bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic Review of Acupuncture for the Treatment of Alcohol Withdrawal Syndrome
Authors: Liu Xiaoxu , Qin Zongshi , Zhu Xiaoming , Yao Qin , Liu Zhishun 
Published: July 2018

Background Acupuncture has been used as a potential therapy for alcohol withdrawal syndrome (AWS), but evidence for its effects on this condition is limited. Objective To assess the effects and safety of acupuncture for AWS. Data sources Central Register of Controlled Trials (CENTRAL), PubMed, Embase, the Cochrane Library, PsycINFO, Chinese Biomedicine Literature (CBM), China National Knowledge Infrastructure (CNKI) and Wan-Fang Database were searched from their inception to August 2016. Study eligibility criteria Randomised controlled trials (RCTs) of drug plus acupuncture or acupuncture alone for the treatment of AWS were included. Data collection and analysis Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were expressed as risk ratio (RR) with 95% CI. Results Eleven RCTs with 875 participants were included. In the acute phase, two trials reported no difference between drug plus acupuncture and drug plus sham acupuncture in the reduction of craving for alcohol; however, two positive trials reported that drug plus acupuncture was superior to drug alone in the alleviation of psychological symptoms. In the protracted phase, one trial reported acupuncture was superior to sham acupuncture in reducing the craving for alcohol, one trial reported no difference between acupuncture and drug (disulfiram), and one trial reported acupuncture was superior to sham acupuncture for the alleviation of psychological symptoms. Adverse effects were tolerable and not severe. Conclusion There was nosignificant difference between acupuncture (plus drug) and sham acupuncture (plus drug) with respect to the primary outcome measure of craving for alcohol among participants with AWS, and no difference in completion rates (pooled results). There was limited evidence from individual trials that acupuncture may reduce alcohol craving in the protracted phase and help alleviate psychological symptoms; however, given concerns about the quantity and quality of included studies, further large-scale and well-conducted RCTs are needed. Protocol registration PROSPERO CRD42016039862.
Antidepressant medication and ocular factors in association with the need for anti-VEGF retreatment in neovascular age-related macular degeneration
Authors: Mantel Irmela , Zola Marta , Mir Olivier , Gaillard Raphael , Behar-Cohen Francine 
Published: July 2018

Background/AimsVascular endothelial growth factor (VEGF) is a key player in the pathogenesis of neovascular age-related macular degeneration (nAMD) and is also involved in the final common pathway of antidepressant medication. This study investigated the relationship between the need for anti-VEGF retreatment in patients with nAMD and antidepressant medication, and the potential impact of ocular structural factors.MethodsData from two identical prospective 2-year treatment protocols using ranibizumab or aflibercept in a variable-dosing regimen (‘Observe-and-Plan’) were analysed. Retreatment requirement was compared with antidepressant medication intake (primary outcome) and a variety of ocular factors from baseline and from month 3 response (secondary outcomes), using univariate and multivariate analyses.ResultsOf the 206 included patients (227 eyes), 19 were on antidepressant medication. Their nAMD eyes significantly more often had pigment epithelium detachment (PED, p=0.04). Multivariate analysis revealed a significant association between anti-VEGF retreatment requirement and antidepressant medication use (p=0.027), as well as thicker central retinal thickness at month 3 (p<0.0001) and month 3 PED height (p=0.001).ConclusionThis study provides evidence that treatment with antidepressant medication increases the anti-VEGF retreatment requirement in patients with nAMD, possibly through the interplay of antidepressant medication, depression status and VEGF levels.
Do ‘physicians in the lead’ support a holistic healthcare delivery approach? A qualitative analysis of stakeholders’ perspectives
Authors: Malik Romana Fattimah , Hilders Carina G J M , Scheele Fedde 
Published: July 2018

ObjectivesValue-based healthcare implies that healthcare issues are addressed most effectively with the ‘physicians in the lead' (PIL) strategy. This study explores whether PIL also supports a holistic care approach that patients are increasingly demanding.DesignA qualitative research design was used.SettingThis study was conducted in a general hospital in the Netherlands with an integrated PIL strategy.ParticipantsSemistructured interviews were conducted with 14 hospital stakeholders: 13 stakeholders of an Obstetrics and Gynaecology department (the hospital’s Patient Council (n=1), nurses (n=2), midwives (n=2), physicians (n=2), residents (n=2), the non-medical business managers of the Obstetrics and Gynaecology department (n=2) the Board of Directors (n=2)) and a member of the Dutch National Healthcare Institute’s Innovative Healthcare Professions programme.ResultsAccording to diverse stakeholders, PIL does not support a holistic healthcare delivery approach, primarily because of the strong biomedical focus of the physicians. Although physicians can be educated to place more emphasis on the holistic outcome, holistic care delivery requires greater integration and teamwork in the care chain. As different healthcare professions are complementary to each other, a new strategy of a ‘team in the lead' was suggested to meet the holistic healthcare demands. Besides this new strategy, there is a need for an extramural care management coordination centre where patients are able to receive support in managing their own care. This centre should also facilitate services similar to the core function of a church or community centre. These services should help patients to deal with different holistic dimensions that are important for their well-being.ConclusionsThe PIL strategy appears to be insufficient for holistic healthcare delivery. A ‘team in the lead’ approach should be considered to meet the holistic healthcare demands. Further research should focus on observing PIL in different cultures and exploring the effectiveness of the strategy ‘team in the lead’.
4 Use of topical haemostatic dressings in an extended field care model of external haemorrhage
Authors: Barratt J , Welch M , Wright C 
Published: July 2018

IntroductionThe use of Celox gauze has been established in military practice as an adjunct in the treatment of external haemorrhage. The future character of conflict means that casualties may take longer to reach definitive care. The aim of this study was to test whether Celox Rapid, a topical haemostatic dressing, would maintain haemostasis during extended use in a junctional haemorrhage model.MethodsAn anaesthetised swine underwent simultaneous bilateral femoral arteriotomies; after 30 s of free bleeding Celox Rapid gauze was applied to the wound and pressure was maintained for 1 min. Following inspection for re-bleeding the Celox gauze was covered with standard field dressings and checked for re-bleeding every hour until the 6 hours had elapsed or the animal deceased.ResultsThere was no evidence of re-bleeding at any point up to and including 6 hours. The animal was declared deceased shortly afterwards. Celox Rapid gauze maintained haemostasis in extended use in this limited single animal model. Post mortem examination revealed a stable clot at the site of the arteriotomy with no evidence of re-bleeding.ConclusionCelox Rapid was effective at achieving initial homeostasis and preventing re-bleeding in this limited study using a single anaesthetised swine. Its potential for use in situations where evacuation and definitive care may be delayed should be explored.
5 The fluro project: a review of the approach and understanding of fluid resuscitation in a military tertiary centre from the perspective of care providers in the emergency setting
Authors: Lowe J , Stevenson L , Wilding D , McLaughlin D , West M 
Published: July 2018

IntroductionThe term fluid resuscitation (FR) is defined as the use of fluids to restore a state of normovolaemia, or to correct a hypovolaemic state. To establish normovolaeamia via FR, the term ‘fluid bolus’ is used to describe a prescribed fluid volume. As such, the authors looked to investigate the understanding of this term and to review approaches to fluid resuscitation by those healthcare workers closely associate with critically unwell patients.MethodsA questionnaire was distributed to all clinical staff across Emergency Medicine (EM), Anaesthesia and Theatres (AT), Intensive Care Medicine (ICM) and Acute Medicine (AM). The questionnaire recorded role, area of responsibility, training grade, type, volume and administration time, time to reassessment and parameters to be assessed in relation to a clinical vignette. The results were then compared directly to the NICE Clinical Audit Standards (NCAS) for FR.Results153 responses were received from across all working environments. Overall, 52% of respondents gave volumes aligned with NCAS (500 ml). 99% of respondents suggested crystalloid use with 88% giving an appropriate time for administration of less than 15 min. 55% of respondents suggested appropriate review times (0–5 min). 99% of respondents agreed heart rate and blood pressure should be reassessed, but other parameters for monitoring were poorly recognised.Between specialties, EM suggested larger volumes while ICM were more likely to continuously review the patient during a bolus. AM were the only group to administer fluids over 60 min. EM and ICM were more likely to review lactate as a marker for effect. Higher specialist trainees were more likely to give a larger volume when compared to other grades.DiscussionThe overall perception of a fluid bolus varies between specialties and training grades. Most responses were aligned to NCAS with notable outliers. This suggests a discrepancy in the understanding of the term fluid bolus. This may also cause issues in fluid administration with multiple patients. It is therefore suggested that further work be undertaken on clarifying the term ‘fluid bolus’, aiming to minimise uncertainty and increase understanding to prevent adverse effects.
Who uses rollies? Trends in product offerings, price and use of roll-your-own tobacco in Australia
Authors: Bayly Megan , Scollo Michelle M , Wakefield Melanie A 
Published: July 2018

ObjectiveWe examined the roll-your-own (RYO) tobacco product market in Australia from 2001 to 2016. Trends in use of RYO tobacco among Australian adults were examined for 2004–2016.MethodsChanges in brand availability, pouch sizes and lowest priced products were noted from trade magazines. Prevalence of smoking of RYO and factory-made (FM) cigarettes among those 18 years and older was obtained from five consecutive waves of a large (n>21 000) nationally representative triennial survey from 2004 to 2016. Trends in cigarette use were examined using logistic regression.ResultsChanges in the Australian RYO market from 2001 to 2016 included a doubling in the number of brands, progressively smaller pouch sizes with smaller increases in price than in traditional RYO and comparable FM products. While use of FM cigarettes declined between 2004 and 2016, the proportion of adults exclusively using RYO tobacco linearly increased with each survey wave (OR 1.03, 95% CI 1.02 to 1.05, p<0.001), from 1.2% in 2004 to 1.7% in 2016. Exclusive RYO use among current smokers increased more among females than males, and young adults compared with those aged 30 years or older, but did not differ by socioeconomic status.ConclusionsIn contrast to substantial declines in FM cigarette use, exclusive use of RYO cigarettes increased in Australians since 2004, particularly among females and young adults. This has corresponded to a period of substantial changes to the RYO market, including progressively smaller and relatively more affordable products. Policy action to reduce price-related marketing and correct consumer misinformation about RYO tobacco are urgently required.
Response of Royal Gala apples to multiple applications of chemical thinners and the dynamics of fruitlet drop
Authors: Cline John A. , Bakker Catherine J. , Gunter Amanda 
Published: July 2018

Apple trees bear an abundance of flowers that produce a surplus of fruit that the tree is unable to support. A self-regulatory mechanism enhances the abscission of immature fruitlets, leading to a reduced fruit load, but this is often insufficient to achieve fruit of marketable size. Supplementary fruit thinning is usually required to optimize economic fruit load and annual bearing. This 2 yr study investigated the response of Royal Gala apple trees to primary single and combination sprays of 6-benzyladenine (6-BA) and carbaryl during fruit set, followed by secondary sprays of either treatment 7 d later. The objective was to determine the effect of a second application of chemical thinner on fruitlet abscission, which compounds are most efficacious, and to characterize the pattern of fruitlet drop. The combinations of chemical thinners varied in their effectiveness at reducing crop density. About 12–14 d were required from the time of the first application of chemical thinner to observed fruitlet beneath trees. A single application of both thinners applied at 8 mm advanced fruit drop by 7 d in most instances. The tank-mix of 6-BA and carbaryl applied at 8–10 mm followed by a secondary spray of carbaryl at 15 mm was the most efficacious thinning combination. Secondary sprays of 6-BA at 15 mm were ineffective at inducing additional fruit drop. Combination sprays of 6-BA and carbaryl were more effective than repeat sprays of the same product. This study enhances our understanding of the dynamics of fruitlet abscission and the benefits of multiple applications of post-bloom chemical thinners.
Relationship between vestibular sensitivity and multisensory temporal integration
Authors: Shayman Corey S. , Seo Jae-Hyun , Oh Yonghee , Lewis Richard F. , Peterka Robert J. , Hullar Timothy E. 
Published: July 2018

A single event can generate asynchronous sensory cues due to variable encoding, transmission, and processing delays. To be interpreted as being associated in time, these cues must occur within a limited time window, referred to as a “temporal binding window” (TBW). We investigated the hypothesis that vestibular deficits could disrupt temporal visual-vestibular integration by determining the relationships between vestibular threshold and TBW in participants with normal vestibular function and with vestibular hypofunction. Vestibular perceptual thresholds to yaw rotation were characterized and compared with the TBWs obtained from participants who judged whether a suprathreshold rotation occurred before or after a brief visual stimulus. Vestibular thresholds ranged from 0.7 to 16.5 deg/s and TBWs ranged from 13.8 to 395 ms. Among all participants, TBW and vestibular thresholds were well correlated ( R2 = 0.674, P < 0.001), with vestibular-deficient patients having higher thresholds and wider TBWs. Participants reported that the rotation onset needed to lead the light flash by an average of 80 ms for the visual and vestibular cues to be perceived as occurring simultaneously. The wide TBWs in vestibular-deficient participants compared with normal functioning participants indicate that peripheral sensory loss can lead to abnormal multisensory integration. A reduced ability to temporally combine sensory cues appropriately may provide a novel explanation for some symptoms reported by patients with vestibular deficits. Even among normal functioning participants, a high correlation between TBW and vestibular thresholds was observed, suggesting that these perceptual measurements are sensitive to small differences in vestibular function. NEW & NOTEWORTHY While spatial visual-vestibular integration has been well characterized, the temporal integration of these cues is not well understood. The relationship between sensitivity to whole body rotation and duration of the temporal window of visual-vestibular integration was examined using psychophysical techniques. These parameters were highly correlated for those with normal vestibular function and for patients with vestibular hypofunction. Reduced temporal integration performance in patients with vestibular hypofunction may explain some symptoms associated with vestibular loss.
Serum Sex Steroids as Prognostic Biomarkers in Patients Receiving Androgen Deprivation Therapy for Recurrent Prostate Cancer: A Post Hoc Analysis of the PR.7 Trial
Authors: Toren Paul , Hoffman Azik , Ding Keyue , Joncas France-Hélène , Turcotte Véronique , Caron Patrick , Pouliot Frédéric , Fradet Yves , Lévesque Éric , Guillemette Chantal , Klotz Laurence 
Published: July 2018

Abstract
Purpose: Phenotypic biomarkers are a high priority for patients receiving androgen deprivation therapy (ADT) for prostate cancer given the increasing number of treatment options. This study evaluates serum sex steroids as prognostic biomarkers in men receiving ADT for recurrent prostate cancer.
Experimental Design: Retrospective cohort study of Canadian patients in the PR.7 trial (accrual 1999–2005) who received continuous ADT for biochemical recurrence postradiotherapy. Patients were excluded with follow-up &lt;2 years or who received estrogens or corticosteroids. Kaplan–Meier and multivariable Cox regression analyses adjusted for baseline prognostic factors assessed time to castration-resistant prostate cancer (CRPC), prostate cancer survival, and overall survival according to tertile of sex steroid measured by mass spectrometry.
Results: Post-ADT initiation, we measured samples in 219 patients as well as two subsequent annual samples in a subset of 101 patients. Testosterone levels correlated with androstenedione (AD) and DHT, while DHT, AD, androsterone (AST), dehydroepiandrosterone (DHEA), and androstenediol (A5diol) were highly correlated to each other and negatively associated with age. Higher tertiles of estrone (E1) and estradiol (E2) were significantly associated with sooner time to CRPC. In patients with longitudinal samples, increases in serum DHEA and AST were significantly associated with sooner time to CRPC. Limitations include the number of events for some groups.
Conclusions: Our data suggest the patient hormonal milieu has long-term prognostic value in men receiving ADT for recurrent prostate cancer, including increased levels of E1 and E2 and rising DHEA and AST levels, which predict a shorter time to CRPC. Clin Cancer Res; 24(21); 5305–12. ©2018 AACR.
Relationships between Clinical Presentation, Serology, Histology, and Duodenal Deposits of Tissue Transglutaminase Antibodies in Pediatric Celiac Disease
Authors: Loberman-Nachum Nurit , Schvimer Michael , Avivi Camila , Barshack Iris , Lahad Avishay , Fradkin Akiva , Bujanover Yoram , Weiss Batia 
Published: July 2018

<b><i>Background:</i></b> The clinical, histological, and serological spectrum of celiac disease (CD) vary widely. We aimed to examine relationships between symptoms, serum anti-tissue transglutaminase antibodies (tTG) levels, mucosal damage, and mucosal anti-tTG deposits in pediatric CD. <b><i>Methods:</i></b> A retrospective single-center, cohort study of children referred for endoscopy with suspected CD during 2011–2014. We retrieved the clinical data, blindly reviewed duodenal biopsies, and performed immunohistochemical staining for anti-tTG deposits. Patients were classified as monosymptomatic or polysymptomatic. Mucosal anti-tTG deposits were classified according to the location of deposits, dominant intensity, maximal intensity, and percentage of stained area. <b><i>Results:</i></b> Of 252 patients with confirmed CD, complete data were available for 100: 37 males in the age range 1.3–16.7 with median 4.0 years. Monosymptomatic patients (<i>n</i> = 54) presented at an older age than polysymptomatic patients (1.3–15.5, median 8.1 vs. 1.3–16.7, median 6.3 years, <i>p</i> = 0.026). Marsh 2–3c was more prevalent in polysymptomatic patients (93 vs. 78%, <i>p</i> = 0.028). The intensity of mucosal anti-tTG deposits correlated with serum anti-tTG levels but not with the clinical presentation. <b><i>Conclusions:</i></b> Multiple symptoms and high serum anti-tTG antibody levels correlated with mucosal damage in children with CD. The role of immunohistochemical staining for intestinal anti-tTG mucosal deposits in the diagnosis of borderline CD is not yet established.
Long-Term Opioid Agonist Treatment Participation after First Treatment Entry is Similar across 4 European Regions but Lower in Non-Nationals
Authors: Nordt Carlos , Wiessing Lucas , Kuijpers Wil , Wisselink Jeroen , Espelt Albert , Brugal M. Teresa , Mravčik Viktor , Nechanská Blanka , Seifritz Erich , Herdener Marcus 
Published: July 2018

Heroin users in opioid agonist treatment (OAT) show markedly reduced heroin consumption, less crime and a lower mortality rate. However, the extent of long-term OAT participation over subsequent treatment episodes remains unclear. We analysed the annual proportion of patients in treatment (at least 1 day) since the start of first OAT in 4 European regions: Barcelona (BA) 1996–2012: 8,602 patients; Czech ­Republic (CZ) 2000–2014: 4,377 patients; Netherlands (NL) 1994–2014: 33,235 patients, Zurich (ZU) 1992–2015: 11,795. We estimated the long-term decline of treatment need due to mortality or abstinence and also a “nuisance” short-term decline until the equilibrium level of cycling in and out of OAT is reached to obtain the adjusted treatment participation value. The adjusted treatment participation was around 50% (BA: 47.4–51.4%; CZ: 49.8–53.9%; NL: 52.3–54.0%; ZU: 46.4–49.3%), and the annual decline of treatment need was close to 4%. Non-nationals (NL patients with a migrant background) showed substantial lower adjusted treatment participation (rate ratio BA: 0.059–0.343; NL: 0.710–0.751; ZU: 0.681–0.797; CZ: n.a.). Our method may provide a policy-relevant indicator of long-term provision, quality and access to OAT following first treatment.
The Role of Constitutional Features in Judicial Review
Authors: Brown Adam R. 
Published: July 2018

AbstractAmerican state constitutions vary tremendously in their length, amendment rate, and age. These three variables—especially the first two—strongly influence the rate at which state supreme courts strike down state actions for violating the state constitution. Longer, more detailed constitutions reduce policy flexibility, increasing judicial invalidations; rarely updated constitutions may fail to address modern concerns, increasing invalidations; and recently adopted constitutions may contain fragile logrolls and similar shortcomings, also increasing invalidations. These findings add new considerations to a rich literature on judicial review in state supreme courts.