bluuebunny/crossref_metadata_2025_split huggingface dataset:
Foreign‐Funded Adaptation to Climate Change in Africa: Mirroring Administrative Traditions or Traditions of Administrative Blueprinting?
Authors: Vink Martinus , Schouten Greetje 
Published: April 2018

AbstractClimate change impacts are most severe in developing countries with limited adaptive capacity. Accordingly, in Africa, climate change adaptation has become an issue of international funding and practice. As suggested in the Introduction to this special issue, administrative traditions could play a role in how adaptation plays out. This, however, raises questions about how foreign funding regimes coincide with recipients' administrative traditions, especially on the African continent where administrative traditions are often meagerly established. To address these questions, this article takes an explorative approach. From a literature review of African state governance and development aid approaches, we take colonial legacy as the most distinctive factor responsible for African administrative traditions. In addition, we define three ways in which foreign aid programs have dealt with African administration: (1) aligning with donor administration, (2) blueprinting administration, and (3) ignoring administration. Using 34 African countries' National Adaptation Programmes of Action (NAPAs), we analyze how African governments actually frame adaptation as a governance challenge. We contrast these frames with: (1) administrative traditions based on colonial legacy and (2) the ways in which development aid programs have historically dealt with recipient African administrations. Our findings indicate that NAPAs only meagerly refer to the administrative tradition that could be expected based on colonial legacy, but extensively refer to blueprint ideas common among international donors, or ignore administration altogether. We discuss the implications for adaptation to climate change.
The emotional self: Embodiment, reflexivity, and emotion regulation
Authors: Burkitt Ian 
Published: April 2018

AbstractCurrent dominant trends in the biological and psychological sciences tend to put emphasis on the role of the brain, cognition, and consciousness in realising emotional states and attempting to regulate them. In this article, I suggest an alternative approach with the idea that emotions emerge within social relations and give meaning and value to the situations in which we are located. Humans are understood as embodied emotional selves for who thought and emotion are intertwined. However, individuals can get caught in obsessive and compulsive thinking and feeling traps where the self loses touch with its emotions, and because of this also loses contact with the social situation and the ability to skilfully navigate it. In such circumstances, the self gets overwhelmed by emotion and loses its poise in the social setting. I consider Buddhist meditation as a technique through which people can develop a more reflexive emotional self, where reflexivity is not about control of emotion but owning one's feelings and being able to respond more sensitively and skilfully in various situations.
Evaluating the Effects of Landscape on Housing Prices in Urban China
Authors: Du Qingyun , Wu Chao , Ye Xinyue , Ren Fu , Lin Yongjun 
Published: April 2018

AbstractThe rapid urbanisation of China has received growing attention regarding its urban residential environments. In this article, we model the spatial heterogeneity of housing prices and explore the spatial discrepancy of landscape effects on property values in Shenzhen, a large Chinese city. In contrast to previous studies, this paper integrates the official housing transaction records and housing attributes from open data along with field surveys. Then, the results using the hedonic price model (HPM), geographically weighted regression (GWR) without landscape metrics and GWR with landscape metrics are compared. The results show that GWR with landscape metrics outperforms the other two models. In summary, this research provides new insights into landscape metrics in real estate studies and can guide decision‐makers plan and design cities while also providing guidance to regulate and control urban property values based on local conditions.
Enzymes Involved in Posttranscriptional RNA Metabolism in Gram-Negative Bacteria
Authors: Mohanty Bijoy K. , Kushner Sidney R. 
Published: April 2018

ABSTRACT
Gene expression in Gram-negative bacteria is regulated at many levels, including transcription initiation, RNA processing, RNA/RNA interactions, mRNA decay, and translational controls involving enzymes that alter translational efficiency. In this review, we discuss the various enzymes that control transcription, translation, and RNA stability through RNA processing and degradation. RNA processing is essential to generate functional RNAs, while degradation helps control the steady-state level of each individual transcript. For example, all the pre-tRNAs are transcribed with extra nucleotides at both their 5′ and 3′ termini, which are subsequently processed to produce mature tRNAs that can be aminoacylated. Similarly, rRNAs that are transcribed as part of a 30S polycistronic transcript are matured to individual 16S, 23S, and 5S rRNAs. Decay of mRNAs plays a key role in gene regulation through controlling the steady-state level of each transcript, which is essential for maintaining appropriate protein levels. In addition, degradation of both translated and nontranslated RNAs recycles nucleotides to facilitate new RNA synthesis. To carry out all these reactions, Gram-negative bacteria employ a large number of endonucleases, exonucleases, RNA helicases, and poly(A) polymerase, as well as proteins that regulate the catalytic activity of particular RNases. Under certain stress conditions, an additional group of specialized endonucleases facilitate the cell’s ability to adapt and survive. Many of the enzymes, such as RNase E, RNase III, polynucleotide phosphorylase, RNase R, and poly(A) polymerase I, participate in multiple RNA processing and decay pathways.
Correction of estimates of retention in care among a cohort of HIV-positive patients in Uganda in the period before starting ART: a sampling-based approach
Authors: Nyakato Patience , Kiragga Agnes N , Kambugu Andrew , Bradley John , Baisley Kathy 
Published: April 2018

ObjectiveThe aim of this study was to use a sampling-based approach to obtain estimates of retention in HIV care before initiation of antiretroviral treatment (ART), corrected for outcomes in patients who were lost according to clinic registers.DesignRetrospective cohort study of HIV-positive individuals not yet eligible for ART (CD4 >500).SettingThree urban and three rural HIV care clinics in Uganda; information was extracted from the clinic registers for all patients who had registered for pre-ART care between January and August 2015.ParticipantsA random sample of patients who were lost according to the clinic registers (>3 months late to scheduled visit) was traced to ascertain their outcomes.Outcome measuresThe proportion of patients lost from care was estimated using a competing risks approach, first based on the information in the clinic records alone and then using inverse probability weights to incorporate the results from tracing. Cox regression was used to determine factors associated with loss from care.ResultsOf 1153 patients registered for pre-ART care (68% women, median age 29 years, median CD4 count 645 cells/µL), 307 (27%) were lost according to clinic records. Among these, 195 (63%) were selected for tracing; outcomes were ascertained in 118 (61%). Seven patients (6%) had died, 40 (34%) were in care elsewhere and 71 (60%) were out of care. Loss from care at 9 months was 30.2% (95% CI 27.3% to 33.5%). After incorporating outcomes from tracing, loss from care decreased to 18.5% (95% CI 13.8% to 23.6%).ConclusionEstimates of loss from HIV care may be too high if based on routine clinic data alone. A sampling-based approach is a feasible way of obtaining more accurate estimates of retention, accounting for transfers to other clinics.
Reducing the default dispense quantity for new opioid analgesic prescriptions: study protocol for a cluster randomised controlled trial
Authors: Bachhuber Marcus A , Nash Denis , Southern William N , Heo Moonseong , Berger Matthew , Schepis Mark , Cunningham Chinazo O 
Published: April 2018

IntroductionAs opioid analgesic consumption has grown, so have opioid use disorder and opioid-related overdoses. Reducing the quantity of opioid analgesics prescribed for acute non-cancer pain can potentially reduce risks to the individual receiving the prescription and to others who might unintentionally or intentionally consume any leftover tablets. Reducing the default dispense quantity for new opioid analgesic prescriptions in the electronic health record (EHR) is a promising intervention to reduce prescribing.Methods and analysisThis study is a prospective cluster randomised controlled trial with two parallel arms. Primary care sites (n=32) and emergency departments (n=4) will be randomised in matched pairs to either a modification of the EHR so that new opioid analgesic prescriptions default to a dispense quantity of 10 tablets (intervention) or to no EHR change (control). The dispense quantity will remain fully modifiable by providers in both arms. From 6 months preintervention to 18 months postintervention, patient-level data will be analysed (ie, the patient is the unit of inference). Patient eligibility criteria are: (A) received a new opioid analgesic prescription, defined as no other opioid analgesic prescription in the prior 6 months; (B) age ≥18 years; and (C) no cancer diagnosis within 1 year prior to the new opioid analgesic prescription. The primary outcome will be the quantity of opioid analgesics prescribed in the initial prescription. Secondary outcomes will include opioid analgesic reorders and health service utilisation within 30 days after the initial prescription. Outcomes will be compared between study arms using a difference-in-differences analysis.Ethics and disseminationThis study has been approved by the Montefiore Medical Center/Albert Einstein College of Medicine Institutional Review Board with a waiver of informed consent (2016-6036) and is registered on ClinicalTrials.gov (NCT03003832, 6 December 2016). Findings will be disseminated through publication, conferences and meetings with health system leaders.Trial registration numberNCT03003832; Pre-results.
Observational cross-sectional study of nasal staphylococcal species of medical students of diverse geographical origin, prior to healthcare exposure: prevalence of SCCmec,fusC,fusBand the arginine catabolite mobile element (ACME) in the absence of selective antibiotic pressure
Authors: Budri Paulo E , Shore Anna C , Coleman David C , Kinnevey Peter M , Humpreys Hilary , Fitzgerald-Hughes Deirdre 
Published: April 2018

ObjectiveThe aim of this study was to investigate co-located nasalStaphylococcus aureusand coagulase-negative staphylococci (CoNS) (mainlyStaphylococcus epidermidis), recovered from healthy medical students in their preclinical year, prior to exposure to the healthcare environment, for the carriage of genes and genetic elements common to both species and that may contribute toS. aureusand methicillin-resistantS. aureus(MRSA) evolution.DesignProspective observational cross-sectional study. Carriage of antimicrobial resistance and virulence-associated genes in the absence of significant antibiotic selective pressure was investigated among healthy medical students from geographically diverse origins who were nasally co-colonised withS. aureusand CoNS. Clonal lineages ofS. aureusisolates were determined.Setting/participantsDublin-based international undergraduate medical students.ResultsNasalS. aureuscarriage was identified in 137/444 (30.8%) students of whom nine (6.6%) carried MRSA (ST59-MRSA-IV (6/9), CC1-MRSA-V-SCCfus(3/9)). The genesmecA,fusB,ileS2, qacA/qacCand the arginine catabolic mobile element-arcwere detected among colonising nasal staphylococci and had a significantly greater association with CoNS thanS. aureus.The rate of co-carriage of any of these genes inS. aureus/CoNS pairs recovered from the same individual was <1%.ConclusionsThe relatively high prevalence of these genes among CoNS of the healthy human flora in the absence of significant antibiotic selective pressure is of interest. Further research is required to determine what factors are involved and whether these are modifiable to help prevent the emergence and spread of antibiotic resistance among staphylococci.
Validating malignant melanoma ICD-9-CM codes in Umbria, ASL Napoli 3 Sud and Friuli Venezia Giulia administrative healthcare databases: a diagnostic accuracy study
Authors: Orso Massimiliano , Serraino Diego , Abraha Iosief , Fusco Mario , Giovannini Gianni , Casucci Paola , Cozzolino Francesco , Granata Annalisa , Gobbato Michele , Stracci Fabrizio , Ciullo Valerio , Vitale Maria Francesca , Eusebi Paolo , Orlandi Walter , Montedori Alessandro , Bidoli Ettore 
Published: April 2018

ObjectivesTo assess the accuracy of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes in identifying subjects with melanoma.DesignA diagnostic accuracy study comparing melanoma ICD-9-CM codes (index test) with medical chart (reference standard). Case ascertainment was based on neoplastic lesion of the skin and a histological diagnosis from a primary or metastatic site positive for melanoma.SettingAdministrative databases from Umbria Region, Azienda Sanitaria Locale (ASL) Napoli 3 Sud (NA) and Friuli Venezia Giulia (FVG) Region.Participants112, 130 and 130 cases (subjects with melanoma) were randomly selected from Umbria, NA and FVG, respectively; 94 non-cases (subjects without melanoma) were randomly selected from each unit.Outcome measuresSensitivity and specificity for ICD-9-CM code 172.x located in primary position.ResultsThe most common melanoma subtype was malignant melanoma of skin of trunk, except scrotum (ICD-9-CM code: 172.5), followed by malignant melanoma of skin of lower limb, including hip (ICD-9-CM code: 172.7). The mean age of the patients ranged from 60 to 61 years. Most of the diagnoses were performed in surgical departments.The sensitivities were 100% (95% CI 96% to 100%) for Umbria, 99% (95% CI 94% to 100%) for NA and 98% (95% CI 93% to 100%) for FVG. The specificities were 88% (95% CI 80% to 93%) for Umbria, 77% (95% CI 69% to 85%) for NA and 79% (95% CI 71% to 86%) for FVG.ConclusionsThe case definition for melanoma based on clinical or instrumental diagnosis, confirmed by histological examination, showed excellent sensitivities and good specificities in the three operative units. Administrative databases from the three operative units can be used for epidemiological and outcome research of melanoma.
Qualitative longitudinal study of episodic disability experiences of older women living with HIV in Ontario, Canada
Authors: Solomon Patricia , O’Brien Kelly K , Nixon Stephanie , Letts Lori , Baxter Larry , Gervais Nicole 
Published: April 2018

ObjectivesTo examine the episodic disability experiences of older women living with HIV over time.DesignQualitative longitudinal study, conducting semistructured in-depth interviews on four occasions over a 20-month time frame. Inductive thematic analyses were conducted cross-sectionally and longitudinally.SettingParticipants were recruited from HIV community organisations in Canada.Participants10 women aged 50 years or older living with HIV for more than 6 years.ResultsTwo major themes related to the episodic nature of the women’s disability. Women were living with multiple and complex sources of uncertainty over time including: unpredictable health challenges, worrying about cognition, unreliable weather, fearing stigma and the effects of disclosure, maintaining housing and adequate finances, and fulfilling gendered and family roles. Women describe strategies to deal with uncertainty over time including withdrawing and limiting activities and participation and engaging in meaningful activities.ConclusionsThis longitudinal study highlighted the disabling effects of HIV over time in which unpredictable fluctuations in illness and health resulted in uncertainty and worrying about the future. Environmental factors, such as stigma and weather, may put older women living with HIV at a greater risk for social isolation. Strategies to promote dealing with uncertainty and building resilience are warranted.
#Stroke
Authors: Bundy Jacob J , Chick Jeffrey Forris Beecham , Hage Anthony N , Srinivasa Ravi N , Chaudhary Neeraj , Srinivasa Rajiv N , Vadlamudi Venu , Gemmete Joseph J 
Published: April 2018

PurposeTo describe the stroke-related Twitter network through analysis of the #Stroke hashtag.Materials and methods621 653 tweets containing the #Stroke hashtag were analyzed from 20 March 2012 to 31 January 2018. Twitter activity metrics, engagement, user characteristics, content analysis, and network analysis were obtained using the healthcare social media analytics platform, Symplur Signals.ResultsThe number of users, the number of impressions, and the number of tweets containing the #Stroke hashtag increased by an annual average of 64.9%, 87.7%, and 89.2% over the past 6 years from 20 March 2012 to 31January 2018. 69 371 tweets (11.2%) contained novel content and 48 568 tweets (7.8%) related to patient care. 181 120 (29.1%) tweets contained at least one image and 436 132 tweets (70.2%) contained links to outside resources. Stroke prevention, diabetes, and atrial fibrillation were commonly discussed topics. With regard to engagement, there were 259 438 retweets (41.7%), 366 561 mentions (59.0%), and 8549 replies (1.4%). Physicians and patients authored 52 197 (8.4%) and 41 822 (6.7%) tweets, respectively. Advocate organizations, patients, and non-healthcare individuals most frequently used the #Stroke hashtag on Twitter.ConclusionThe use of the #Stroke hashtag on Twitter has grown significantly over the 6-year study period. The majority of the discussions were held between stroke support groups and non-healthcare-related individuals, with discussion content centering around stroke prevention, stroke symptoms, associated medical conditions, and treatment options.
Prognostic Significance of Nuisance Bleeding in Anticoagulated Patients With Atrial Fibrillation
Authors: O’Brien Emily C. , Holmes DaJuanicia N. , Thomas Laine E. , Fonarow Gregg C. , Allen Larry A. , Gersh Bernard J. , Kowey Peter R. , Singer Daniel E. , Ezekowitz Michael D. , Naccarelli Gerald V. , Ansell Jack E. , Chan Paul S. , Mahaffey Kenneth W. , Go Alan S. , Freeman James V. , Reiffel James A. , Peterson Eric D. , Piccini Jonathan P. , Hylek Elaine M. 
Published: April 2018

Background:
Bleeding is commonly cited as a reason for stopping oral anticoagulants (OACs). Whether minor bleeding events (nuisance bleeding, NB) in patients with atrial fibrillation on OACs are associated with OAC discontinuation, major bleeding, and stroke/systemic embolism (SSE) is unknown.

Methods:
Within the ORBIT-AF prospective, outpatient registry (Outcomes Registry for Better Informed Treatment of Atrial Fibrillation), we identified 6771 patients ≥18 years of age at 172 sites with atrial fibrillation and eligible follow-up visits. NB was ascertained from the medical record and was defined as minor bleeding that did not require medical attention (eg, bruising, hemorrhoidal bleeding). We used multivariable pooled logistic regression modeling to evaluate the associations between NB and major bleeding and SSE in the 180 days after documentation of NB. Our unit of analysis was the patient visit, occurring at ≈6-month intervals for a median of 1.5 years following enrollment. Changes in anticoagulation treatment satisfaction after NB were examined descriptively in a subset of patients.

Results:

The median age of the overall population was 75.0 (interquartile range, 67.0–81.0); 90.0% were white and 42.5% were female. Among 6771 patients (18 560 visits), n=1357 (20.0%) had documented NB, for an incidence rate of 14.8 events per 100 person-years. Over 96.4% of patients remained on OAC therapy after the NB event. Overall, 287 (4.3%) patients experienced major bleeding and 64 (0.96%) had a SSE event during follow-up. NB was not associated with a significant increased risk of major bleeding over 6 months in models adjusting for the ATRIA bleeding score (Anticoagulation and Risk Factors in Atrial Fibrillation) (odds ratio, 1.04; 95% confidence interval, 0.68–1.60;
P
=0.86). NB was also not associated with increased SSE risk over 6 months in models adjusting for the CHA
2
DS
2
-VASc risk score (odds ratio, 1.24; 95% confidence interval, 0.53–2.91;
P
=0.62).

Conclusions:
NB is common among patients with atrial fibrillation on OACs. However, NB was not associated with a higher risk of major bleeding or SSE over the next 6 months, suggesting its occurrence should not lead to changes in anticoagulation treatment strategies in OAC-treated patients.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01165710.
Genetic Risks and Doctors’ Disclosure Obligations — Revisiting the Duty of Confidentiality
Authors: de Paor Aisling 
Published: April 2018

Abstract
With developments in the field of genetics, new technologies such as genetic testing are fast emerging. Although offering unparalleled opportunities, these developments raise many ethical, legal and other issues. One challenge relates to the duty of confidentiality and disclosure obligations on doctors. Considering the familial nature of genetic information, doctors will increasingly have access to predictive health information, about individuals and individuals’ relatives. This article examines whether disclosure obligations on doctors should be expanded to encompass an obligation to disclose genetic risk to family members, and whether the exceptions to the duty of confidentiality should recognise genetic risk as potential harm. With recognition of the competing rights, the article considers the implications of recent case law in the United Kingdom, indicating a willingness to extend the duty of disclosure. This article argues that there is a case to be made for expanding disclosure obligations on doctors in certain circumstances.