bluuebunny/crossref_metadata_2025_split huggingface dataset:
Regional cluster of vanishing gastroschisis: A comparative study of antenatal and post‐natal outcomes
Authors: Granger Jeremy , Do‐Wyeld Montgommery , Cundy Thomas P , Galek Alison , Stark Michael J , Cord‐Udy Catherine L 
Published: October 2019

AimVanishing gastroschisis describes the in utero spontaneous closure of the periumbilical defect. It is usually associated with intestinal loss due to ischaemia, necrosis and atresia. This comparative study aims to investigate the spectrum of pathology, antenatal ultrasound characteristics and post‐natal outcomes.MethodsOur tertiary centre provides antenatal and post‐natal care of major congenital anomalies for a population of 1.6 million. Medical records were retrospectively evaluated for all cases of vanishing gastroschisis from May 2014 to May 2015. Cases of normal variant gastroschisis born during the same period were used for comparison. Maximum antenatael bowel diameter measurements were compared using the Mann–Whitney U‐test.ResultsSix infants with vanishing gastroschisis were born during the study period, representing 50% of all live‐born gastroschisis. Antenatal ultrasound showed progressively increasing intra‐abdominal bowel dilatation, with antenatal intra‐abdominal bowel diameter significantly greater in vanishing, than normal, variant gastroschisis (23.2 vs. 4.1 mm, P < 0.01). The classification of vanishing gastroschisis severity comprised two type I, three type II and one type III cases. Complete midgut atresia affected three infants, leading to overall mortality of 50% for the vanishing gastroschisis group versus 0% in the normal variant group (P = 0.05).ConclusionVanishing gastroschisis is a severe, often catastrophic variant of gastroschisis. Aetiological factors contributing to the recent high incidence of this rare complication in our population of newborns remain unknown, prompting secondary prevention strategies to salvage the midgut. We propose closer antenatal surveillance for fetuses with intra‐abdominal bowel dilatation >10 mm to prompt consideration of earlier delivery to improve morbidity and mortality.
Is an unfunded social security system good or bad for growth? A theoretical analysis of social security systems financed by VAT
Authors: Maebayashi Noritaka 
Published: October 2019

AbstractThis study investigates how unfunded public pensions financed by value added tax (VAT), as discussed in Japan, affect economic growth and whether payroll tax (PT) or VAT is the more growth‐friendly tax structure for financing public pensions. We examine these issues using overlapping generations models with parental altruism and find that a public pension system financed by VAT may increase economic growth when bequests are operative. By contrast, when bequests are inoperative, public pensions hinder growth unless agents are sufficiently patient. Finally, public pensions financed by VAT are more growth‐friendly than those financed by PT.
Extra‐pair mating in a passerine bird with highly duplicated major histocompatibility complex class II: Preference for the golden mean
Authors: Rekdal Silje L. , Anmarkrud Jarl Andreas , Lifjeld Jan T. , Johnsen Arild 
Published: October 2019

AbstractGenes of the major histocompatibility complex (MHC) are essential in vertebrate adaptive immunity, and they are highly diverse and duplicated in many lineages. While it is widely established that pathogen‐mediated selection maintains MHC diversity through balancing selection, the role of mate choice in shaping MHC diversity is debated. Here, we investigate female mating preferences for MHC class II (MHCII) in the bluethroat (Luscinia svecica), a passerine bird with high levels of extra‐pair paternity and extremely duplicated MHCII. We genotyped family samples with mixed brood paternity and categorized their MHCII alleles according to their functional properties in peptide binding. Our results strongly indicate that females select extra‐pair males in a nonrandom, self‐matching manner that provides offspring with an allelic repertoire size closer to the population mean, as compared to offspring sired by the social male. This is consistent with a compatible genes model for extra‐pair mate choice where the optimal allelic diversity is intermediate, not maximal. This golden mean presumably reflects a trade‐off between maximizing pathogen recognition benefits and minimizing autoimmunity costs. Our study exemplifies how mate choice can reduce the population variance in individual MHC diversity and exert strong stabilizing selection on the trait. It also supports the hypothesis that extra‐pair mating is adaptive through altered genetic constitution in offspring.
Mediators’ and Disputing Parties’ Perceptions of Trust‐Building in Family Mediation
Authors: Riera Adrover Joan Albert , Cuartero Castañer María Elena , Montaño Moreno Juan José 
Published: October 2019

AbstractDifferent studies have demonstrated that trust‐building between mediators and disputing parties is a basic factor in the success of mediation processes. The aim of this study was to conduct an integrated analysis of mediation by taking into account the perceptions of mediators working for the Mediation Service and those of the service users over a period of one year. The obtained results show statistically significant differences in the two groups’ analyzed response patterns associated with a series of factors that predict trust‐building (the mediator's legal expertise; suggesting an alternative; sincerity; focusing on settling the dispute; the appointment of a mediator by public authorities and/or by a recognized service; focusing on the parties’ common goals; highlighting the rules of mediation; and devoting some time to talking about informal matters). The identification of these factors contributes to improved training and professional practices in the field of mediation.
Effects of acotiamide on functional dyspepsia patients with heartburn who failed proton pump inhibitor treatment in Japanese patients: A randomized, double‐blind, placebo‐controlled crossover study
Authors: Funaki Yasushi , Ogasawara Naotaka , Kawamura Yurika , Yoshimine Takashi , Tamura Yasuhiro , Izawa Shinya , Ebi Masahide , Sasaki Makoto , Kasugai Kunio 
Published: October 2019

AbstractBackgroundFunctional dyspepsia (FD) and non‐erosive reflux disease (NERD) are gastrointestinal disorders that often overlap. In this randomized, double‐blind, placebo‐controlled crossover study, the effects of adding acotiamide to treatment with proton pump inhibitors (PPI) were investigated in FD patients with heartburn who failed PPI treatment, corresponding to PPI‐resistant NERD.MethodsThe subjects included 16 FD patients with heartburn who failed PPI treatment, and they were administered acotiamide or a placebo for 28 days. After suspending medication for 28 days, the trial drug and placebo were crossed over and administered for 28 days. Before the study began and after each administration period, high‐resolution impedance manometry (HRiM) was performed, and the modified frequency scale for the symptoms of gastroesophageal reflux disease (FSSG) questionnaire was administered.Key ResultsPostprandial fullness in the FD assessment and all modified FSSG items were significantly lower in the acotiamide group than in the placebo group. Esophagogastric junction pressure was significantly higher in the acotiamide group. The distal contractile integral (DCI) pressure and the highest DCI pressure both increased significantly in the acotiamide group. Moreover, in the acotiamide group, the frequency of abnormal primary peristalsis decreased to normal levels; complete bolus transit (CBT), an indicator of esophageal clearance, increased; and CBT time decreased.Conclusions & InferencesAcotiamide was considered to improve upper gastrointestinal functions not only in the stomach but also in the esophagus. Adding acotiamide to PPI therapy appears to improve upper abdominal symptoms in FD patients with heartburn who failed PPI treatment.
Brachiopod shell thickness links environment and evolution
Authors: Balthasar Uwe , Jin Jisuo , Hints Linda , Cusack Maggie 
Published: October 2019

AbstractWhile it is well established that the shapes and sizes of shells are strongly phylogenetically controlled, little is known about the phylogenetic constraints on shell thickness. Yet, shell thickness is likely to be sensitive to environmental fluctuations and has the potential to illuminate environmental perturbations through deep time. Here we systematically quantify the thickness of the anterior brachiopod shell which protects the filtration chamber and is thus considered functionally homologous across higher taxa of brachiopods. Our data come from 66 genera and 10 different orders and shows well‐defined upper and lower boundaries of anterior shell thickness. For Ordovician and Silurian brachiopods we find significant order‐level differences and a trend of increasing shell thickness with water depth. Modern (Cenozoic) brachiopods, by comparison, fall into the lower half of observed shell thicknesses. Among Ordovician–Silurian brachiopods, older stocks commonly have thicker shells, and thick‐shelled taxa contributed more prominently to the Great Ordovician Biodiversification but suffered more severely during the Late Ordovician Mass Extinction. Our data highlight a significant reduction in maximum and minimum shell thickness following the Late Ordovician mass extinction. This points towards stronger selection pressure for energy‐efficient shell secretion during times of crisis.
Assessing the Benefits and Costs of Homeland Security Research: A Risk‐Informed Methodology with Applications for the U.S. Coast Guard
Authors: von Winterfeldt Detlof , Farrow R. Scott , John Richard S. , Eyer Jonathan , Rose Adam Z. , Rosoff Heather 
Published: October 2019

AbstractThis article describes a methodology for risk‐informed benefit–cost analyses of homeland security research products. The methodology is field‐tested with 10 research products developed for the U.S. Coast Guard. Risk‐informed benefit–cost analysis is a tool for risk management that integrates elements of risk analysis, decision analysis, and benefit–cost analysis. The cost analysis methodology includes a full‐cost accounting of research projects, starting with initial fundamental research costs and extending to the costs of implementation of the research products and, where applicable, training, maintenance, and upgrade costs. The benefits analysis methodology is driven by changes in costs and risks leading to five alternative models: cost savings at the same level of security, increased security at the same cost, signal detection improvements, risk reduction by deterrence, and value of information. The U.S. Coast Guard staff selected 10 research projects to test and generalize the methodology. Examples include tools to improve the detection of explosives, reduce the costs of harbor patrols, and provide better predictions of hurricane wind speeds and floods. Benefits models and estimates varied by research project and many input parameters of the benefit estimates were highly uncertain, so risk analysis for sensitivity testing and simulation was important. Aggregating across the 10 research products, we found an overall median net present value of about $385 million, with a range from $54 million (5th percentile) to $877 million (95th percentile). Lessons learned are provided for future applications.
Using sensor‐based technology for safety and independence – the experiences of people with dementia and their families
Authors: Malmgren Fänge Agneta , Carlsson Gunilla , Chiatti Carlos , Lethin Connie 
Published: October 2019

BackgroundThe majority of people with dementia prefer to live independently and safely in their own home cared for by their family members. Much effort has been invested in the development of technology, such as sensor‐based networks. Many challenges remain, in particular gaining more knowledge about their experiences and perceived benefits. This study aimed to explore experiences, needs and benefits with using sensor‐based technology for safety and independence in the homes of people with dementia and their family members.MethodsThis study is part of the TECH@HOME project, aiming to evaluate the effects of sensor‐based technology on independence among people with dementia and caregiver stress among their family members. This study applied an inductive, qualitative approach with semi‐structured interviews of people with dementia (n = 9) and family members (n = 21). The participants were interviewed between June and September 2018 after using the technology for at least 6 months. The interviews were analysed with manifest content analysis.ResultsOur findings highlighted that technology was considered as a precaution and a safety measure that could provide a sense of having control of the everyday life of the person with dementia. Understanding and acceptance of the technology were as important, together with the reliability of the technology. Ethical dilemmas related to the monitoring of the person with dementia in the home were also raised.ConclusionThis study provides insights into how people with dementia and family members experience and benefit from using sensor‐based technology in their own homes. The knowledge generated is essential for healthcare professionals and policymakers developing and implementing care and service systems including technology, as well as for the industry.
Lone and lonely in a double ambivalence situation as experienced by callers while waiting for the ambulance in a rural environment
Authors: Nord‐Ljungquist Helena , Engström Åsa , Fridlund Bengt , Elmqvist Carina 
Published: October 2019

BackgroundIn a rural environment where distances and access to ambulance resources in people’s immediate area are limited, other responders like firefighters dispatched to perform a first aid before ambulance arrives in areas where a longer response time exists; an assignment called ‘While Waiting for the Ambulance’ (WWFA). Knowledge is limited about the experience from a caller’s perspective when a person has a life‐threatening condition needing emergency help and both firefighters in a WWFA assignment and ambulance staff are involved.AimThe aim of the study is to describe the emergency situation involving a WWFA assignment in a rural environment from the caller's perspective.MethodA descriptive design using qualitative methodology with a reflective lifeworld research (RLR) approach was used for this study, including in‐depth interviews with eight callers.ResultsAn emergency situation involving WWFA assignment in a rural environment mean a sense of being lone and lonely with a vulnerability in while waiting to hand over responsibility for the affected person. Ambivalence in several dimensions arises with simultaneous and conflicting emotions. A tension between powerlessness and power of action where the throw between doubt and hope are abrupt with a simultaneous pendulum between being in a chaos and in a calm.ConclusionA double ambivalence emerges between, on one hand feeling alone in the situation and having full control, on the other hand, with trust handing over the responsibility, thereby losing control. Contact with the emergency medical dispatcher becomes a saving lifeline to hold onto, and access to emergency help in the immediate area of WWFA is valuable and important. Trust and confidence are experienced when callers are met with empathy, regardless of personal acquaintance with arriving responders.
Telenurses’ experiences of monitoring calls to parents of children with gastroenteritis
Authors: Sandelius Susanna , Wahlberg Anna Carin 
Published: October 2019

Aims and objectiveTo describe telenurses’ experiences of monitoring calls in telephone advice nursing to parents of children with gastroenteritis.BackgroundIn previous studies, making monitoring calls is mentioned as a method used by telenurses to assess the need for care. MonitoringTHE terms ‘care‐seekers’, ‘care‐seeker’ and ‘careseekers’ are used inconsistently in the article. Please suggest which one to follow. We suggest Care‐seeker calls in telephone advice nursing have been described as when telenurses call care‐seekers back once or twice after an initial call. Calls from parents of children with gastroenteritis are common, and many of these calls result in telenurses providing self‐care advice.MethodsNineteen telenurses from two healthcare call centres in Sweden were interviewed. Data were analysed using inductive qualitative content analysis.ResultsOne main category, four generic categories and eleven sub‐categories emerged. The telenurses described how working with monitoring calls aimed to provide self‐care at home in a patient‐safe way. Their focus on the parents aimed at increasing their feeling of security and focus on the child aimed at ensuring patient safety. Monitoring calls also provided a learning opportunity for parents and telenurses, and the possibility of relieving pressure on healthcare services. The findings indicate that the use of monitoring calls aims to provide a patient‐safe form of telephone advice nursing.ConclusionThis study shows that many parents feel insecure when their child has gastroenteritis, and the use of monitoring calls may be an effective approach to help them feel more secure at home with their sick child.
Variability among four refractometers for the measurement of urine specific gravity and comparison with urine osmolality in dogs
Authors: Rudinsky Adam J. , Wellman Maxey , Tracy Gaemia , Stoltenberg Lisa , DiBartola Stephen P. , Chew Dennis J. 
Published: October 2019

AbstractBackgroundRefractometry is often used in clinical veterinary medicine to estimate urine concentration. Variability among commonly‐used refractometers has not been critically evaluated.ObjectiveThis study aimed to evaluate the variability of urine specific gravity (USG) among four refractometers and compare results of USG measurements with those of urine osmolality (Uosm), the gold standard for determining urine concentrations.MethodsUSG was determined in 100 dogs using three optical refractometers, the American Optical Abbe refractometer 10450, Reichert TS 400 refractometer, and Heska Veterinary refractometer 2737‐E02, and one digital refractometer, the Misco Palm Abbe Digital refractometer #PA203. Results were compared between each pair of refractometers and between each refractometer and urine osmolality determined by freezing point depression using a Multi‐Osmette 2430E osmometer. Results were analyzed with Bland‐Altman plots and Passing‐Bablok regression analysis.ResultsThe Reichert, Heska, and Misco refractometers provide USG measurements that can be used interchangeably based on small differences, consistently less than 0.002, between the USG measurements. The AO refractometer measured USG values with much larger differences, which were deemed clinically significant by the study parameters. None of the refractometers were able to accurately predict Uosm or vice versa within a clinically acceptable range.ConclusionsVarying degrees of differences were seen in the USG measurements among the different refractometers. These differences were refractometer‐dependent, and the results from one instrument could affect clinical decisions.
Recent rapid changes in the spatio‐temporal distribution of West Nile Neuro‐invasive Disease in Italy
Authors: Moirano Giovenale , Richiardi Lorenzo , Calzolari Mattia , Merletti Franco , Maule Milena 
Published: October 2019

AbstractIn Italy, the first human case of West Nile Virus (WNV) infection was reported in 2008 and, since then, the number of cases has been steadily increasing. In this study, we describe the temporal and spatial pattern of WNV infection risk among humans in Italy, focusing on the human cases of West Nile Neuro‐invasive Disease (WNND) observed between 2008 and 2017. Incidence rates are estimated for each year and province under study. The incidence temporal trend is estimated using Poisson regression, and a spatio‐temporal cluster detection analysis is performed to detect high‐risk areas. In total, 231 WNND cases were notified in Italy between 2008 and 2017. The annual incidence rates increased during the study period (annual percentage change: 11.7%; 95%CI: −0.9%; 26.1%). A geographical spread of the disease was observed during the study period throughout Northern Italy, with an increasing number of affected provinces. Provinces close to the Po River (the main river in the north of Italy) and the Oristano province (in the Sardinia Island) experienced the highest incidence rates during the study period. Our study shows a gradual, but rapid spread of WNND across Northern Italy from east to west and suggests the hypothesis that provinces close to Po River might present ecological and climatic conditions favourable to the virus circulation.
Investigation of the Effect of Perforated Sheath on Thermal-Flow Characteristics Over a Gas Turbine Reverse-Flow Combustor—Part 1: Experiment
Authors: Wang Liang , Wang Ting 
Published: October 2019

Abstract
Reverse-flow combustors have been used in heavy, land-based gas turbines for many decades. A sheath is typically installed over the external walls of the combustor and transition piece to provide enhanced cooling through hundreds of small impinging cooling jets, followed by a strong forced convection channel flow. However, this cooling is at the expense of a large pressure loss. With the modern advancements in metallurgy and thermal-barrier coating technologies, it may become possible to remove this sheath to recover the pressure loss without causing thermal damage to the combustor chamber and the transition piece walls. However, without the sheath, the flow inside the dump diffuser may exert nonuniformly reduced cooling on the combustion chamber and transition piece walls. The objective of this paper is to investigate the difference in flow pattern, pressure drop, and heat transfer distribution in the dump diffuser and over the outer surface of the combustor with and without a sheath. Both experimental and computational studies are performed and presented in Part 1 and Part 2, respectively. The experiments are conducted under low pressure and temperature laboratory conditions to provide a database to validate the computational model, which is then used to simulate the thermal-flow field surrounding the combustor and transition piece under elevated gas turbine operating conditions. The experimental results show that the pressure loss between the dump diffuser inlet and exit is 1.15% of the total inlet pressure for the non-sheathed case and 1.9% for the sheathed case. This gives a 0.75 percentage point (or 40%) reduction in pressure losses. When the sheath is removed in the laboratory, the maximum increase of surface temperature is about 35%, with an average increase of 13–22% based on the temperature scale of 23 K, which is the difference between the bulk inlet and the outlet temperatures.