bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct and indirect effects of executive function on reading comprehension in young adults
Authors: Georgiou George K. , Das J. P.
Published: November 2016

The purpose of this study was to examine what components of executive function (EF) – inhibition, shifting and updating/working memory – predict reading comprehension in young adults. Ninety university students (65 females, 25 males; mean age = 21.82 years) were assessed on shifting (Planned Connections and Colour/Shape Shifting), inhibition (Colour‐Word Stroop and Number Stroop), updating/working memory (Digit Memory and Listening Span), reading fluency (Word Reading Efficiency), vocabulary (Peabody Picture Vocabulary Test), and reading comprehension (Nelson‐Denny Reading Test). The results of path analysis indicated that only shifting predicted directly reading comprehension. These findings extend those of previous studies showing that different EF components predict different reading outcomes and suggest that EF has a place in reading comprehension models over and above traditional predictors of reading comprehension such as reading fluency and vocabulary.
Flowability and wetting behaviour of milk protein ingredients as influenced by powder composition, particle size and microstructure
Authors: Silva Juliana V C , O'Mahony James A
Published: November 2016

This work aimed to provide a comprehensive characterisation of several physicochemical properties of different milk protein powders frequently used as ingredients in dairy‐based food formulations, in particular flowability and wettability. The flow and wetting properties were influenced mainly by the powder composition, less than by other physicochemical properties, such as particle size and microstructure. Powders with high fat content had poor flow and wetting properties. The wetting properties were also influenced by the protein content (mainly by the casein content) of the powders and were poor for powders having poor release of ionic calcium.
Lesbian and bisexual women's gynaecological conditions: a systematic review and exploratory meta‐analysis
Authors: Robinson K , Galloway KY , Bewley S , Meads C
Published: November 2016

Background

Little is known about the gynaecological health of lesbian and bisexual (LB) women.

Objectives

To examine differences in incidence and/or prevalence of gynaecological conditions in LB compared with heterosexual women.

Search strategy

The systematic review protocol was prospectively registered (PROSPERO‐CRD42015027091) and searches conducted in seven databases.

Selection criteria

Comparative studies published 2000–2015, reporting any benign (non‐infectious) and/or malignant gynaecological conditions with no language or setting restrictions.

Data collection and analysis

Inclusions, data extraction and quality assessment were conducted in duplicate. Meta‐analyses of condition prevalence rates were conducted where ≥3 studies reported results.

Main results

From 567 records, 47 full papers were examined and 11 studies of mixed designs included. No studies directly addressing the question were found. Two chronic pelvic pain studies reported higher rates in bisexual compared with heterosexual women (38.5 versus 28.2% and 18.6 versus 6.4%). Meta‐analyses showed no statistically significant differences in polycystic ovarian syndrome, endometriosis and fibroids. There was a higher rate of cervical cancer in bisexual than heterosexual women [odds ratio (OR) = 1.94; 95% CI 1.46–2.59] but no difference overall (OR = 0.76; 95% CI 0.15–3.92). There was a lower rate of uterine cancer in lesbian than heterosexual women (OR = 0.28; 95% CI 0.11–0.73) and overall (OR = 0.36; 95% CI 0.13–0.97), but no difference in bisexual women (OR = 0.43; 95% CI 0.06–3.07).

Conclusions

More bisexual women may experience chronic pelvic pain and cervical cancer than heterosexual women. There is no information on potential confounders. Better evidence is required, preferably monitoring sexual orientation in research using the existing validated measure and fully reporting results.

Tweetable abstract

Lesbians have less uterine cancer than heterosexual women; bisexuals have more pelvic pain and cervical cancer.
Does place and attendance at birth improve early neonatal mortality? Secondary analysis of nine Demographic and Health Surveys
Authors: Bellizzi S , Sobel HL , Mathai M , Temmerman M
Published: November 2016

Objectives

To determine the relation between place and skilled birth attendance at birth and early neonatal mortality.

Design

Retrospective analysis using data from Demographic and Health Surveys on obstetric complications.

Setting

Nine low and middle income countries between 2006 and 2013.

Population

71 758 women aged 15–49 years.

Methods

A secondary analysis was carried out to investigate the occurrence and effect of obstetric complications on early neonatal mortality and association with place and attendance at birth. Obstetric complications studied were prolonged labour, puerperal infection and eclampsia.

Main outcome measures

Association between early neonatal mortality and place and attendance at birth, unadjusted and adjusted for presence of severe obstetric complications.

Results

Thirty‐five percent of all births were at home: 70% of these were without skilled attendamts. Obstetric complications were reported in 17 079 women: 82% of these women gave birth in health facilities. Overall, no association was observed between place of birth or attendance at birth and early neonatal mortality. When adjusted for obstetric complications, the odds of early neonatal deaths for births at home without a skilled attendant were 1.3 (95% CI 1.1–1.5) compared with 1.2 (95% CI 1.0–1.5) with a skilled attendant and births in health facilities.

Conclusions

When adjusted for obstetric complications, births in health facilities were associated with reduced early neonatal mortality. However, reporting and referral bias account for at least part of the association.

Tweetable abstract

Births in health facilities are linked with fewer early newborn deaths when adjusted for obstetric complications.
Early Impact of the Affordable Care Act's Medicaid Expansion on Dental Care Use
Authors: Nasseh Kamyar , Vujicic Marko
Published: November 2016

Objective

To examine the impact of the Affordable Care Act on dental care use among poor adults ages 21–64 in 2014.

Data

2010–2014 Gallup‐Healthways Wellbeing Index Survey.

Study Design

Among poor adults with income at or below 138% of the Federal Poverty Level, a differences‐in‐differences analysis was used to compare the changes in dental care use in states with different Medicaid expansion and adult dental policies.

Principal Findings

Relative to the pre‐reform period and other states, in Medicaid expansion states with adult dental benefits, dental care use increased between 2 and 6 percent points in the second half of 2014, but most of these changes were not statistically significant.

Conclusions

Early evidence suggests that the Affordable Care Act may either not be having a substantial impact on dental care use or it is too early to assess the impact.
Deaths Due to Accidental Air Conditioner Compressor Explosion: A Case Series
Authors: Behera Chittaranjan , Bodwal Jatin , Sikary Asit K. , Chauhan Mohit Singh , Bijarnia Manjul
Published: November 2016

In an air‐conditioning system, the compressor is a large electric pump that pressurizes the refrigerant gas as part of the process of turning it back into a liquid. The explosion of an air conditioner (AC) compressor is an uncommon event, and immediate death resulted from the blast effect is not reported in forensic literature. We report three such cases in which young AC mechanics were killed on the spot due to compressor blast, while repairing the domestic split AC unit. The autopsy findings, the circumstances leading to the explosion of the compressor, are discussed in this study.
Case of Fatal Starvation: Can Stable Isotope Analysis Serve to Support Morphological Diagnosis and Approximate the Length of Starvation?
Authors: Baković Marija , Vreča Polona , Mayer Davor
Published: November 2016

The diagnosis of death as a result of starvation is established on anthropological measurements, visual appearance of the deceased on external and internal examination, microscopic analysis, laboratory testing, and exclusion of other causes of death. Herein, we present our findings on a case of 95‐year‐old man who died of starvation. After the diagnosis of starvation was established by traditional forensic medicine methods, we have conducted retrospective segmental analysis of stable carbon (δ13C) and nitrogen (δ15N) isotope ratios in hair sample. This method reveals periods of starvation through decrease in δ13C and increase in δ15N along the strand of hair. Our analysis revealed the decrease of 0.6 ‰ in δ13C during the last 10–12 weeks prior to death, similar as reported in other investigations. Also, a decrease of 0.7 ‰ in δ15N during the last 8–10 weeks prior to death was determined that was different than observed in previous studies.
Chronic Alcohol Abuse Leads to Low Bone Mass with No General Loss of Bone Structure or Bone Mechanical Strength,
Authors: Ulhøi Maiken Parm , Meldgaard Karoline , Steiniche Torben , Odgaard Anders , Vesterby Annie
Published: November 2016

Chronic alcohol abuse (CAA) has deleterious effects on skeletal health. This study examined the impact of CAA on bone with regard to bone density, structure, and strength. Bone specimens from 42 individuals with CAA and 42 individuals without alcohol abuse were obtained at autopsy. Dual‐energy X‐ray absorptiometry (DEXA), compression testing, ashing, and bone histomorphometry were performed. Individuals with CAA had significantly lower bone mineral density (BMD) in the femoral neck and significantly lower bone volume demonstrated by thinner trabeculae, decreased extent of osteoid surfaces, and lower mean wall thickness of trabecular osteons compared to individuals without alcohol abuse. No significant difference was found for bone strength and structure. Conclusion: CAA leads to low bone mass due to a decrease in bone formation but with no destruction of bone architecture nor a decrease in bone strength. It is questionable whether this per se increases fracture risk.
Taphonomic Effects of Mechanical Plowing on Buried Juvenile‐Sized Remains
Authors: Newcomb Alyssa M. , Pokines James T. , Moore Tara L.
Published: November 2016

Agricultural activity is a worldwide taphonomic process and can present unique challenges in the recovery of buried remains. Previous research has been mostly within the realm of site formation processes of archeological sites utilizing only surface material. This research expands upon the previous research by incorporating the distribution of subsurface material by the use of archeological excavation techniques. An experiment was conducted utilizing juvenile pig (Sus scrofa) skeletons buried in relative anatomical position at two different depths (15 cm below the surface [cmbs] and 22 cmbs). The burials were then subjected to different intervals of mechanical plowing: one, three, five, seven, or 10 plow passes. The skeletal material was recovered using pedestrian survey followed by hand excavation and screening of all sediments. This research shows that there is a significant relationship between the degree of plowing and the distance skeletal material is distributed and the percentage of material recovered undamaged.
Multiple Giant Coronary Artery Aneurysms: A Rare Cause of Sudden Cardiac Death
Authors: Janík Martin , Hejna Petr , Ublová Michaela , Šteiner Ivo
Published: November 2016

Multiple giant aneurysms involving the coronary arteries are uncommon and rarely reported. In the presented case, a 63‐year‐old man with poorly controlled hypertension died suddenly. Gross autopsy examination showed multiple giant thrombus‐filled coronary artery aneurysms, atherosclerotic coronary artery disease, and cardiomegaly. Histological sections of the coronary aneurysms showed atherosclerotic changes with both organized and fresh thrombus. Giant coronary aneurysm is defined as a segmental enlargement of a coronary artery with a diameter exceeding 20 mm or more. The main etiology of this nebulous entity is attributed to atherosclerosis and inflammatory or inherited connective tissue disorders with the remainder being congenital, infectious, or idiopathic. Before its cataclysmic presentation, when ruptured or thrombosed, giant coronary aneurysm usually has a silent clinical course. Sudden death owing to giant multiple coronary aneurysms is rare and mandates careful classification of the aneurysms and prudent search for autoimmune‐mediated or genetically based factors for subsequent ancillary autopsy studies.
The Interplay Between Diabetes and Pancreatitis: Two Case Reports of Sudden, Natural Deaths and a Review of the Literature
Authors: Butler Daniel C. , Emanuel Anthony J. , Self Sally E. , Batalis Nicholas I.
Published: November 2016

Diabetes mellitus (DM) is a common disease involving insulin resistance or deficit that, when left unchecked, may cause severe hyperglycemia and subsequent end‐organ damage. Acute pancreatitis (AP) is inflammation of the pancreas that can lead to significant morbidity and mortality. AP and DM both account for a significant amount of sudden deaths, and rarely both disease processes may be present in the same decedent, causing some difficulty in wording the cause of death statement. Although much research has been directed at studying the causes and risk factors for AP and DM, there is a complex interplay between these diseases that is not fully understood. This study presents two autopsy cases of sudden, natural deaths that illustrate this interplay, along with a review of the literature. An algorithm for differentiating AP and DM is then discussed in the context of the presented cases as a proposed aid for forensic pathologists in the certification of such deaths.
The Impact of Freezing on Bone Mineral Density: Implications for Forensic Research
Authors: Hale Amanda R. , Ross Ann H.
Published: November 2016

It is common for researchers using animal or human remains for scientific study to freeze samples prior to use. However, effects of freezing on bone macro‐ or microstructure are relatively unknown. The research objective of this study was to determine whether freezing could potentially bias experimental results by analyzing changes in bone mineral density (BMD) with the freezing of remains over time. Eight fetal pigs were scanned to determine their initialBMDbefore freezing. Three piglets underwent a freeze‐thaw cycle to assess the effects of the freezing process. Four piglets were frozen and scanned weekly for 20 weeks to assess freezing over time. The overall average between the fresh initial scan and final frozen scan was significantly different (p< 0.001). Per contra, the final thawedBMDscans did not differ from the initial fresh scan (p= 0.418). Thus, completely thawed remains are recommended for experimental studies.
Patient Profiles of Criminal Behavior in the Context of Traumatic Brain Injury
Authors: Lane Kristy S. , St. Pierre Maria E. , Lauterbach Margo D. , Koliatsos Vassilis E.
Published: November 2016

Traumatic brain injury (TBI) can lead to significant post‐traumatic disturbances in mood and behavior, with the frontal lobes playing a key role in emotional and behavioral regulation. Injury to the frontal lobe can result in disinhibition and aggression which can result in police intervention and/or incarceration. We highlight four adult cases with a history of severe TBI with frontal lobe injuries and the presence of post‐TBI criminal behaviors. There is evidence to support an anatomical basis for aggressive behaviors, yet there are other risk factors to be considered. Behaviors must be investigated thoroughly by obtaining adequate pre‐ and post‐TBI psychiatric and psychosocial histories. By having a comprehensive understanding of aggression while appreciating the complex relationship between TBI, aggression, and premorbid risk factors, clinicians can more adequately treat patients with TBI, with the aim of potentially preventing criminal behaviors and recidivism.
Evaluation of the Role of Toxicological Data in Discriminating Between H2S Femoral Blood Concentration Secondary to Lethal poisoning and Endogenous H2S Putrefactive Production
Authors: Barbera Nunziata , Montana Angelo , Indorato Francesca , Arbouche Nadia , Romano Guido
Published: November 2016

Hydrogen sulfide is a colorless gas and has a strong odor of rotten eggs. It is absorbed by the upper respiratory tract mucosa, and it causes histotoxic hypoxemia and respiratory depression by exerting an inhibitory effect on cytochrome oxidase. To evaluate the role of toxicological data in distinguishing between the H2S blood concentration secondary to lethal poisoning and the endogenous H2S produced during putrefaction, we compared the postmortem H2S concentrations of six fatal H2S poisoning cases (8.7–28.6 mg/L) with the postmortem concentrations of endogenous H2S of 12 subjects who died from other causes (traffic‐related deaths) (2.2–32.7 mg/L). These results will be of interest to the forensic community as it underlines the importance of considering circumstantial evidence along with the toxicological and pathological findings in the identification of H2S lethal poisoning.
Comparing single‐incision versus standard laparoscopic gastrostomy in paediatric patients
Authors: Chung Patrick H.Y. , Wong Kenneth K.Y. , Tam Paul K.H.
Published: November 2016

Aim

The aim of the present study was to evaluate the outcomes of single‐incision laparoscopic gastrostomy (SILG) compared with standard laparoscopic gastrostomy (LG).

Patients and Methods

Paediatric patients (age <18 years) with gastrostomy placement (+/−concomitant fundoplication) in the past 3 years were reviewed. Demographic data and intraoperative and postoperative events were compared.

Results

Thirty‐eight patients were identified (LG : SILG = 25:13). There were no significant differences between (LG vs SILG) age (5.7 vs 4.2 years, P = 0.45) and body weight at operation (15.3 vs 12.4 kg, P = 0.36). The median operative durations for the LG and SILG groups were 38 versus 45 min, respectively (P = 0.21). There was one major complication in the LG group, but none was reported in the SILG group. Seven patients (28 per cent) in the LG group suffered from minor complications compared to two (15.4 per cent) in the SILG group (P = 0.8). Gastrostomy feeding was initiated on postoperative day 1 the in majority of patients in both groups (LG: 92 per cent vs SILG: 100 per cent, P = 0.18).

Conclusion

SILG is technically feasible in paediatric patients, and outcomes were comparable to LG in the present study. This approach should be considered when concomitant procedure is not required in order to minimize the number of surgical wounds.
Procurement under public scrutiny: auctions versus negotiations
Authors: Gretschko Vitali , Wambach Achim
Published: November 2016

We compare two commonly used mechanisms in public procurement: auctions and negotiations. The execution of the procurement mechanism is delegated to an agent of the buyer. The agent has private information about the buyer's preferences and may collude with one of the sellers. We provide a general characterization of both mechanisms based on public scrutiny requirements and show—contrary to conventional wisdom—that an intransparent negotiation always yields higher social surplus than a transparent auction. Moreover, there exists a lower bound on the number of sellers such that the negotiation also generates a higher buyer surplus.
Push‐me pull‐you: comparative advertising in the OTC analgesics industry
Authors: Anderson Simon P. , Ciliberto Federico , Liaukonyte Jura , Renault Régis
Published: November 2016

We derive equilibrium incentives to use comparative advertising that pushes up own brand perception and pulls down the brand image of targeted rivals. Data on content and spending for all TV advertisements in Over‐The‐ Counter (OTC) analgesics enable us to construct matrices of rival targeting expenditures and estimate the structural model. Using brands' optimal choices, these attack matrices identify diversion ratios, from which we derive comparative advertising damage measures. We find that comparative advertising causes more damage to the targeted rival than benefit to the advertiser. We simulate banning comparative advertising to find industry profits rise.
Effective Reduction of Acute Ethanol Withdrawal by the Tetracycline Derivative, Tigecycline, in Female and Male DBA/2J Mice
Authors: Martinez Joseph M. , Groot Jessica A. , Curtis David C. , Allison Clayton L. , Marquardt Patrick C. , Holmes Ashley N. , Edwards David S. , Trotter David R. M. , Syapin Peter J. , Finn Deborah A. , Bergeson Susan E.
Published: November 2016

Background

Alcohol use disorder (AUD) is a spectrum disorder characterized by mild to severe symptoms, including potential withdrawal signs upon cessation of consumption. Approximately five hundred thousand patients with AUD undergo clinically relevant episodes of withdrawal annually (New Engl J Med, 2003, 348, 1786). Recent evidence indicates potential for drugs that alter neuroimmune pathways as new AUD therapies. We have previously shown the immunomodulatory drugs, minocycline and tigecycline, were effective in reducing ethanol (EtOH) consumption in both the 2‐bottle choice and drinking‐in‐the‐dark paradigms. Here, we test the hypothesis that tigecycline, a tetracycline derivative, will reduce the severity of EtOH withdrawal symptoms in a common acute model of alcohol withdrawal (AWD) using a single anesthetic dose of EtOH in seizure sensitive DBA/2J (DBA) mice.

Methods

Naïve adult female and male DBA mice were given separate injections of 4 g/kg i.p. EtOH with vehicle or tigecycline (0, 20, 40, or 80 mg/kg i.p.). The 80 mg/kg dose was tested at 3 time points (0, 4, and 7 hours) post EtOH treatment. Handling‐induced convulsions (HICs) were measured before and then over 12 hours following EtOH injection. HIC scores and areas under the curve were tabulated. In separate mice, blood EtOH concentrations (BECs) were measured at 2, 4, and 7 hours postinjection of 4 g/kg i.p. EtOH in mice treated with 0 and 80 mg/kg i.p. tigecycline.

Results

AWD symptom onset, peak magnitude, and overall HIC severity were reduced by tigecycline drug treatment compared to controls. Tigecycline treatment was effective regardless of timing throughout AWD, with earlier treatment showing greater efficacy. Tigecycline showed a dose‐responsive reduction in acute AWD convulsions, with no sex differences in efficacy. Importantly, tigecycline did not affect BECs over a time course of elimination.

Conclusions

Tigecycline effectively reduced AWD symptoms in DBA mice at all times and dosages tested, making it a promising lead compound for development of a novel pharmacotherapy for AWD. Further studies are needed to determine the mechanism of tigecycline action.
Practitioner mentoring of undergraduate accounting students: helping prepare students to become accounting professionals
Authors: Adler Ralph , Stringer Carolyn
Published: November 2016

Employers have long raised concerns about university accounting graduates' business awareness and understanding of the real world. This paper describes and explores the effectiveness of an undergraduate student mentoring programme for accounting majors that includes as one of its aims promoting students' real‐world understandings of accounting. The programme has been operating for the past 12 years at a large Australasian, research‐focused university and involves highly experienced business practitioners as mentors (i.e. partners of accounting firms, CFOs, COOs or CEOs), who represent a wide range of industries (e.g. Big Four, small/regional accounting firm, healthcare, manufacturing, retail). The programme has been associated with a high degree of success. Compared with a control group of students who did not participate in the mentoring programme, mentored students reported having better professional networks and a better understanding of the benefits and responsibilities of being a member of a professional accounting body. Some support was also found for mentored students having superior understandings of work and career opportunities. As encouraged by The Pathways Commission Report () and the 2015 CPA Australia report Shaping the future of accounting in business education in Australia, the study's findings provide support for how a mentoring programme like the one described in this paper can assist with showcasing the wider purposes and career opportunities associated with the accounting profession, as well as forge closer linkages between accounting practitioners and accounting educators and better integration of accounting practice into accounting curricula.
Advanced parental age and autism risk in children: a systematic review and meta‐analysis
Authors: Wu S. , Wu F. , Ding Y. , Hou J. , Bi J. , Zhang Z.
Published: November 2016

Objective

Advanced parental age has raised additional concern as a risk factor of autism. We conducted a meta‐analysis of observational studies investigating the association between advanced parental age and risk of autism.

Method

PubMed, EMBASE, and Web of Science were searched for reports published up to November 11, 2015. Risk estimates from individual studies were pooled using random‐effects models.

Results

Twenty‐seven studies were included in the meta‐analysis. Compared with the reference points, the lowest parental age category was associated with a reduced risk of autism in the offspring, with adjusted odds ratios (ORs) 0.89 (95% confidence intervals [CIs] 0.75–1.06) and 0.81 (95% CI 0.73–0.89) for mother and father, respectively, and the highest parental age category was associated with an increased risk of autism in the offspring, with adjusted ORs 1.41 (95% CI 1.29–1.55) and 1.55 (95% CI 1.39–1.73) for mother and father respectively. Dose–response meta‐analysis indicated that an increase of 10 years in maternal and paternal age was associated with an 18% and 21% higher risk of autism.

Conclusion

Advanced parental age was associated with an increased risk of autism in the offspring. More mechanistic studies are needed to further explain this positive association.
Placental implantation and migration following a previous caesarean section scar
Authors: Pirjani Reihaneh , Seifmanesh Farahnaz , Tehranian Afsaneh , Hosseini Ladan , Heidari Reza , Ghajar Alireza , Sepidarkish Mahdi
Published: November 2016

This prospective cohort study was conducted in Arash Women's Hospital between August 2014 and August 2015 to define the relationship between caesarean section scar and placental implantation and migration. Seven hundred and thirty women with one previous birth (caesarean section or vaginal delivery) and a singleton pregnancy underwent three ultrasound examinations for placental evaluation at 11–14, 20 and 34 weeks gestation. Previous caesarean section was related to the increased odds of anterior placental implantation but no relation was seen between low‐lying placenta or placenta praevia and previous caesarean. The placental migration from low‐lying to non‐low‐lying position was similar between women with and without previous caesarean.
Is outpatient hysteroscopy the new gold standard? Results from an 11 year prospective observational study
Authors: Ma Tony , Readman Emma , Hicks Lauren , Porter Jenny , Cameron Melissa , Ellett Lenore , Mcilwaine Kate , Manwaring Janine , Maher Peter
Published: November 2016

Background

In Australia, gynaecologists continue to investigate women with abnormal bleeding and suspected intrauterine pathology with inpatient hysteroscopy despite some evidence in the literature that that there is no difference in safety and outcome when compared to an outpatient procedure.

Aims

This prospective study assessed the safety, effectiveness and acceptability of outpatient hysteroscopy over 11 years at a tertiary hospital in Australia. Resource savings were then calculated.

Materials and Methods

A prospective database was analysed from March 2003 to January 2014 (130 months, 990 women).

Results

Successful hysteroscopic access was obtained in 94% of cases. Twenty‐six percent of patients required a second procedure, including 132 for endometrial polyps and 33 for submucosal fibroids that were not able to be treated in the outpatient setting. On questioning, 88% of women would be happy to have the procedure again. Factors affecting success were pre‐procedure pain, menopausal status and previous vaginal delivery. The difference between pain experienced versus pain expected was a major factor in patient acceptability. A vasovagal episode occurred in 5% of cases.

Conclusion

Outpatient hysteroscopy was demonstrated to be safe, effective and acceptable to women. Provision of an outpatient hysteroscopy service saves theatre time and approximately $1000 per case. Improved techniques and technology will allow progression to a ‘see and treat’ service, providing further savings. With budget constraints, increasing wait times for major procedures and concerns about trainee surgical experience, an outpatient hysteroscopy service should be considered the ‘gold standard’ investigation over hysteroscopy in theatre.
Interest in rural clinical school is not enough: Participation is necessary to predict an ultimate rural practice location
Authors: Playford Denese , Puddey Ian B.
Published: November 2016

Objective

Rural exposure during medical school is associated with increased rural work after graduation. How much of the increase in rural workforce by these graduates is due to pre‐existing interest and plans to work rurally and how much is related to the extended clinical placement is not known.

Design

This cohort study compared the employment location of medical graduates who professed no rural interest as undergraduates (negative control), with those who applied but did not participate in Rural Clinical School of Western Australia (RCSWA) (positive control), and those who applied and participated in RCSWA (participants).

Participants

All 1026 University of Western Australia students who had an opportunity to apply for a year‐long rotation in RCSWA from 2004 to 2010, and who had subsequently graduated by the end of 2011, were included.

Main Outcome Measure

Graduates’ principal workplace location (AHPRA, Feb 2014).

Result

The three groups differed significantly in their graduate work locations (χ2 = 39.2, P < 0.001). In multivariate analysis, only being of older age at graduation (OR 2.28 (95% CI 1.40, 3.72), P = 0.001), being from a rural background (OR 2.99 (95% CI 1.85, 4.85), P < 0.001), being a recipient of a Medical Rural Bonded Scholarship (OR 3.36 (95% CI 1.68, 6.73, P = 0.001) and actually participating in the RCSWA remained significantly related to rural work (OR 3.10 (95% CI 1.95, 4.93), P < 0.001).

Conclusion

After accounting for other factors relating to rural work, RCSWA graduates were three times more likely to work rurally than either control group. These data suggest that RCSWA has a significant independent effect on rural workforce.
Prepregnancy body mass index influences lipid oxidation rate during pregnancy
Authors: Bugatto Fernando , Quintero‐Prado Rocío , Vilar‐Sánchez José M. , Perdomo Germán , Torrejón Rafael , Bartha José L.
Published: November 2016

Introduction

The influence of maternal body mass index (BMI) on respiratory quotient during pregnancy is not clear. We aim to evaluate longitudinal changes in energy expenditure, respiratory quotient, and substrate oxidation rates in normal and overweight women with uncomplicated pregnancies. We hypothesized that the threshold period in switching from a predominantly carbohydrate to a predominantly lipid metabolism may be different in normal and overweight women.

Material and methods

Forty healthy pregnant women were recruited for a prospective cohort study. They were divided into two groups, normal and overweight (BMI <25 kg/m2 or ≥25 kg/m2). Comparisons of indirect calorimetry data were performed monthly throughout pregnancy. The relationships between energy and substrate metabolism variables and maternal BMI were also analyzed.

Results

There was a significant increase in oxygen consumption (Vo2), carbon dioxide production (Vco2) and resting energy expenditure during pregnancy in both normal and overweight women. In the normal weight group, respiratory quotient decreased during the second trimester and increased in the last trimester. Respiratory quotient was lower in the overweight group in the second trimester and decreased in the last trimester; between‐group differences being significant at 20 and 36 weeks (0.85 ± 0.06 vs. 0.81 ± 0.01, p = 0.009; 0.87 ± 0.05 vs. 0.80 ± 0.03, p = 0.01, respectively). Lipid oxidation was significantly higher in overweight women at both 20 and 36 weeks (36.8 ± 19.7% vs. 55.2 ± 5.6%, p = 0.003 and 33.6 ± 18.2% vs. 59.6 ± 12.7%, p = 0.007, for normal and overweight group, respectively).

Conclusion

Prepregnancy maternal BMI influences lipid oxidation rate and respiratory quotient during pregnancy.
The early postnatal nutritional intake of preterm infants affected neurodevelopmental outcomes differently in boys and girls at 24 months
Authors: Christmann Viola , Roeleveld Nel , Visser Reina , Janssen Anjo J.W.M. , Reuser Jolanda J.C.M. , van Goudoever Johannes B. , van Heijst Arno F.J.
Published: November 2016

Aim

This study assessed whether increased amino acid and energy intake in preterm infants during the first week of life was associated with improved neurodevelopment at the corrected age (CA) of 24 months.

Methods

We evaluated preterm infants from two consecutive cohorts in 2004 (Cohort 1) and 2005 (Cohort 2) with different nutritional intakes in the Netherlands. Nutritional intake and growth were recorded until week 5 and after discharge. Neurodevelopment was determined using the Bayley Scales of Infant Development – Second Edition at a CA of 24 months.

Results

Compared to Cohort 1 (n = 56), Cohort 2 (n = 56) received higher nutritional intake during week 1 (p < 0.001). The weight gain in Cohort 2 was higher until week 5, especially among boys (p < 0.002). The mean Mental Developmental Index (MDI) scores did not differ, but Cohort 2 was associated with an increased chance of having an MDI ≥ 85, with an odds ratio of 6.4 and 95% confidence interval (CI) of 1.5–27.4, among all girls with a higher protein intake (5.3, 1.2–23.3). The Psychomotor Developmental Index increased with increasing nutritional intake, especially among boys (β‐coefficient 3.1, 95% CI 0.2–6.0).

Conclusion

Higher nutritional intake was associated with different improvements in growth and neurodevelopment in boys and girls.
Changes in ventilatory capacity and pulmonary gas exchange during systemic and pulmonary inflammation in humans
Authors: Hartmann Jacob P. , Mottelson Mathis N. , Berg Ronan M. G. , Plovsing Ronni R.
Published: November 2016

The exact mechanism linking the systemic inflammatory response associated with sepsis to changes in lung function remains to be determined. In a human experimental model of inflammation, we investigated how acute systemic and local pulmonary inflammation affects ventilatory capacity and pulmonary gas exchange. Fifteen volunteers received Escherichia coli lipopolysaccharide (LPS) intravenously or endobronchially on two different study days. Blood samples were obtained hourly (t = 0–8 h) and spirometry was performed at baseline and after 8 h. Both interventions decreased ventilatory capacity compared to baseline (p < 0.01), and this was more pronounced after intravenous (forced expiratory volume in 1‐s, FEV1; 0.6 L/12% reduction) compared to endobronchial (FEV1; 0.32 L/7% reduction) administration (p < 0.05). Furthermore, the alveolar‐arterial oxygen difference increased after intravenous but not after endobronchial endotoxin. These findings indicate that pulmonary gas exchange is impaired to a greater extent during endotoxin‐induced systemic inflammation than during endotoxin‐induced local pulmonary inflammation.
Louse‐borne relapsing fever in Finland in two asylum seekers from Somalia
Authors: Hytönen Jukka , Khawaja Tamim , Grönroos Juha O. , Jalava Anna , Meri Seppo , Oksi Jarmo
Published: November 2016

We report two cases of louse‐borne relapsing fever (LBRF) in young Somali asylum seekers having recently arrived to Finland. They had sought medical attention for a febrile illness. Blood smears were examined for suspected malaria, but instead, spirochete shaped bacteria were observed. The bacteria were confirmed as Borrelia recurrentis by PCR and sequencing. The patients survived, but their treatment was complicated by Jarisch–Herxheimer reaction. We conclude that LBRF must be considered as a diagnostic option in febrile refugees also in the northernmost parts of Europe.
Effect of castration at 10 months of age on growth physiology and behavior of male feral beef cattle
Authors: Álvarez‐Rodríguez Javier , Albertí Pere , Ripoll Guillermo , Blasco Isabel , Sanz Albina
Published: November 2016

This study compared the growth performance, plasma testosterone and cortisol levels around castration at 10 months of age, and plasma insulin‐like growth factor (IGF)‐I concentration and flight speed, in intact bulls and steers from 10 to 21 months of age in a feral Spanish breed. Fourteen bulls (366.5 ± 48.5 kg live weight) were assigned at random to one of two treatments: surgically castrated (steers) or intact (bulls), and submitted to an identical fattening period. Steers reared until heavy live weights (21 months of age) grew slowly and had lower plasma IGF‐I concentrations than intact bulls. These differences were mainly highlighted the month after surgery (11 months of age) and the last part of the fattening period (from 19 to 21 months of age). After surgical castration (11 and 12 months of age), steers showed a tendency to display greater flight speed values than intact bulls but baseline plasma cortisol concentration did not differ between groups at this time. At the end, steers and bulls reached nearly similar temperament, as flight speed did not differ between them. The results confirm the role of IGF‐I as a key anabolic hormone in male beef cattle and thus it may reflect growth differences due to altered sex steroids production.
Activated Charcoal Haemoperfusion in the Treatment of Experimental Amitriptyline Poisoning in Pigs – The Effect on Amitriptyline Plasma Concentration and Haemodynamic Parameters
Authors: Jansen Tejs , Petersen Henrik , Malskær Cecilie M. , Gabel‐Jensen Charlotte , Dalhoff Kim , Eriksen Thomas , Belhage Bo , Hoegberg Lotte C. G.
Published: November 2016

Coated activated charcoal haemoperfusion (CAC‐HP) is a well‐known treatment modality. Case reports have revealed conflicting results about the efficacy of CAC‐HP in the treatment of amitriptyline (AT) poisoning, and no randomized clinical trials have been identified in the literature. This study aimed at quantifying the efficacy of modern CAC‐HP as an adjunctive treatment of AT intoxication compared with standard care alone. Fourteen female Danish landrace pigs were randomized to either standard care or standard care plus 4 hr of CAC‐HP. The pigs were anaesthetized, and vital parameters were continuously recorded. Amitriptyline infusion (7.5 mg/kg) was completed in 20 min. Thirty minutes after AT infusion, activated charcoal was instilled orally in both groups. In the intervention group, CAC‐HP was initiated 60 min. after AT infusion. Blood and urine samples were collected as were vital parameters at specific time intervals. The protocol was approved by the Danish Experimental Animal Expectorate and complied with the NIH guide for care and use of laboratory animals. Data were managed according to the ARRIVE guidelines. No statistical significant differences between intervention and control groups were found when analysing for differences in AT levels in plasma at any time‐point. Furthermore, significant differences between the control and intervention groups in regard to vital parameters could not be found either. In our animal model, the addition of CAC‐HP did not improve the clearance of AT compared with standard treatment alone. We suggest that the effect of modern CAC‐HP as a treatment modality in AT‐poisoned human patients may be inadequate.
Biodistribution of Carbon Nanotubes in Animal Models
Authors: Jacobsen Nicklas Raun , Møller Peter , Clausen Per Axel , Saber Anne Thoustrup , Micheletti Christian , Jensen Keld Alstrup , Wallin Håkan , Vogel Ulla
Published: November 2016

The many interesting physical and chemical properties of carbon nanotubes (CNT) make it one of the most commercially attractive materials in the era of nanotechnology. Here, we review the recent publications on in vivo biodistribution of pristine and functionalized forms of single‐walled and multi‐walled CNT. Pristine CNT remain in the lung for months or even years after pulmonary deposition. If cleared, the majority of CNT move to the gastrointestinal (GI) tract via the mucociliary escalator. However, there appears to be no uptake of CNT from the GI tract, with a possible exception of the smallest functionalized SWCNT. Importantly, a significant fraction of CNT translocate from the alveolar space to the near pulmonary region including lymph nodes, subpleura and pleura (<7% of the pulmonary deposited dose) and to distal organs including liver, spleen and bone marrow (~1%). These results clearly demonstrate the main sites of long‐term CNT accumulation, which also includes pleura, a major site for fibre‐induced pulmonary diseases. Studies on intravenous injection show that CNT in blood circulation are cleared relatively fast with a half‐life of minutes or hours. The major target organs were the same as identified after pulmonary exposure with the exception of urine excretion of especially functionalized SWCNT and accumulation in lung tissue. Overall, there is evidence that CNT will primarily be distributed to the liver where they appear to be present at least one year after exposure.
Differential neurometabolite alterations in brains of medication‐free individuals with bipolar disorder and those with unipolar depression: a two‐dimensional proton magnetic resonance spectroscopy study
Authors: Li Hui , Xu Haiyun , Zhang Yinnan , Guan Jitian , Zhang Jie , Xu Chongtao , Shen Zhiwei , Xiao Bo , Liang Chunlian , Chen Kaiyuan , Zhang Jinling , Wu Renhua
Published: November 2016

Objectives

Bipolar disorder (BD) is a mental disorder characterized by periods of elevated mood and depression. Many individuals with BD are initially misdiagnosed and treated for unipolar depression (UD). In this study, we report direct comparisons between medication‐free individuals with BD and those with UD in terms of the neurometabolites in the anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), parietal cortex (PC), and posterior cingulate cortex (PCC) of the brain.

Methods

Participants included medication‐free patients with BD or UD, and matched healthy controls. All patients were in the depressive state and had similar symptoms. All subjects were subjected to a multi‐voxel proton magnetic resonance spectroscopy procedure with a 3.0 T GE Signa MR scanner. After post‐processing, the absolute concentrations of glycerophosphocholine + phosphocholine (GPC + PC), phosphocreatine + creatine (PCr + Cr), Glx (glutamate + glutamine), myo‐inositol (MI), and N‐acetyl aspartate (NAA) from the above brain regions were compared across the three groups.

Results

Patients with BD showed significantly higher levels of Glx in their ACC, lower GPC + PC, PCr + Cr, MI, and NAA in their PC, and lower NAA in their mPFC, compared to healthy controls; patients with UD presented significantly lower levels of GPC + PC, PCr + Cr, and NAA in their PCC, and lower Glx in their mPFC. All analyzed brain metabolites, except Glx, were significantly lower in the PC of patients with BD, whereas levels of GPC + PC, PCr + Cr, and NAA were significantly reduced in the PCC of patients with UD.

Conclusions

These results add to the evidence of brain metabolite differences in brains of patients with UD and BD which may be of help in differentiating these two mood disorders.
A Semiparametric Model for VQTL Mapping
Authors: Hong Chuan , Ning Yang , Wei Peng , Cao Ying , Chen Yong
Published: November 2016

Quantitative trait locus analysis has been used as an important tool to identify markers where the phenotype or quantitative trait is linked with the genotype. Most existing tests for single locus association with quantitative traits aim at the detection of the mean differences across genotypic groups. However, recent research has revealed functional genetic loci that affect the variance of traits, known as variability-controlling quantitative trait locus. In addition, it has been suggested that many genotypes have both mean and variance effects, while the mean effects or variance effects alone may not be strong enough to be detected. The existing methods accounting for unequal variances include the Levene's test, the Lepage test, and the D-test, but suffer from their limitations of lack of robustness or lack of power. We propose a semiparametric model and a novel pairwise conditional likelihood ratio test. Specifically, the semiparametric model is designed to identify the combined differences in higher moments among genotypic groups. The pairwise likelihood is constructed based on conditioning procedure, where the unknown reference distribution is eliminated. We show that the proposed pairwise likelihood ratio test has a simple asymptotic chi-square distribution, which does not require permutation or bootstrap procedures. Simulation studies show that the proposed test performs well in controlling Type I errors and having competitive power in identifying the differences across genotypic groups. In addition, the proposed test has certain robustness to model mis-specifications. The proposed test is illustrated by an example of identifying both mean and variances effects in body mass index using the Framingham Heart Study data.
Cost Analysis of Following Up Incomplete Low‐Risk Fetal Anatomy Ultrasounds
Authors: O'Brien Karen , Shainker Scott A. , Modest Anna M. , Spiel Melissa H. , Resetkova Nina , Shah Neel , Hacker Michele R.
Published: November 2016

Objectives

To examine the clinical utility and cost of follow‐up ultrasounds performed as a result of suboptimal views at the time of initial second‐trimester ultrasound in a cohort of low‐risk pregnant women.

Methods

We conducted a retrospective cohort study of women at low risk for fetal structural anomalies who had second‐trimester ultrasounds at 16 to less than 24 weeks of gestation from 2011 to 2013. We determined the probability of women having follow‐up ultrasounds as a result of suboptimal views at the time of the initial second‐trimester ultrasound, and calculated the probability of detecting an anomaly on follow‐up ultrasound. These probabilities were used to estimate the national cost of our current ultrasound practice, and the cost to identify one fetal anomaly on follow‐up ultrasound.

Results

During the study period, 1,752 women met inclusion criteria. Four fetuses (0.23% [95% CI 0.06–0.58]) were found to have anomalies at the initial ultrasound. Because of suboptimal views, 205 women (11.7%) returned for a follow‐up ultrasound, and one (0.49% [95% CI 0.01–2.7]) anomaly was detected. Two women (0.11%) still had suboptimal views and returned for an additional follow‐up ultrasound, with no anomalies detected. When the incidence of incomplete ultrasounds was applied to a similar low‐risk national cohort, the annual cost of these follow‐up scans was estimated at $85,457,160. In our cohort, the cost to detect an anomaly on follow‐up ultrasound was approximately $55,000.

Conclusions

The clinical yield of performing follow‐up ultrasounds because of suboptimal views on low‐risk second‐trimester ultrasounds is low. Since so few fetal abnormalities were identified on follow‐up scans, this added cost and patient burden may not be warranted.