bluuebunny/crossref_metadata_2025_split huggingface dataset:
Post-menopausal bleeding – Is transvaginal ultrasound a useful first-line investigation in tamoxifen users?
Authors: Abdaal A , Mushtaq Y , Khasati L , Moneim J , Khan F , Ahmed H , Bolton H 
Published: February 2018

Objective To evaluate the role of transvaginal ultrasound triage in women with a history of tamoxifen treatment who present with post-menopausal bleeding. Study design A retrospective review was undertaken of patients who presented with symptoms of post-menopausal bleeding and underwent ultrasound triage. Endometrial thickness and ultrasonographic features were then correlated with hysteroscopic and histopathological outcome data. The findings and outcomes for women with a history of tamoxifen use (tamoxifen group) were compared to those who had not taken tamoxifen (non-tamoxifen group). Results A total of 614 women with post-menopausal bleeding underwent transvaginal ultrasound triage, of whom 53 had a history of current or previous tamoxifen treatment. An endometrial thickness of ≥5 mm or the presence of other abnormal features was used to triage women to further investigation by hysteroscopy and biopsy. Endometrial thickness was significantly greater in the tamoxifen group (11 mm vs. 6 mm). Nearly all of the tamoxifen group were triaged to further investigation (98.1%), compared with significantly fewer in the non-tamoxifen group (68.3%) Overall, the incidence of endometrial pathology was also significantly higher in tamoxifen patients (43.4% vs. 31.7%). Conclusion For women presenting with post-menopausal bleeding, the use of transvaginal ultrasound as a triage tool is rarely helpful in evaluating women who have a history as tamoxifen use, as most will require further investigation with hysteroscopy and biopsy. A post-menopausal bleeding protocol that omits transvaginal ultrasound for women with a history of tamoxifen use may be an appropriate and effective pathway for managing these patients.
A Multidisciplinary Delphi Consensus-Based Checklist to Define Clinical Documentation Tools for Both Routine and Research Purposes
Authors: Veraar Cecilia , Hasler Paul , Schirmer Michael 
Published: February 2018

Background: To the best of our knowledge, a strategic approach to define the contents of structured clinical documentation tools for both clinical routine patient care and research purposes has not been reported so far, although electronic health record will become more and more structured and detailed in the future. Objective: To achieve an interdisciplinary consensus on a checklist to be considered for the preparation of disease- and situation-specific clinical documentation tools. Methods: A 2-round Delphi consensus-based process was conducted both with 19 physicians of different disciplines and 14 students from Austria, Switzerland, and Germany. Agreement was defined as 80% or more positive votes of the participants. Results: The participants agreed that a working group should be set up for the development of structured disease- or situation-specific documentation tools (97% agreement). The final checklist included 4 recommendations concerning the setup of the working group, 12 content-related recommendations, and 3 general and technical recommendations (mean agreement [standard deviation] = 97.4% [4.0%], ranging from 84.2% to 100.0%). Discussion and Conclusion: In the future, disease- and situation-specific structured documentation tools will provide an important bridge between registries and electronic health records. Clinical documentation tools defined according to this Delphi consensus-based checklist will provide data for registries while serving as high-quality data acquisition tools in routine clinical care.
Contextual factors in maternal and newborn health evaluation: a protocol applied in Nigeria, India and Ethiopia
Authors: Sabot Kate , Marchant Tanya , Spicer Neil , Berhanu Della , Gautham Meenakshi , Umar Nasir , Schellenberg Joanna 
Published: February 2018

Abstract
Background
Understanding the context of a health programme is important in interpreting evaluation findings and in considering the external validity for other settings. Public health researchers can be imprecise and inconsistent in their usage of the word “context” and its application to their work. This paper presents an approach to defining context, to capturing relevant contextual information and to using such information to help interpret findings from the perspective of a research group evaluating the effect of diverse innovations on coverage of evidence-based, life-saving interventions for maternal and newborn health in Ethiopia, Nigeria, and India.

Methods
We define “context” as the background environment or setting of any program, and “contextual factors” as those elements of context that could affect implementation of a programme. Through a structured, consultative process, contextual factors were identified while trying to strike a balance between comprehensiveness and feasibility. Thematic areas included demographics and socio-economics, epidemiological profile, health systems and service uptake, infrastructure, education, environment, politics, policy and governance. We outline an approach for capturing and using contextual factors while maximizing use of existing data. Methods include desk reviews, secondary data extraction and key informant interviews. Outputs include databases of contextual factors and summaries of existing maternal and newborn health policies and their implementation. Use of contextual data will be qualitative in nature and may assist in interpreting findings in both quantitative and qualitative aspects of programme evaluation.

Discussion
Applying this approach was more resource intensive than expected, in part because routinely available information was not consistently available across settings and more primary data collection was required than anticipated. Data was used only minimally, partly due to a lack of evaluation results that needed further explanation, but also because contextual data was not available for the precise units of analysis or time periods of interest. We would advise others to consider integrating contextual factors within other data collection activities, and to conduct regular reviews of maternal and newborn health policies. This approach and the learnings from its application could help inform the development of guidelines for the collection and use of contextual factors in public health evaluation.
Αλλάζοντας του Κανόνες: Η Πολιτική Οικονομία της Πρωτογενούς Ανισότητας
Authors: Κικίλιας Ηλίας 
Published: February 2018

Οι μετασχηματισμοί που έλαβαν χώρα τις τελευταίες δεκαετίες έχουν ως συνέπεια μια αντίστροφη από τη συνήθη «αναδιανομή» του εισοδήματος προς την κορυφή της εισοδηματικής κλίμακας, αν και δεν πρόκειται για μια αναδιανομή με την συνηθισμένη έννοια του όρου. Η διαδικασία αυτή δεν επήλθε μέσω της φορολόγησης της μεσαίας τάξης και των φτωχών και την μεταβίβαση των εισοδημάτων τους στους πλουσιότερους, δηλ. μέσω ενός ιδιόμορφα παρεμβατικού κράτους. Δεν επήλθε επίσης, είτε μέσω της μείωσης της φορολόγησης των κερδών – που αποτελεί ένα μικρό μόνο μέρος της συνολικής εικόνας – είτε μέσω της «διαφθοράς» με τη συνήθη έννοια. Η αναδιανομή αυτή του εισοδήματος προς την κορυφή της εισοδηματικής κλίμακας επήλθε με πιο έμμεσο, «αόρατο» αλλά δραστικό τρόπο: μέσω της αλλαγής των κανόνων λειτουργίας της ελεύθερης αγοράς.
Awareness Reduces Racial Bias
Authors: Pope Devin G. , Price Joseph , Wolfers Justin 
Published: February 2018

Can raising awareness of racial bias subsequently reduce that bias? We address this question by exploiting the widespread media attention highlighting racial bias among professional basketball referees that occurred in May 2007 following the release of an academic study. Using new data, we confirm that racial bias persisted in the years after the study’s original sample but prior to the media coverage. Subsequent to the media coverage, though, the bias disappeared. Several potential mechanisms may have produced this result, including voluntary behavior changes by individual referees, adjustments by players to new information, and changes in referee behavior due to institutional pressure. These results suggest a new kind of Hawthorne effect in which greater scrutiny of even subtle forms of bias can bring about meaningful change. This paper was accepted by John List, behavioral economics.
Search for new biomarkers of pediatric multiple sclerosis: application of immunoglobulin free light chain analysis
Authors: Ganelin-Cohen Esther , Golderman Sizilia , Yeskaraev Regina , Rozenberg Ayal , Livneh Avi , Kaplan Batia 
Published: February 2018

AbstractBackground:Identifying new biomarkers is needed to overcome the diagnostic difficulties of pediatric multiple sclerosis (MS). Recently, we developed a new technique including CSF analysis of free light chain (FLC) monomers and dimers, which can improve diagnosis of adult MS. The present study has been designed to evaluate the utility of our technique for MS diagnosis in children.Methods:Patients with MS (n=21) and non-MS demyelinating or inflammatory neurological disorders (n=35) participated in the study. MS diagnosis was based on clinical and magnetic resonance imaging (MRI) findings. Western blot analysis was applied to examine FLC in the patients’ CSF and serum. FLC indices for FLC monomer and dimer levels and κ/λ ratios were estimated. The samples were also analyzed by oligoclonality test.Results:The study revealed abnormally elevated levels of κ-FLC monomers and dimers in the CSF of 10 MS patients (“κ-type MS”). Increased amounts of λ dimers were found in six MS cases (“λ-type MS”), while high levels of both κ and λ FLC (“mixed type MS”) were documented in three MS cases. MRI and clinical assessment showed a more aggressive disease form for the “mixed” and “λ-type” cases. Our method demonstrated higher sensitivity (90.5%) and specificity (91.4%) for discrimination between MS and non-MS patients, as compared to oligoclonality test (81% and 65.7%, respectively).Conclusions:The proposed method may significantly contribute to diagnosis and prognosis of pediatric MS.
Numerical Validation of Chemical Compositional Model for Wettability Alteration Processes
Authors: Bekbauov Bakhbergen , Berdyshev Abdumauvlen , Baishemirov Zharasbek , Bau Domenico 
Published: February 2018

AbstractChemical compositional simulation of enhanced oil recovery and surfactant enhanced aquifer remediation processes is a complex task that involves solving dozens of equations for all grid blocks representing a reservoir. In the present work, we perform a numerical validation of the newly developed mathematical formulation which satisfies the conservation laws of mass and energy and allows applying a sequential solution approach to solve the governing equations separately and implicitly. Through its application to the numerical experiment using a wettability alteration model and comparisons with existing chemical compositional model’s numerical results, the new model has proven to be practical, reliable and stable.
Kontinuitäten und Umbrüche – Fünf Beobachtungen zum deutschen Stiftungswesen
Authors: Oldenburg Felix 
Published: February 2018

Zusammenfassung
Der Beitrag erläutert anhand von fünf prägnanten Beispielen, wie sich zur Zeit das Feld verändert, in dem Stiftungen operieren können. Die Vielfalt der Stifterkonzepte, der seit etwa 10 Jahren dramatisch veränderte Kapitalmarkt, die Rückbesinnung auf alte Traditionen deutscher Stiftungen in Verbindung mit gemeinnützigem Unternehmertum, die gerade für Stiftungen relevante Diskussion um Legitimität und Aufgaben von Eliten und nicht zuletzt die Internationalisierung der Lebenswelten haben erheblichen Einfluss auf die Überlegungen von Stifterinnen und Stiftern ebenso wie von Stiftungsverwaltern, die sich den Veränderungen aktiv stellen müssen.
Rapid expansion of the American mink poses a serious threat to the European mink in Spain
Authors: Põdra Madis , Gómez Asunción 
Published: February 2018

Abstract
The American mink (Neovison vison) was introduced in Europe for fur farming in the 1920s and feral populations were formed due to escapes or intentional releases to the wild thereafter. Nowadays, the species is widely distributed across much of the continent, and is considered the main cause of extinction of the European mink (Mustela lutreola). In Spain, the first populations of the American mink were formed in the 1980s and since then a continuous expansion in their range has been observed. We describe the expansion process of the American mink based on reports of its distribution in the literature, focusing particularly on its increasing overlap with the distribution of the native, endangered European mink. Over the 27 years (1985–2012), the distribution area of non-native mink in Spain increased by 17 times, with an average annual increment of 16.5% and no significant variation among populations. By 2012, a quarter of continental Spain was occupied by the American mink and its presence was confirmed in one-third of the distribution area of the European mink. The status of native mink has worsened drastically in Spain over the last years and urgent conservation measures are required to stop further spread of the American mink.
Identifying the Role of Complement in Triggering Neuroinflammation after Traumatic Brain Injury
Authors: Alawieh Ali , Langley E. Farris , Weber Shannon , Adkins DeAnna , Tomlinson Stephen 
Published: February 2018

The complement system is implicated in promoting acute secondary injury after traumatic brain injury (TBI), but its role in chronic post-traumatic neuropathology remains unclear. Using various injury-site targeted complement inhibitors that block different complement pathways and activation products, we investigated how complement is involved in neurodegeneration and chronic neuroinflammation after TBI in a clinically relevant setting of complement inhibition. The current paradigm is that complement propagates post-TBI neuropathology predominantly through the terminal membrane attack complex (MAC), but the focus has been on acute outcomes. Following controlled cortical impact in adult male mice, we demonstrate that although inhibition of the MAC (with CR2-CD59) reduces acute deficits, inhibition of C3 activation is required to prevent chronic inflammation and ongoing neuronal loss. Activation of C3 triggered a sustained degenerative mechanism of microglial and astrocyte activation, reduced dendritic and synaptic density, and inhibited neuroblast migration several weeks after TBI. Moreover, inhibiting all complement pathways (with CR2-Crry), or only the alternative complement pathway (with CR2-fH), provided similar and significant improvements in chronic histological, cognitive, and functional recovery, indicating a key role for the alternative pathway in propagating chronic post-TBI pathology. Although we confirm a role for the MAC in acute neuronal loss after TBI, this study shows that upstream products of complement activation generated predominantly via the alternative pathway propagate chronic neuroinflammation, thus challenging the current concept that the MAC represents a therapeutic target for treating TBI. A humanized version of CR2fH has been shown to be safe and non-immunogenic in clinical trials.SIGNIFICANCE STATEMENTComplement, and specifically the terminal membrane attack complex, has been implicated in secondary injury and neuronal loss after TBI. However, we demonstrate here that upstream complement activation products, generated predominantly via the alternative pathway, are responsible for propagating chronic inflammation and injury following CCI. Chronic inflammatory microgliosis is triggered by sustained complement activation after CCI, and is associated with chronic loss of neurons, dendrites and synapses, a process that continues to occur even 30 d after initial impact. Acute and injury-site targeted inhibition of the alternative pathway significantly improves chronic outcomes, and together these findings modify the conceptual paradigm for targeting the complement system to treat TBI.
Indice de la calidad de aire en el distrito de Morales debido a la presencia de material particulado 2.5 microgramos
Authors: Guevara Reátegui Julio Rafael , Pérez Carpio Jackson Edgardo 
Published: February 2018

El objetivo de la investigación es determinar la concentración de partículas menores de 2.5 microgramos para luego ser comparados con el índice y el estándar de calidad de aire (D.S. N° 003-2008-MINAM) de los sectores Jr. Alfonso Ugarte y Jr. Victoria Vásquez del Distrito de Morales Departamento de San Martin, los monitoreo se ha realizado teniendo en cuenta los procedimientos que nos indica el “Protocolo de monitoreo de calidad de aire y gestión de datos” elaborado por la DIGESA (2005). El equipo que se utilizó es un equipo Hivol PM2.5 de alto volumen el tipo de investigación es no experimental descriptivo comparativo de corte trassectorial porque determina el grado de relación de variables de estudio. De acuerdo a los resultados obtenidos la concentración de partículas PM2.5 registradas en los punto de monitoreo Jr. Alfonso Ugarte y Jr. Victoria Vásquez realizados del 03 al 14 de octubre del 2016 registraron concentraciones (12.8 μg/m3, 20.8 μg/m3, 14.2 μg/m3, 10.7 μg/m3 y 22.5 μg/m3, 18.4 μg/m3, 19.2 μg/m3, 12.7 μg/m3) estos valores no excedieron al nivel de referencia 25 μg/m3 establecido por la normativa nacional de estándares de calidad de aire D.S N.° 003-2008 MINAM, también se han comparados con el índice de calidad de aire, teniendo como resultado el nivel de riesgo de color amarillo y color verde obteniendo una calificación moderada y buena, se puede interpretar que la calidad del aire es aceptable y cumple con el ECA, se puede realizar actividades al aire libre y con restricciones para los pobladores sensibles.
Evaluación de contaminación sonora vehicular en el centro de la ciudad de Tarapoto, San Martín, 2015
Authors: Delgadillo Mendoza Mary Cruz , Pérez Carpio Jackson Edgardo 
Published: February 2018

El objetivo de este artículo es realizar una evaluación de la contaminación sonora vehicular en el centro de la Ciudad de Tarapoto, cuyas zonas consideradas fueron zona comercial y zona de protección especial. Se identificó siete puntos de monitoreo, en el horario diurno (7:00 am - 8:00 am, 12:30 pm – 1:30 pm y 5:00 pm - 6:00 pm), durante siete semanas. Los resultados obtenidos superan los Estándares de Calidad Ambiental para Ruido (D.S. N°085-2003-PCM), encontrándose que el punto 5 (P-5) ubicado en la intersección de Jr. Jiménez Pimentel con Jr. Shapaja perteneciente a la Zona Comercial, presenta los niveles de presión sonora más altos en los tres períodos (80.4, 81.6, y 87.8 dB), en el análisis de varianza, en el periodo 1, el ANOVA indica que hay diferencia significativa y la prueba Tukey, donde confirma que el P-5, presenta nivel de presión sonora más alto. El flujo vehicular estuvo compuesto por moto lineal, motocarro y otros vehículos (autos, combis, camioneta, etc.), en la que el vehículo con mayor circulación durante la evaluación fue el motocarro.
La importancia de la formación para minimizar las brechas digitales en Andalucía
Authors: Santiago Segura María Jesús , Fernández Castaño Felix 
Published: February 2018

La desigualdad es un concepto que siempre nos ha preocupado a los sociólogos. La sociología ha estudiado la desigualdad desde distintos ámbitos: culturales, educativos, económicos etc. En esta investigación que presentamos, queremos dar un paso innovador y actual, analizando la desigualdad digital a través de la llamada “Brecha Digital”. Para ello, hemos optado por utilizar una metodología cuantitativa acotándola en un periodo concreto, 2010-2014. Concretamente, la pretensión última de este estudio es mostrar la relación existente entre la formación académica y el uso de Tecnologías. Nos adentramos en diferenciar el uso a nivel usuario de las TICs y, el uso de las TICs con repercusión en la mejora de la calidad de vida de los ciudadanos y, por ende, en igualar a la ciudadanía evitando de este modo un “cleavage” social insalvable entre ciudadanos digitalizados y ciudadanos no-digitalizados. Por último, señalar que el espacio territorial que hemos escogido para nuestro análisis es el de la Comunidad Autonómica Andaluza, donde estas nuevas realidades de desigualdades digitales establecen unos nuevos desequilibrios, la llamada segunda Brecha Digital y Brecha Digital de Género.
Sacubitril/Valsartan for Heart Failure: Exciting Times but Are Doctors Informed and Ready?
Authors: Banerjee Prithwish 
Published: February 2018

Sacubitril/Valsartan in now being prescribed by heart failure/cardiology teams across the United Kingdom following the publication of the NICE technology appraisal guidance but is everyone ready for it? This article discusses the practical aspects of what to do and not to do in relation to the drug based on real world experience from our centre.
EFFECTS OF LYCOPENE ON SPERMATOZOA MORPHOLOGY IN Balb/C MICE EXPOSED TO 2-METHOXYETHANOL (2-ME)
Authors: Sitaresmi Sandra Dewi , I'tishom Reny , Mustika Arifa 
Published: February 2018

The compound of 2-methoxyethanol (2-ME) is one of toxic materials that potentially damage male reproductive organs. This compound can enter the body by various means of direct contact through the skin, respiratory and digestive tract. This compound can cause oxidative stress in spermatozoa which is the main cause of spermatozoa dysfunction. Lycopene, also known as red pigment, is an antioxidant class of carotene. Lycopene has antioxidant activity twice stronger than beta carotene and ten times stronger than vitamin E. Thus, the lycopene reaction as an antioxidant in the body is better than vitamin A, C, E, and other minerals. This study was conducted to determine the effects of lycopene on spermatozoa morphology in mice exposed to 2-ME. The study was conducted on 30 mice, divided into 5 groups. The K-group was the control group without 2-methoxyethanol and lycopene, the K + group was the group with 200 mg/kg BW 2-methoxyethanol on days 1-5, and the P1, P2 and P3 groups were the ones with 200 mg/kg BW 2-methoxyethanol on days 1-5 and lycopene doses of 5, 10 and 20 mg/kg BW on days 6-35. 2-ME was given intraperito-neally and lycopene was given per sonde. On day 36, the mice were sacrificed and the epididymis and vas deferens were removed for morphological examination of spermatozoa. The observations were performed using a microscope with 1000x magnification. The results showed that there was significant difference. In the morphology of spermatozoa, the administration of lycopene increases normal morphological percentage of spermatozoa in mice exposed to 2-ME.