bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimal Timing of P2Y12 Inhibitor Loading in Patients Undergoing PCI: A Meta-Analysis
Authors: Komosa Anna , Lesiak Maciej , Krasiński Zbigniew , Grygier Marek , Siniawski Andrzej , Skorupski Włodzimierz , Olasińska-Wiśniewska Anna , Pyda Małgorzata , Araszkiewicz Aleksander , Mitkowski Przemysław , Grajek Stefan , Mularek-Kubzdela Tatiana , Hengstenberg Christian , Siller-Matula Jolanta M. 
Published: March 2019

Background and Aim The timing of P2Y12 inhibitor loading in patients undergoing percutaneous coronary intervention (PCI) is a matter of debate. The aim of our study was to compare the efficacy and safety of oral P2Y12 inhibitors: clopidogrel, ticagrelor and prasugrel administered at two different time points in relation to PCI: early (> 2 hours pre-PCI) versus late (< 2 hours pre-PCI or post-PCI).
Methods This is a systematic review and meta-analysis. Randomized controlled trials and non-randomized studies were included. Outcomes evaluated were combined major adverse cardiovascular events (MACEs), myocardial infarction (MI), target vessel revascularization, death and bleeding complications. Summary estimates of the relative risks with therapy were calculated.
Results Twenty-three studies met the selection criteria and included 60,907 patients. Early P2Y12 inhibitor loading was associated with a 22% relative risk reduction (RRR) of MACE (95% confidence interval [CI] = 0.68–0.89; p < 0.001). Early clopidogrel loading was associated with a 25% RRR of MACE (95% CI = 0.65–0.85; p < 0.001), a 30% RRR of MI (95% CI = 0.6–0.82; p < 0.0001) and 25% RRR of death (95% CI = 0.64–0.87; p = 0.0002), without an impact on major bleedings. In ST-elevation myocardial infarction as well as non-ST elevation acute coronary syndrome (NSTE-ACS), early clopidogrel loading resulted in 35 and 22% RRR in 30 days MACE (p < 0.001), respectively, with no impact in elective PCI. Whereas early loading with prasugrel and ticagrelor did not improve ischaemic outcomes, prasugrel administered early increased bleeding risks in NSTE-ACS.
Conclusion Early clopidogrel loading is associated with a better efficacy and similar safety, whereas timing of ticagrelor or prasugrel loading had no effects on ischaemic events.
Toward optical coherence tomography angiography-based biomarkers to assess the safety of peripheral nerve electrostimulation
Authors: Vasudevan Srikanth , Vo Jesse , Shafer Benjamin , Nam Ahhyun S , Vakoc Benjamin J , Hammer Daniel X 
Published: March 2019

Abstract

Objective. Peripheral nerves serve as a link between the central nervous system and its targets. Altering peripheral nerve activity through targeted electrical stimulation is being investigated as a therapy for modulating end organ function. To support rapid advancement in the field, novel approaches to predict and prevent nerve injury resulting from electrical stimulation must be developed to overcome the limitations of traditional histological methods. The present study aims to develop an optical imaging-based approach for real-time assessment of peripheral nerve injury associated with electrical stimulation. Approach. We developed an optical coherence tomography (OCT) angiography system and a 3D printed stimulating nerve stabilizer (sNS) to assess the real-time microvascular and blood flow changes associated with electrical stimulation of peripheral nerves. We then compared the microvascular changes with established nerve function analysis and immunohistochemistry to correlate changes with nerve injury. Main results. Electrical stimulation of peripheral nerves has a direct influence on vessel diameter and capillary flow. The stimulation used in this study did not alter motor function significantly, but a delayed onset of mechanical allodynia at lower thresholds was observed using a sensory function test. Immunohistochemical analysis pointed to an increased number of macrophages within nerve fascicles and axon sprouting potentially related to nerve injury. Significance. This study is the first to demonstrate the ability to image peripheral nerve microvasculature changes during electrical stimulation. This expands the knowledge in the field and can be used to develop potential biomarkers to predict nerve injury resulting from electrical stimulation.
Agricultural Productivity and Soil Carbon Dynamics: A Bioeconomic Model
Authors: Berazneva Julia , Conrad Jon M , Güereña David T , Lehmann Johannes , Woolf Dominic 
Published: March 2019

AbstractWe examine the dynamic management of a soil resource—the issue at the core of both environmental and development challenges in developing countries. Our theoretical framework extends the traditional bioeconomic model of renewable resources to soil carbon management and investigates the effects of changes in agricultural practices on farmers' natural resource base and livelihoods. We parameterize the model using an eight‐year panel data set from an agronomic experiment and data from household and market surveys in the western Kenyan highlands. The optimal maize yields and soil carbon stocks are higher than those observed in the region. This divergence is partly explained by farmers' heterogeneous time preferences (with the implied discount rates of 5% to 25%), information barriers, and market imperfections. The steady‐state shadow price for soil carbon ranges from $95/Mg to $168/Mg, indicating a significant opportunity cost for soil mismanagement.
The role of endothelial glycocalyx in health and disease
Authors: Yilmaz Onur , Afsar Baris , Ortiz Alberto , Kanbay Mehmet 
Published: March 2019

AbstractThe endothelium is the largest organ in the body and recent studies have shown that the endothelial glycocalyx (eGCX) plays a major role in health and disease states. The integrity of eGCX is vital for homoeostasis and disruption of its structure and function plays a major role in several pathologic conditions. An increased understanding of the numerous pathophysiological roles of eGCX may lead to the development of potential surrogate markers for endothelial injury or novel therapeutic targets. This review provides a state-of-the-art update on the structure and function of the eGCX, emphasizing the current understanding of interorgan crosstalk between the eGCX and other organs that might also contribute to the pathogenesis of kidney diseases.
SGAC: A Multi-Layered Access Control Model with Conflict Resolution Strategy
Authors: Huynh Nghi , Frappier Marc , Pooda Herman , Mammar Amel , Laleau Régine 
Published: March 2019

AbstractThis paper presents SGAC (Solution de Gestion Automatisée du Consentement / automated consent management solution), a new healthcare access control model and its support tool, which manages patient wishes regarding access to their electronic health records (EHR). This paper also presents the verification of access control policies for SGAC using two first-order-logic model checkers based on distinct technologies, Alloy and ProB. The development of SGAC has been achieved within the scope of a project with the University of Sherbrooke Hospital (CHUS), and thus has been adapted to take into account regional laws and regulations applicable in Québec and Canada, as they set bounds to patient wishes: for safety reasons, under strictly defined contexts, patient consent can be overriden to protect his/her life (break-the-glass rules). Since patient wishes and those regulations can be in conflict, SGAC provides a mechanism to address this problem based on priority, specificity and modality. In order to protect patient privacy while ensuring effective caregiving in safety-critical situations, we check four types of properties: accessibility, availability, contextuality and rule effectivity. We conducted performance tests comparison: implementation of SGAC versus an implementation of another access control model, XACML, and property verification with Alloy versus ProB. The performance results show that SGAC performs better than XACML and that ProB outperforms Alloy by two order of magnitude thanks to its programmable approach to constraint solving.
Post-orthodontic retention: how much do people deciding on a future orthodontic treatment know and what do they expect? A questionnaire-based survey
Authors: Lasance Sandrine J , Papageorgiou Spyridon N , Eliades Theodore , Patcas Raphael 
Published: March 2019

SummaryObjectiveThis cross-sectional study aimed to explore the level of knowledge and expectations people deciding on a future orthodontic treatment have about post-orthodontic retention and to investigate the influence of sociocultural characteristics.Material and methodsA total of 227 consecutive people involved as legal decision maker (as patient, parent, or legal guardian) for a prospective orthodontic treatment (mean age 37.1 years; 37.3 per cent male) received before their first appointment a questionnaire to assess their knowledge and expectations about post-orthodontic retention. Data were analysed descriptively, whereas predictors were identified with logistic regressions at P value of less than or equal to 0.05.ResultsAmong the 220 responders, 46.3 per cent (n = 99) knew that retention appliances are used after orthodontic treatment and 52.8 per cent (n = 113) believed perfect results can guarantee stability, whereas at the same time, 77.8 per cent (n = 168) knew that teeth can move on their own without any orthodontic appliances. The majority considered stability of the orthodontic result important or extremely important (94.5 per cent; n = 206), preferred bonded over removable retainers (67.2 per cent; n = 133), believed the orthodontist to be primarily responsible for a stable result (73.2 per cent; n = 158), and found it appropriate to charge for recall visits (72.9 per cent; n = 153). Participants’ gender, age, education, nationality, and past orthodontic experiences within the close family significantly influenced answers.LimitationsThe setting of a single-centred survey conducted in one university moderates the generalizability of the portrayed results.ConclusionsAlthough stability of orthodontic treatment results is very important to people deciding about a prospective orthodontic treatment, knowledge regarding the need for post-orthodontic retention varies and may at times be contradictious. Sociocultural factors seem to influence the level of knowledge and the expectations on post-orthodontic retention.
Imprints from idea origin on innovation and the development environment
Authors: Bodas Freitas Isabel Maria , Lawson Cornelia 
Published: March 2019

AbstractThis study builds on the evolutionary and organization literatures to explore how the nature of innovation outcomes was influenced by the innovation’s original idea and the environment in which it was developed. We use data from a survey of inventors on the development processes of three types of innovations: market success innovations, technologically novel innovations, and innovations that are both technologically novel and of market success. Our results suggest that the environment in which the project is developed erodes the effect of the original knowledge sources on the innovation outcome. Specifically, a stronger imprinting effect of knowledge sources is found for independent inventors, while ideas are more likely to be eroded in projects undertaken by inventors at technology leader firms.
Domains, tasks, and knowledge for clinical informatics subspecialty practice: results of a practice analysis
Authors: Silverman Howard D , Steen Elaine B , Carpenito Jacqueline N , Ondrula Christopher J , Williamson Jeffrey J , Fridsma Douglas B 
Published: March 2019

Abstract

Objective
The study sought to develop a comprehensive and current description of what Clinical Informatics Subspecialty (CIS) physician diplomates do and what they need to know.

Materials and Methods
Three independent subject matter expert panels drawn from and representative of the 1695 CIS diplomates certified by the American Board of Preventive Medicine contributed to the development of a draft CIS delineation of practice (DoP). An online survey was distributed to all CIS diplomates in July 2018 to validate the draft DoP. A total of 316 (18.8%) diplomates completed the survey. Survey respondents provided domain, task, and knowledge and skill (KS) ratings; qualitative feedback on the completeness of the DoP; and detailed professional background and demographic information.

Results
This practice analysis resulted in a validated, comprehensive, and contemporary DoP comprising 5 domains, 42 tasks, and 139 KS statements.

Discussion
The DoP that emerged from this study differs from the 2009 CIS Core Content in 2 respects. First, the DoP reflects the growth in amount, types, and utilization of health data through the addition of a practice domain, tasks, and KS statements focused on data analytics and governance. Second, the final DoP describes CIS practice in terms of tasks in addition to identifying knowledge required for competent practice.

Conclusions
This study (1) articulates CIS diplomate tasks and knowledge used in practice, (2) provides data that will enable the American Board of Preventive Medicine CIS examination to align with current practice, (3) informs clinical informatics fellowship program requirements, and (4) provides insight into maintenance of certification requirements.
Reproductive den selection and its consequences for fisher neonates, a cavity-obligate mustelid
Authors: Matthews Sean M , Green David S , Higley J Mark , Rennie Kerry M , Kelsey Caylen M , Green Rebecca E 
Published: March 2019

AbstractSelection of habitat characteristics by reproductive females during neonate development can mediate the influence of adverse environmental conditions on the fitness of offspring. Previous research has suggested that cavities and burrows used for reproduction by cavity-obligate species offer thermoregulatory benefits, access to prey, and can limit predation pressure. As fishers (Pekania pennanti) are secondary cavity-obligate breeders, we hypothesized that they select particular characteristics of reproductive den cavities at discrete stages of offspring development to mediate adverse biotic and environmental effects on their neonates. To test our hypothesis, we located 406 reproductive dens and 154 cavity rest sites used by 65 individual adult female fishers during 11 reproductive seasons (2005–2016) in northwestern California. We counted 53 (27 F, 26 M) kits in 31 litters born to 19 females during six of these reproductive seasons. The weight of kits varied significantly by sex and by age, whereas the length of kits varied only by age, suggesting that adult females in this population might be preferentially investing in male kits. We found that natal and early-maternal dens buffered minimum temperatures significantly more than late-maternal dens and cavities used during the nonreproductive season. A male fisher skull was also less likely to fit through the cavity openings of natal dens than through the openings of cavities used by adult females during the nonreproductive season. Litter survival was significantly lower at natal dens than at late-maternal dens. The age of adult female fishers did not affect the probability of litter survival. Our results emphasize the vulnerability of vertebrate offspring during early developmental periods and how cavity-obligate species select cavities to mediate environmental conditions during reproduction.
Housing Instability Results in Increased Acute Care Utilization in an Urban HIV Clinic Cohort
Authors: Clemenzi-Allen Angelo , Neuhaus John , Geng Elvin , Sachdev Darpun , Buchbinder Susan , Havlir Diane , Gandhi Monica , Christopoulos Katerina 
Published: March 2019

Abstract

Background
People living with HIV (PLWH) who experience homelessness and unstable housing (HUH) often have fragmented health care. Research that incorporates granular assessments of housing status and primary care visit adherence to understand patterns of acute care utilization can help pinpoint areas for intervention.

Methods
We collected self-reported living situation, categorized as stable (rent/own, hotel/single room occupancy), unstable (treatment/transitional program, staying with friends), or homeless (homeless shelter, outdoors/in vehicle) at an urban safety-net HIV clinic between February and August 2017 and abstracted demographic and clinical information from the medical record. Regression models evaluated the association of housing status on the frequency of acute care visits—urgent care (UC) visits, emergency department (ED) visits, and hospitalizations—and whether suboptimal primary care visit adherence (&lt;75%) interacted with housing status on acute care visits.

Results
Among 1198 patients, 25% experienced HUH. In adjusted models, unstable housing resulted in a statistically significant increase in the incidence rate ratio for UC visits (incidence rate ratio [IRR], 1.35; 95% confidence interval [CI], 1.10 to 1.66; P &lt; .001), ED visits (IRR, 2.12; 95% CI, 1.44 to 3.13; P &lt; .001), and hospitalizations (IRR, 1.75; 95% CI, 1.10 to 2.77; P = 0.018). Homelessness led to even greater increases in UC visits (IRR, 1.75; 95% CI, 1.29 to 2.39; P &lt; .001), ED visits (IRR, 4.18; 95% CI, 2.77 to 6.30; P &lt; .001), and hospitalizations (IRR, 3.18; 95% CI, 2.03 to 4.97; P &lt; .001). Suboptimal visit adherence differentially impacted UC and ED visits by housing status, suggesting interaction.

Conclusions
Increased acute care visit frequency among HUH-PLWH suggests that interventions at these visits may create opportunities to improve care.
Advancing public health policy making through research on the political strategies of alcohol industry actors
Authors: McCambridge Jim , Kypri Kypros , Sheldon Trevor A , Madden Mary , Babor Thomas F 
Published: March 2019

Abstract
Development and implementation of evidence-based policies is needed in order to ameliorate the rising toll of non-communicable diseases (NCDs). Alcohol is a key cause of the mortality burden and alcohol policies are under-developed. This is due in part to the global influence of the alcohol industry. We propose that a better understanding of the methods and the effectiveness of alcohol industry influence on public health policies will support efforts to combat such influence, and advance global health. Many of the issues on the research agenda we propose will inform, and be informed by, research into the political influence of other commercial actors.
Role of Vitamin-D Deficiency in Term Neonates with Late-Onset Sepsis: A Case–Control Study
Authors: Agrawal Amit , Gupta Aekta , Shrivastava Jyotsna 
Published: March 2019

Abstract

Objective
To find the relationship between vitamin-D levels and late-onset sepsis (LOS) in term neonates.

Methods
This case–control study was conducted in neonatal intensive care unit of a tertiary care teaching institution in central India. Full-term neonates with culture-proven LOS were taken as cases. Maternal and neonatal demography, clinical examination and investigations were recorded. Correlation of vitamin-D deficiency (<20 ng/ml) with LOS was assessed.

Results
Total 225 term neonates including 175 cases and 50 controls were included. Maternal and neonatal demographic profile was comparable. The mean vitamin-D level in cases (12.28 ± 6.11 ng/ml) was significantly lower than that in controls (14.88 ± 7.2 ng/ml) (p = 0.002). Total 151 (86.29%) neonates out of 175 cases and 37 (74%) out of 50 controls had the vitamin-D deficiency (p = 0.00003). On multiple regression analysis, neonatal sepsis (p = 0.00003) was found to be significantly associated with vitamin-D deficiency.

Conclusion
This study shows that vitamin-D deficiency in term neonates may predispose them to LOS.
Retrofit modelling of existing dwellings in the UK: the Salford Energy House case study
Authors: Ji Yingchun , Lee Angela , Swan William 
Published: March 2019

Purpose
There is a clear consensus that improving energy efficiency of existing housing stock is necessary to meet the UK’s legally binding carbon emission targets by 2050. The purpose of this paper is to assess the energy saving potentials from building retrofit using an end-terrace house, similar houses represent about 30 per cent of the existing building stock in the UK.

Design/methodology/approach
The Salford Energy House – a unique pre-1919 Victorian end-terrace house built within an environmental chamber – was used. Retrofit modelling analysis was carried out using IESVE – a dynamic thermal simulation tool. The retrofitted model was also evaluated using future projected climate data (CIBSE latest release) to examine energy demands and overheating.

Findings
Findings show that improving building fabric thermal characteristics can reduce space heating demands substantially. Heating modes, set point preferences and infiltration level all have strong impact on heating demands. Space heating demand savings can be as much as 77 per cent when the property facades were upgraded to the similar requirements of Passivhaus standards. The research implicates that, for dwelling retrofit practices, a whole house holistic approach should be the preferred option to improve energy efficiency. With future climate scenarios where temperatures are potentially elevated, the heating demands can be potentially reduced as much as 27 per cent.

Practical implications
The likelihood of overheating in dwellings after a deep retrofit due to future elevated temperatures becomes apparent. Therefore, mitigation of overheating risk becomes a necessity for future domestic housing stock retrofit planning and policy making.

Originality/value
The research presented in this paper highlights the effectiveness of various retrofit measures individually as well as holistically, also the implications on energy demands and the likelihood of overheating in dwellings under future climate scenarios.
The relationship between perceived service quality of antenatal care and use among rural women in Ghana
Authors: Osei Asibey Benedict , Boakye Dankwah Augustina , Agyemang Seth 
Published: March 2019

Purpose
The purpose of this paper was to examine rural women’s perceived quality of antenatal care (ANC) and its influence on the extent of ANC in the Amansie Central District in the Ashanti Region of Ghana.

Design/methodology/approach
A quantitative cross-sectional study was conducted with 120 women attending postnatal care at selected public health facilities. Structured interviews were used to obtain data. Crude odds ratio with 95% confidence interval (CI) was generated to determine the odds of women’s utilisation of ANC with their perceived service quality. The association between women’s background characteristics and ANC use was determined and assessed using Pearson’s χ2 (2) test.

Findings
Majority of the women (58.3 percent) utilised ANC for at least four times during pregnancy. Women’s education (p=0.027), religious affiliation (p=0.006), source of income (p=0.012) and insurance status (p=0.023) all had a positive relationship with ANC use. Women who perceived ANC quality as good were three times more likely to have four or more ANC visits than those who perceived quality as poor (OR= 3.042, 95% CI=0.181–0.647, p=0.001).

Originality/value
Ghana has had numerous policy interventions that address the accessibility and quality of ANC service. However, little is known about the extent to which they are observed and about the quality of service from users’ perspective. Most existing literature on ANC use in Ghana focusses on socio-economic factors that influence utilisation. This paper will be the first to examine the perceived quality of ANC provided, and its influence on the extent of ANC visits among rural women in Ghana.