound by antibodies. Data contained herein reject the hypothesis that lack of clearance is due to insufficient antibody or overwhelming of phagocytic machinery; rather, we establish that surviving RBCs represent a distinct population resistant to clearance.ConclusionsThese studies demonstrate that surviving RBCs during incompatible transfusion can represent a population that is resistant to clearance.
Predictors of suboptimal and crash initiation of dialysis at two tertiary care centers
Authors: Chiu Kenrry , Alam Ahsan , Iqbal Sameena 
Published: October 2012

AbstractMany end‐stage renal disease patients do not have an optimal start to dialysis. Many patients have suboptimal initiation, while others “crash” start on dialysis without prior care from a nephrologist. We examined factors associated with suboptimal or crash starts. We conducted a retrospective cohort study of 377 incident dialysis patients at two tertiary care centers from January 2006 to April 2011. Logistic regression was used to identify factors associated with suboptimal and crash starts to dialysis. Out of 377 patients, 102 (27%) had optimal starts, 221 (59%) had suboptimal starts, and 54 (14%) had crash starts. Three hundred thirty‐four patients (89%) began with hemodialysis, while 11% started with peritoneal dialysis. Factors independently associated with a suboptimal start as opposed to an optimal start included nephrology care more than 12 months prior to initiation of dialysis (odds ratio [OR], 0.26; 95% confidence interval [CI], 0.12–0.58), Charlson Comorbidity Index (OR, 1.25 per 1 point; 95% CI, 1.09–1.43), and age (OR, 1.02 per 1 year; 95% CI, 1.00–1.04). In comparison, diabetic nephropathy (OR, 0.25; 95% CI, 0.12–0.54), a history of pulmonary edema within 6 months prior to initiation of dialysis (OR, 3.70; 95% CI, 1.77–7.75), and a diagnosis of chronic obstructive lung disease (OR, 0.07; 95% CI, 0.01–0.52) were independently associated with a crash start. There was a low incidence of optimal dialysis starts in our tertiary care dialysis population. Our study highlights that suboptimal and crash start patients are distinct populations. Modifying factors that predict nonoptimal dialysis starts will need to consider these distinctions.
De novo HBV infection in a Mayo Clinic hemodialysis population: Economic impact of reduced HBV testing and a call for changes in current US CDC guidelines on HBV testing protocols
Authors: Onuigbo Macaulay A. C. , Onuigbo Nnonyelum T. C. 
Published: October 2012

AbstractHemodialysis (HD) exposes end‐stage renal disease patients to significantly higher risks for Hepatitis B Virus (HBV) infection, a major public health scourge. Therefore, current US CDC guidelines, last revised in 2001, call for monthly HbsAg tests. The charge to Medicare per HbsAg test is $100. In an economic analysis, we hypothesized that in the new environment of Medicare Fee Bundling, this is unwise and wasteful if de novo HBV infection rate among HD patients is <1%. We determined de novo HBV infection rate among a Mayo Clinic HD cohort, July 2000–July 2010. A retrospective analysis of all relevant medical records of the cohort was completed to identify de novo HBV infection. Nine hundred sixty‐five HD patients were analyzed. One case of de novo HBV infection was identified in a 54‐year old known IV drug user, a previous Hepatitis C carrier. This translates to a de novo HBV case incidence rate of 0.1%. De novo HBV infection among HD patients in the US, 2000–2010, is only 0.1%. In the early 1970s, rates were as high as 30%. We recommend 3‐monthly HbsAg testing, but to continue current monthly testing for IV drug users and other high‐risk groups. Huge cost savings would result, without any compromise of quality outcomes. With over 500,000 HD patients, this represents a mind‐boggling $40 billion savings in Medicare charges over 10 years. The US CDC should revise these outdated guidelines, last revised in 2001, to fall in line with current clinical realities on the ground.
Decompensated high‐output congestive heart failure in a patient with AVF and the role of right heart catheterization: A case study
Authors: Malhotra Kunal , Dhawan Vibhu , Dalal Pranav , Ariyamuthu Venkatesh , Bichu Prasad , Botdorf Joshua , Khanna Ramesh 
Published: October 2012

AbstractA 70‐year‐old Caucasian male presented 8 months postcadaveric renal transplant with slowly progressive shortness of breath, abdominal distention, and cough for a duration of a few days. Thorough evaluation found him to have severe pulmonary hypertension (PH) on echocardiogram with decompensated high‐output congestive heart failure. A right heart catheterization was done, which confirmed elevated right‐sided pressures and high cardiac output. The mean pulmonary artery pressure, on a Swan–Ganz catheter, improved from 37 to 30 mmHg on partial manual occlusion of his still functioning hemodialysis arteriovenous fistula. Subsequently, the patient underwent ligation of the fistula and this led to gradual improvement in his symptoms. Follow‐up right heart catheterization and echocardiogram showed marked improvement and normalization of right heart pressures. We recommend that patients with arteriovenous fistula should undergo close monitoring for development of early signs and symptoms of congestive heart failure and screening for PH by echocardiography post‐kidney transplant. Right heart catheterization should be considered if screening is positive. Risk and benefit of fistula closure should be weighed in face of reduced survival from PH in dialysis patients and closure should be considered in post‐transplant patients.
Improving Interunit Transitions of Care Between Emergency Physicians and Hospital Medicine Physicians: A Conceptual Approach
Authors: Beach Christopher , Cheung Dickson S. , Apker Julie , Horwitz Leora I. , Howell Eric E. , O’Leary Kevin J. , Patterson Emily S. , Schuur Jeremiah D. , Wears Robert , Williams Mark 
Published: October 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1188–1195 © 2012 by the Society for Academic Emergency MedicineAbstractPatient care transitions across specialties involve more complexity than those within the same specialty, yet the unique social and technical features remain underexplored. Further, little consensus exists among researchers and practitioners about strategies to improve interspecialty communication. This concept article addresses these gaps by focusing on the hand‐off process between emergency and hospital medicine physicians. Sensitivity to cultural and operational differences and a common set of expectations pertaining to hand‐off content will more effectively prepare the next provider to act safely and efficiently when caring for the patient. Through a consensus decision‐making process of experienced and published authorities in health care transitions, including physicians in both specialties as well as in communication studies, the authors propose content and style principles clinicians may use to improve transition communication. With representation from both community and academic settings, similarities and differences between emergency medicine and internal medicine are highlighted to heighten appreciation of the values, attitudes, and goals of each specialty, particularly pertaining to communication. The authors also examine different communication media, social and cultural behaviors, and tools that practitioners use to share patient care information. Quality measures are proposed within the structure, process, and outcome framework for institutions seeking to evaluate and monitor improvement strategies in hand‐off performance. Validation studies to determine if these suggested improvements in transition communication will result in improved patient outcomes will be necessary. By exploring the dynamics of transition communication between specialties and suggesting best practices, the authors hope to strengthen hand‐off skills and contribute to improved continuity of care.
Efficacy and Safety of Once-Daily Tadalafil in Men with Erectile Dysfunction Who Reported No Successful Intercourse Attempts at Baseline
Authors: Shabsigh Ridwan , Seftel Allen D. , Kim Edward D. , Ni Xiao , Burns Patrick R. 
Published: October 2012

ABSTRACT

Introduction
Tadalafil is efficacious and well tolerated for erectile dysfunction (ED), but effects in men with “complete ED” are unclear.

Aim
To investigate effects of once-daily tadalafil in men with no successful intercourse attempts at baseline.

Methods
Through a post hoc, pooled-data analysis of four randomized, double-blind trials on the effects of tadalafil 2.5 or 5 mg (vs. placebo) in men with ED, we evaluated efficacy and safety in subjects with 0 “yes” responses to Sexual Encounter Profile question 3 (SEP3) during an initial 4-week treatment-free run-in period.

Main Outcome Measures
Changes from baseline in the SEP diary and the International Index of Erectile Function-erectile function (IIEF-EF) domain were subjected to analysis of covariance models.

Results
Five hundred ninety-five subjects with no successful attempts at baseline were included in the analysis. The mean (±standard deviation) age was 58.2 ± 10.7 years; and most subjects had ED for ≥1 year (95.0%). ED was severe in 61.5% and moderate in 26.4%. Approximately 45% had diabetes mellitus or hypertension. After 12 weeks, the mean per-patient SEP3 percentage increased from 0% to 32.4% with tadalafil 2.5 mg and to 46.4% with tadalafil 5 mg (each P &lt; 0.001 vs. placebo). Corresponding data for successful penetration (SEP2) were increases from 21.1% to 48.2% with tadalafil 2.5 mg and from 24.4% to 66.2% with 5 mg (each P &lt; 0.001 vs. placebo). Mean IIEF-EF increased from 9.7 to 15.7 with tadalafil 2.5 mg and from 10.7 to 19.2 with 5 mg (each P &lt; 0.001 vs. placebo). Tadalafil also significantly improved the intercourse-satisfaction and overall-satisfaction domains (vs. placebo). Both doses of tadalafil were generally well tolerated, with adverse event rates similar to placebo.

Conclusions
The posttreatment intercourse success rate was 32% and 46% for tadalafil 2.5 mg and 5 mg, respectively, in men with no successful intercourse attempts at baseline.
A Pilot Study of HIV/STI Risk Among Men Having Sex with Men Using Erectile Dysfunction Medications: Challenges and Opportunities for Sexual Medicine Physicians
Authors: Goltz Heather Honoré , Coon David W. , Catania Joseph A. , Latini David M. 
Published: October 2012

ABSTRACT

Introduction
A growing literature suggests relationships between erectile dysfunction medications (EDM) and riskier sexual behavior among men who have sex with men (MSM). Questions remain concerning EDM use and related HIV/sexually transmitted infections (STI) risk among older MSM, particularly those 40 years and over, for whom EDM may be medically warranted.

Aim
This exploratory pilot study explores the relationship between EDM and risky sexual behavior in a convenience sample of MSM using EDM and attending historic sex-on-premises venues.

Methods
We examined anonymous surveys from 139 MSM. Bivariate relationships were examined. We then fit a multiple logistic regression model to determine predictors of engaging in unprotected anal intercourse (UAI) at last EDM, using variables identified as being significantly related to UAI in the bivariate analyses. Potential predictors entered the model in a stepwise fashion.

Main Outcome Measures
The primary outcome measure was engaging in UAI at last EDM use.

Results
MSM participating in the study ranged from 27 to 77 years and averaged 52.0 years (standard deviation = 10.73 years). These participants were primarily older MSM; fewer were younger MSM (12.12%), under age 40. Participants reporting UAI at last EDM use (N = 41) were significantly younger (P &lt; 0.01). Men visiting bars within the last 6 months reported less UAI (P &lt; 0.01). Both variables were independent predictors of UAI in the logistic regression model (P &lt; 0.01).

Conclusion
Similar to reports from younger MSM, our findings suggest older MSM using EDM and reporting UAI are also recreational drug users. We include recommendations for urologists and other sexual medicine physicians treating MSM who may be at elevated risk for HIV/STI infection because of joint EDM and club drug use.
Two Unconventional Risk Factors for Major Adverse Cardiovascular Events in Subjects with Sexual Dysfunction: Low Education and Reported Partner’s Hypoactive Sexual Desire in Comparison with Conventional Risk Factors
Authors: Rastrelli Giulia , Corona Giovanni , Fisher Alessandra D. , Silverii Antonio , Mannucci Edoardo , Maggi Mario 
Published: October 2012

ABSTRACT

Introduction
The classification of subjects as low or high cardiovascular (CV) risk is usually performed by risk engines, based upon multivariate prediction algorithms. However, their accuracy in predicting major adverse CV events (MACEs) is lower in high-risk populations as they take into account only conventional risk factors.

Aim
To evaluate the accuracy of Progetto Cuore risk engine in predicting MACE in subjects with erectile dysfunction (ED) and to test the role of unconventional CV risk factors, specifically identified for ED.

Methods
A consecutive series of 1,233 men (mean age 53.33 ± 9.08 years) attending our outpatient clinic for sexual dysfunction was longitudinally studied for a mean period of 4.4 ± 2.6 years.

Main Outcome Measure
Several clinical, biochemical, and instrumental parameters were evaluated. Subjects were classified as high or low risk, according to previously reported ED-specific risk factors.

Results
In the overall population, Progetto Cuore-predicted population survival was not significantly different from the observed one (P = 0.545). Accordingly, receiver operating characteristic (ROC) analysis shows that Progetto Cuore has an accuracy of 0.697 ± 0.037 (P &lt; 0.001) in predicting MACE. Considering subjects at high risk according to ED-specific risk factors, the observed incidence of MACE was significantly higher than the expected for both low educated and patients reporting partner’s hypoactive sexual desire (HSD, both &lt;0.05), but not for other described factors. The area under ROC curves of Progetto Cuore for MACE in subjects with low education and reported partner’s HSD were 0.659 ± 0.053 (P = 0.008) and 0.550 ± 0.076 (P = 0.570), respectively.

Conclusion
Overall, Progetto Cuore is a proper instrument for evaluating CV risk in ED subjects. However, in ED, other factors such as low education and partner’s HSD concur to risk profile. At variance with low education, Progetto Cuore is not accurate enough to predict MACE in subjects with partner’s HSD, suggesting that the latter effect is not mediated by conventional risk factors included in the algorithm.
High‐Temperature Shear Strength and Bonding Mechanism of the Mullite Ceramic/Fiber Brick Component Joined by Phosphate Adhesive
Authors: Hao Ruihua , Liu Jiachen , Dong Xue , Guo Anran , Hou Zhenguang , Wang Min 
Published: October 2012

The mullite ceramic/fiber brick system was bonded by two kinds of phosphate adhesives. The specimens were treated from 200 to 1400°C. The mechanical properties were tested at room temperature and at high temperature, and the relevant bonding mechanism was also discussed. The results show that the addition of silicon can greatly improve the adhesive's mechanical properties. The room‐temperature shear strength of the component bonded by adhesive with the silicon calcined at 800°C can reach 6.58 MPa. The shear strength of the adhesive with silicon tested at 800°C can reach 0.42 MPa.
Determination of the cause of selected canine urolith formation by advanced analytical methods
Authors: Kaiser J. , Stĕpánková K. , Koř istková T. , Šedo O. , Melnyk G. , Hartl M. , Paloušek D. , Kuc̆era J. 
Published: October 2012

ObjectiveThe goal of this study was to determine the cause of selected canine urolith formation using less conventional but more advanced analytical methods.MethodsA routine laboratory specialising in urinary calculi analysis noticed a special type of core zone in some canine uroliths, which was typically made up of cylindrical holes. Of 4028 canine samples analysed, non‐absorbable suture material was detected in 9 (0·22%) cases. A hollow cylindrical central area was found in a further 13 (0·32%) samples. X‐ray microtomography (μCT) was utilised in order to reveal the channel structure inside this urolith sample. Matrix‐assisted laser desorption‐ionisation – time of flight mass spectrometry was used in order to assess the cause of this urinary stone formation.ResultsThe diameter of the channel structure corresponded with the diameter of the previously utilised suture material and indicated that this urolith was formed around residual suture material. Further confirmation was provided by the comparative matrix‐assisted laser desorption‐ionisation – time of flight mass spectrometry chemical analysis. This channel structure is formed by a surgical thread that serves as a base for the urolith growth.Clinical SignificanceResults of this study confirm the causative role of absorbable suture material in the pathogenesis of hollow channel structures in some canine compound uroliths.
Prevalence and nature of dentoalveolar injuries among patients with maxillofacial fractures
Authors: Soukup J. W. , Mulherin B. L. , Snyder C. J. 
Published: October 2012

ObjectiveAlthough not previously reported, experience suggests that dentoalveolar injury is ‐common among patients with maxillofacial fractures. The objective of this study was to evaluate and describe the prevalence and nature of dentoalveolar injuries in patients identified with maxillofacial fractures.MethodsMedical records of 43 dogs and cats diagnosed with maxillofacial fractures between 2005 and 2012 were reviewed to identify patients with concurrent dentoalveolar injury. Medical records of patients with dentoalveolar injury were abstracted for the following information: signalment (including sex, age and skull type), mechanism of maxillofacial trauma, location and number of maxillofacial fractures, dentoalveolar injury type and location and the number of dentoalveolar injury per patient. Statistical evaluation was performed to determine associations between signalment, mechanism of trauma, location and number of maxillofacial fractures and the prevalence and nature of concurrent dentoalveolar injury.ResultsDentoalveolar injuries are common among patients with maxillofacial trauma. Age and mechanism of trauma are significant predictors of the presence of dentoalveolar injuries in patients with maxillofacial trauma.Conclusions and Clinical RelevanceThe findings of this study serve to encourage veterinarians to fully assess the oral cavity in patients with maxillofacial fractures as dentoalveolar injuries are common and can be predicted by age and mechanism of trauma.
Toward effective nature conservation on farmland: making farmers matter
Authors: de Snoo Geert R. , Herzon Irina , Staats Henk , Burton Rob J.F. , Schindler Stefan , van Dijk Jerry , Lokhorst Anne Marike , Bullock James M. , Lobley Matt , Wrbka Thomas , Schwarz Gerald , Musters C.J.M. 
Published: October 2012

AbstractUntil now the main instrument to counteract the loss of biodiversity and landscape quality in the European countryside has been agri‐environment schemes (AES), which offer short‐term payments for performing prescribed environmental management behaviors. In our opinion this approach is, in its current set‐up, not a sustainable way of enhancing biodiversity and landscape quality. Here we will argue that conservation in agricultural areas is also a social challenge. To change farmers’ behaviors toward more sustainable conservation of farmland biodiversity, instruments should aim to influence individual farmer's motivation and behavior. We should aim to place farmland biodiversity “in the hands and minds of farmers.”