bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of landmark endovascular stroke trials on logistical performance measures: a before-and-after evaluation of real-world data from a regional stroke system of care
Authors: Kollikowski Alexander Marco , Amaya Franco , Stoll Guido , Müllges Wolfgang , Schuhmann Michael Klaus , Pham Mirko 
Published: October 2018

Background and purposeEndovascular treatment of large-vessel occlusion stroke often necessitates patient transfer by a twin-track approach: endovascular thrombectomy (ET) in endovascular-capable facilities preceded by intravenous thrombolysis in primary stroke centers. We tested the open hypothesis that recent landmark trials on ET had any significant effect on logistical performance measures among different modes of admission.MethodsWe retrospectively categorized 250 patients who presented at our institution as: (A) primarily admitted or transferred from (B) inner-city and (C) regional hospitals. The period from May 2015 to June 2017 was compared with the preceding period of August 2009 to April 2015 with respect to real-life transfer distances and sectional time metrics from symptom onset to angiographic recanalization.ResultsOnset-to-recanalization time decreased in the primary admission path, whereas delays persisted for inter-hospital transfer: (A: 261 min (210–315) vs 198 (167–264) P<0.0001; B: 257 (214–306) vs 265 (199– 360) P=0.566; and C: 371 (322–415) vs 346 (307–405) P=0.559). Onset-to-recanalization time was negatively correlated with recanalization success (mTICI; r=-0.4195 P<0.0001). The rate of secondarily referred patients (26% vs 48% P=0.0004) and off-hour presentation (36% vs 44% P=0.004) increased, as did the catchment area (C: 52.2 km (30,4–64,5) vs 64.4 (43,2–78,9) P=0.032). Improvement in door-in-door-out time at the referring hospitals (C: 113 min (30) vs 86 (29) P=0.0236) did not translate into reduced total referral times or the accelerated initiation of ET.ConclusionRecent landmark trials already led to a considerable streamlining of ET workflow if patients were directly admitted. Prehospital time management and triage seem to be the major determinants of optimization.
Human papillomavirus infection and associated factors for cervical intraepithelial neoplasia in women living with HIV in China: a cross-sectional study
Authors: Wang Qian , Ma Xiaomeng , Zhang Xiaosong , Ong Jason J , Jing Jun , Zhang Lei , Wang Lin-Hong 
Published: October 2018

ObjectiveWomen living with HIV (WLHIV) face disproportionately higher risks of acquiring human papillomavirus (HPV) compared with HIV negative counterparts. We aimed to investigate the prevalence of HPV in WLHIV in Chinese hospital setting and identify associated factors to the progression of late-stage cervical intraepithelial neoplasia (CIN2+) in this population.MethodThis retrospective study collected data from 183 WLHIV on antiretroviral treatment (ART), based on reproductive health questionnaires. Gynaecological examination results including serum (for HIV viral load, CD4 T-cell count, hepatitis B infections, syphilis) and vaginal swabs for common bacterial sexually transmitted infections (STIs). Multivariate-logistic regression was applied to analyze the contributing factors to CIN2+.ResultsHIV coinfection with other Sexually Transmitted Infections (STIs) were observed in 99 participants (54.1%, (99/183)). HPV (43.7% (80/183)) was the most prevalent STI. The three most prevalent HPV subtypes were all high-risk HPV (HR-HPV), including HPV52 (33.8% (27/80)), HPV58 (21.3% (17/80)) and HPV33 (13.75% (11/80)). About a third (37.5%, 30/80) of women with HPV had HR-HPV. Multiple HPV coinfections were common in HIV-HPV coinfected women (41.3%, 33/80). Cytological examinations revealed that 77.5% (62/80) HPV+ women had detectable cervical lesions. In comparison, only 4.9% (5/103) HPV negative womenwith Atypia and 1.0% (1/103) with CIN1 were diagnosed. Multivariate logistic regression revealed that HPV16 (OR=19.04, 2.53 to 122.92; p=0.004) and HPV18 (OR=11.54, 1.45 to 91.64; p=0.021) infections were significantly associated with CIN2+ in HIV-HPV coinfected women.ConclusionA high prevalence of HPV was found in women on ART. HPV16/18 infection are strong associated factors to CIN2+ in HIV-HPV coinfected women.
Can vaccines for contagious agalactia reduce disease progression in infected animals: a preliminary study?
Authors: Loria Guido Ruggero , Puleio Roberto , Agnello Stefano , Marogna Gavino , Nicholas Robin A J 
Published: October 2018

A flock of sheep in Central Sicily was affected by a severe outbreak of contagious agalactia (CA) caused by Mycoplasma agalactiae, affecting nearly 30% resulting in a large drop in milk production. Many ewes had warm and swollen udders that often became sclerotic and was accompanied by keratoconjunctivitis and arthritis in both adults and young. As antibiotic treatment appeared ineffective, the whole flock was given two doses of an inactivated vaccine against M agalactiae two weeks apart. A small group was selected for close examination and additional tests. A fortnight after the last vaccination mycoplasma excretion fell in all but one of the selected ewes and was undetectable in all but two animals two weeks after that. In nearly all the selected ewes, there was an improvement in milk quality and udder condition. This work provided preliminary evidence for the continued use of CA vaccines to slow or prevent disease progression.
Consistent individual and sex-specific differences in behaviour of common cuckoo chicks: is there a potential impact on host-parasite coevolutionary dynamics?
Authors: Trnka Alfréd , Samaš Peter , Grim Tomáš 
Published: October 2018

AbstractResearch on brood parasitism has focused primarily on specific host anti-parasite behaviours and parasite counter-adaptations, and little is known about other aspects of their behaviours such as consistent behavioural differences between individuals. Therefore, we examined consistency in behaviour of nestlings of common cuckoos (Cuculus canorus) raised by great reed warblers (Acrocephalus arundinaceus). Cuckoo chicks showed high repeatability of both aggressive behaviour and breath rate, and both traits were strongly correlated with each other. This represents the first evidence for consistent differences in behaviour among avian brood parasites. Males were consistently more aggressive and less stressed than females. Nestlings of both sexes that hatched later in the season exhibited higher levels of aggression and lower stress responses than nestlings hatched earlier. This suggests that rearing conditions (e.g., food availability and quality) may modulate stress and aggressive phenotypes of brood parasites. We discuss potential effects of the observed patterns on host-parasite dynamics.
Regional Vegetation Histories: An Overview of the Pollen Evidence from the Central Mediterranean
Authors: Kouli Katerina , Masi Alessia , Mercuri Anna Maria , Florenzano Assunta , Sadori Laura 
Published: October 2018

Abstract
Vegetation patterns during the 1st millennium AD in the central Mediterranean, exhibit a great variability, due to the richness of these habitats and the continuous shaping of the environment by human societies. Variations in land use, witnessed in the pollen record, reflect the role that local vegetation and environmental conditions played in the choices made by local societies. The interdisciplinary study of off-site cores remains the key evidence for palaeoenvironmental transformations mirroring the ‘semi-natural’ vegetation, and revealing temporal fluctuations and the amount of human impact on a regional scale.
Variation in the Continuity of Land-Use Patterns through the First Millennium AD in Lowland Britain
Authors: Rippon Stephen , Fyfe Ralph 
Published: October 2018

AbstractThis paper explores the contribution that palaeoenvironmental evidence, and in particular palynology, is making to our understanding of landscape evolution in Britain during the 1st millenniumAD. This was a period of profound social and economic change including a series of invasions, some associated with a mass folk migration. Archaeologists and historians continue to debate the significance of these events, and palaeoenvironmental evidence is now starting to provide an additional perspective. Key to this has been obtaining pollen sequences, although there remains a need for more evidence from lowland areas, alongside higher resolution sampling and improved dating. It is suggested that although the 1st millenniumADsaw some significant long-term shifts in climate, these are unlikely to have had a significant causal effect on landscape change in lowland areas (both in areas with and without significant Anglo-Saxon immigration). The analysis of pollen data from across Britain shows very marked regional variations in the major land-use types (arable, woodland, improved pasture, and unimproved pasture) throughout the Roman and Early Medieval periods. While Britain ceasing to be part of the Roman empire appears to have led to a decline in the intensity of agriculture, it was the ‘long 8th c.’ (the later 7th to early 9th c.) that saw a more profound change, with a period of investment, innovation, and intensification, including an expansion in arable cultivation.
Climatic Changes and Their Impacts in the Mediterranean during the First Millennium AD
Authors: Labuhn Inga , Finné Martin , Izdebski Adam , Roberts Neil , Woodbridge Jessie 
Published: October 2018

AbstractMany events and developments in human history have been suspected to be, at least partly, influenced by climate and environmental changes. In order to investigate climate impacts on societies, reliable palaeoclimatic data of adequate dating precision, resolution, spatial representativeness, and so on, are needed. This paper presents a survey and analysis of published palaeoclimatic data of the Mediterranean for the 1st millenniumAD, and identifies regional patterns of hydro-climate variability, useful for comparison with archaeological/historical studies. It also provides general guidelines to palaeoclimatic data for archaeologists/historians interested in climatic change. We conclude with a discussion of how the emerging patterns of regional climate histories may have had an impact on Mediterranean societies in Late Antiquity.
Mysterious and Mortiferous Clouds: The Climate Cooling and Disease Burden of Late Antiquity
Authors: Newfield Timothy P. 
Published: October 2018

AbstractWhat influence did climate have on disease in Late Antiquity? Natural archives of pre-instrumental temperature indicate significant summer cooling throughout the period. The coolest stretch spanned the 6th and 7th c., and corresponds startlingly to the appearance of the Justinianic Plague in the Mediterranean region. Drawing on principles from landscape epidemiology, this paper marries textual evidence for disease with palaeoclimatic data, in order to understand how gradual and dramatic climatic change, the 535–50 downturn especially, may have altered the pathogenic burden carried in Late Antiquity. Particular attention is paid to the Justinianic Plague, but the potential impacts of a changing climate on malaria and non-yersinial, non-plague, epidemics are not overlooked.
Modelling the Supply of Wood Fuel in Ancient Rome
Authors: Graham Benjamin , Van Dam Raymond 
Published: October 2018

AbstractProvisioning the city of Rome required complex systems of management and procurement. Despite the importance of wood for baking the grain of theannonaand heating the water for baths (among other applications), there is little evidence for the human or ecological connections that supplied Rome with this crucial fuel. By examining parallel institutions, this article provides a model for explaining how the city of Rome met the energy demands of its massive population. We suggest some ways urban labour was linked to Italian forests, creating a sustainable mode of supply that lasted for centuries.
Understanding the Equatorial Pacific Cold Tongue Time-Mean Heat Budget. Part II: Evaluation of the GFDL-FLOR Coupled GCM
Authors: Ray Sulagna , Wittenberg Andrew T. , Griffies Stephen M. , Zeng Fanrong 
Published: October 2018

AbstractThe heat budget of the Pacific equatorial cold tongue (ECT) is explored using the GFDL-FLOR coupled GCM (the forecast-oriented low ocean resolution version of CM2.5) and ocean reanalyses, leveraging the two-layer framework developed in Part I. Despite FLOR’s relatively weak meridional stirring by tropical instability waves (TIWs), the model maintains a reasonable SST and thermocline depth in the ECT via two compensating biases: 1) enhanced monthly-scale vertical advective cooling below the surface mixed layer (SML), due to overly cyclonic off-equatorial wind stress that acts to cool the equatorial source waters; and 2) an excessive SST contrast between the ECT and off-equator areas, which boosts the equatorward heat transport by TIWs. FLOR’s strong advective cooling at the SML base is compensated by strong downward diffusion of heat out of the SML, which then allows FLOR’s ECT to take up a realistic heat flux from the atmosphere. Correcting FLOR’s climatological SST and wind stress biases via flux adjustment (FA) leads to weaker deep advective cooling of the ECT, which then erodes the upper-ocean thermal stratification, enhances vertical mixing, and excessively deepens the thermocline. FA does strengthen FLOR’s meridional shear of the zonal currents in the east Pacific, but this does not amplify either the simulated TIWs or their equatorward heat transport, likely due to FLOR’s coarse zonal ocean resolution. The analysis suggests that to advance coupled simulations of the ECT, improved winds and surface heat fluxes must go hand in hand with improved subseasonal and parameterized ocean processes. Implications for model development and the tropical Pacific observing system are discussed.
Concussion Bingo: Taking an active learning approach to concussion education with vulnerable populations
Authors: Wallace Jessica , Covassin Tracey , Beidler Erica 
Published: October 2018

Objective: The ability of athletes in underserved communities to recognise sport-related concussion (SRC) may be complicated by the lack of a qualified professional, such as an athletic trainer, present. An active learning educational activity (Concussion Bingo) was developed to assist in SRC identification. This study examined learning outcomes following the use of this activity by athletes in two US Title I (low socioeconomic status) high schools. Design: Cross-sectional study. Setting: High school sports. Methods: Participants ( n = 102 athletes) completed 10-minute SRC knowledge of concussion surveys before and after participating in a Concussion Bingo activity. The 45-question survey assessed SRC knowledge through questions about SRC signs/symptoms, general injury information relating to loss of consciousness, the injured anatomical structure, complications of multiple SRCs and premature return to play. Participants had to mark key SRC terms on a Bingo card as they appeared throughout an SRC presentation including content from published consensus/position statements. Descriptive and parametric statistics were used to analyse the data. Results: Analysis of covariance revealed significant differences between pre- and post-Concussion Bingo scores. Athletes had the greatest knowledge increase of fogginess ( n = 30, 29.5%), mood changes ( n = 29, 28.5%), nausea ( n = 27; 26.5%) and sleep problems ( n = 27, 29.5%). On questions pertaining to the injury itself, athletes had the greatest increase on ‘you have to be hit in the head to get a concussion’ ( n = 51, 50%), ‘what kind of an injury is a concussion’ ( n = 31, 40.2%) and a concussion only occurs if you ‘black out’ ( n = 24, 23.4%). Conclusion: Concussion Bingo increased Title I high school athletes’ knowledge of SRCs, suggesting that it may be an effective active learning tool for increasing SRC knowledge.
A history of injection treatments – II sclerotherapy
Authors: Myers Kenneth 
Published: October 2018

Introduction Sclerotherapy in all its current forms is based on experience going back to the 1850s. Methods To trace the evolution of sclerotherapy over the past 250 years, using the internet for past documentation and the literature. Conclusion Sclerotherapy principles were established long ago, although current modifications have been made possible by the introduction of detergent sclerosants and ultrasound guidance.
La régression signée : principe et mode d’emploi
Authors: Windal Pierre Marie 
Published: October 2018

Résumé Il n’existe pas à notre connaissance de méthode de régression linéaire garantissant systématiquement que le signe des coefficients concorde avec celui de la corrélation simple entre la variable à expliquer et chacun des régresseurs et dont la valeur ne se cale pas sur la contrainte qu’on pourrait leur imposer. Or ce double impératif – un coefficient positif et suffisamment différent de zéro pour chaque variable – est souvent requis par les praticiens travaillant, notamment, dans le domaine de la satisfaction où la colinéarité statistique est la norme. L’objectif de cet article est de leur fournir une méthode formelle qui réponde à cette attente et produise des résultats comparables à ceux de méthodes statistiquement fondées, au respect strict et systématique du signe près.
Perceived Barriers to Mobility in a Medical ICU: The Patient Mobilization Attitudes & Beliefs Survey for the ICU
Authors: Goodson Carrie M. , Friedman Lisa Aronson , Mantheiy Earl , Heckle Kevin , Lavezza Annette , Toonstra Amy , Parker Ann M. , Seltzer Jason , Velaetis Michael , Glover Mary , Outten Caroline , Schwartz Kit , Jones Antionette , Coggins Sarah , Hoyer Erik H. , Chan Kitty S. , Needham Dale M. 
Published: October 2018

Purpose: Early mobilization in the intensive care unit (ICU) can improve patient outcomes but has perceived barriers to implementation. As part of an ongoing structured quality improvement project to increase mobilization of medical ICU patients by nurses and clinical technicians, we adapted the existing, validated Patient Mobilization Attitudes & Beliefs Survey (PMABS) for the ICU setting and evaluated its performance characteristics and results. Materials and Methods: The 26-item PMABS adapted for the ICU (PMABS-ICU) was administered as an online survey to 163 nurses, clinical technicians, respiratory therapists, attending and fellow physicians, nurse practitioners, and physician assistants in one medical ICU. We evaluated the overall and subscale (knowledge, attitude, and behavior) scores and compared these scores by respondent characteristics (clinical role and years of work experience). Results: The survey response rate was 96% (155/163). The survey demonstrated acceptable discriminant validity and acceptable internal consistency for the overall scale (Cronbach α: 0.82, 95% confidence interval: 0.76-0.85), with weaker internal consistency for all subscales (Cronbach α: 0.62-0.69). Across all respondent groups, the overall barrier score (range: 1-100) was relatively low, with attending physicians perceiving the lowest barriers (median [interquartile range]: 30 [28-34]) and nurses perceiving the highest (37 [31-40]). Within the first 10 years of work experience, greater experience was associated with a lower overall barrier score (−0.8 for each additional year; P = 0.02). Conclusions: In our medical ICU, across 6 different clinical roles, there were relatively low perceived barriers to patient mobility, with greater work experience over the first 10 years being associated with lower perceived barriers. As part of a structured quality improvement project, the PMABS-ICU may be valuable in assisting to identify specific perceived barriers for consideration in designing mobility interventions for the ICU setting.
How telehealth facilitates the provision of culturally appropriate healthcare for Indigenous Australians
Authors: Caffery Liam J , Bradford Natalie K , Smith Anthony C , Langbecker Danette 
Published: October 2018

Introduction The aim of this study was to explore how telehealth facilitates or impedes the provision of culturally appropriate healthcare to Indigenous Australians from the perspective of staff at an Aboriginal Community Controlled Health Service (ACCHS). Methods An exploratory qualitative study was performed. Semi-structured interviews were conducted with nine ACCHS staff. Interview transcripts were analysed using thematic analysis. Results One central theme and three sub-themes were identified. The central theme of Care provided in a supportive environment describes how telehealth enabled specialist consultations to be conducted in the safe environment of an ACCHS instead of a mainstream health service. The first sub-theme described how telehealth improved affordability and convenience and brought a reduction in the stress of healthcare. The second sub-theme explained the importance of the presence of an Indigenous health worker to facilitate culturally appropriate healthcare. The third sub-theme described how telehealth supported a holistic view of health. Discussion Our findings show culturally appropriate healthcare may be enhanced by the use of telehealth because it allows care to be provided in the supportive environment of an ACCHS. It allows the community member to have the advocacy and assistance of an Indigenous health worker and reduces the burden of travel and dislocation from community and family.
Vitamin C supplementation in the critically ill: A systematic review and meta-analysis
Authors: Zhang Michael , Jativa David F 
Published: October 2018

Background: Low plasma levels of vitamin C are associated with adverse outcomes, including increased mortality, in critically ill patients. Several trials have suggested that the administration of intravenous vitamin C in this setting may have beneficial effects, such as reducing the incidence of organ failure and improving survival. However, these studies have generally involved combination therapies consisting of vitamin C along with other antioxidants, confounding the effects of vitamin C alone. The primary objective of this meta-analysis is to investigate the effects of isolated intravenous supplementation of vitamin C in adults with critical illness. Methods: A database search was conducted for studies on the use of intravenous vitamin C in adult patients with critical illness. The primary outcome assessed was mortality at the longest follow-up time available. Secondary outcomes were the duration of mechanical ventilation, duration of vasopressor support, fluid requirements, and urine output in the first 24 h of intensive care unit admission. Results: Five studies (four randomized controlled trials and one retrospective review) enrolling a total of 142 patients were included in this meta-analysis. Compared with controls, the administration of intravenous vitamin C was associated with a decreased need for vasopressor support (standardized mean difference −0.71; 95% confidence interval (−1.16 to −0.26); p = 0.002) and decreased duration of mechanical ventilation (standardized mean difference −0.5; 95% confidence interval (−0.93 to −0.06); p = 0.03), but no difference was found in mortality (odds ratio 0.76; 95% confidence interval (0.27 to 2.16); p = 0.6). Trends were also noted toward decreased fluid requirements and increased urine output. No adverse effects were reported. Conclusion: The administration of intravenous vitamin C may lead to vasopressor sparing effects and a reduced need for mechanical ventilation in the critically ill, without affecting overall mortality. However, these results should be interpreted in light of the limitations of the primary literature and should serve as a preview of upcoming trials in this area.