bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spontaneous hemoperitoneum and anaphylactic shock associated with Hymenoptera envenomation in a dog
Authors: Caldwell Dana J. , Petras Kaelyn E. , Mattison Brandi L. , Wells Raegan J. , Heffelman Victoria L. 
Published: August 2018

AbstractObjectiveTo describe the clinical presentation of a dog with spontaneous hemoperitoneum associated with anaphylactic shock from Hymenoptera envenomation.Case SummaryAn 8‐year‐old female neutered Beagle presented as an emergency for acute onset of collapse, hematemesis, and hematochezia. The dog was tachycardic, tachypneic, and hypotensive. Initial assessment revealed a hemoperitoneum with documentation of a nonclotting sanguineous peritoneal effusion with PCV 81% and total protein concentration 65 g/L (6.5 g/dL). No obvious masses were appreciated ultrasonographically during original presentation and cytology of the peritoneal effusion was unremarkable. Peripheral PCV was 67% and total plasma protein concentration was 72 g/L (7.2 g/dL). A bee stinger was located in the right upper lip after presentation and was postulated to be the inciting trigger for the abdominal hemorrhage and shock. The patient was medically stabilized and ultimately made an uneventful recovery. Abdominal ultrasound performed 3 days after discharge revealed a single 0.85 cm hyperechoic liver nodule. Follow‐up evaluation at 6 and 18 months after presentation documented a normal physical examination, unremarkable thoracic radiographs, and no change in the original hyperechoic liver nodule.New or Unique Information ProvidedThis report details an unusual clinical presentation of anaphylactic shock due to Hymenoptera envenomation in a dog. To the authors’ knowledge, spontaneous hemoperitoneum associated with anaphylaxis and bee envenomation has not been documented in the veterinary literature.
Validity and reliability of a medical record review method identifying transitional patient safety incidents in merged primary and secondary care patients’ records
Authors: van Melle Marije A , Zwart Dorien L M , Poldervaart Judith M , Verkerk Otto Jan , Langelaan Maaike , van Stel Henk F , de Wit Niek J 
Published: August 2018

ObjectiveInadequate information transfer during transitions in healthcare is a major patient safety issue. Aim of this study was to pilot a review of medical records to identify transitional safety incidents (TSIs) for use in a large intervention study and assess its reliability and validity.DesignA retrospective medical record review study.Settings and participantsCombined primary and secondary care medical records of 301 patients who had visited their general practitioner and the University Medical Center Utrecht, the Netherlands, in 2013 were randomly selected. Six trained reviewers assessed these medical records for presence of TSIs.OutcomesTo assess inter-rater reliability, 10% of medical records were independently reviewed twice. To assess validity, the identified TSIs were compared with a reference standard of three objectively identifiable TSIs.ResultsThe reviewers identified TSIs in 52 (17.3%) of all transitional medical records. Variation between reviewers was high (range: 3–28 per 50 medical records). Positive agreement for finding a TSI between reviewers was 0%, negative agreement 80% and the Cohen’s kappa −0.15. The reviewers identified 43 (22%) of 194 objectively identifiable TSIs.ConclusionThe reliability of our measurement tool for identifying TSIs in transitional medical record performed by clinicians was low. Although the TSIs that were identified by clinicians were valid, they missed 80% of them. Restructuring the record review procedure is necessary.
Batched Point Location in SINR Diagrams via Algebraic Tools
Authors: Aronov Boris , Katz Matthew J. 
Published: August 2018

The
SINR (Signal to Interference plus Noise Ratio) model
for the quality of wireless connections has been the subject of extensive recent study. It attempts to predict whether a particular transmitter is heard at a specific location, in a setting consisting of
n
simultaneous transmitters and background noise. The SINR model gives rise to a natural geometric object, the
SINR diagram
, which partitions the space into
n
regions where each of the transmitters can be heard and the remaining space where no transmitter can be heard.

Efficient
point location
in the SINR diagram, i.e., being able to build a data structure that facilitates determining, for a query point, whether any transmitter is heard there, and if so, which one, has been recently investigated in several articles. These planar data structures are constructed in time at least quadratic in
n
and support logarithmic-time approximate queries. Moreover, the performance of some of the proposed structures depends strongly not only on the number
n
of transmitters and on the approximation parameter
ε
, but also on some geometric parameters that cannot be bounded
a priori
as a function of
n
or
ε
.

In this article, we address the question of
batched
point location queries, i.e., answering many queries simultaneously. Specifically, in one dimension, we can answer
n
queries
exactly
in amortized polylogarithmic time per query, while in the plane we can do it approximately.

In another result, we show how to answer
n
2
queries
exactly
in amortized polylogarithmic time per query, assuming the queries are located on a possibly non-uniform
n
×
n
grid.

All these results can handle
arbitrary
power assignments to the transmitters. Moreover, the amortized query time in these results depends only on
n
and
ε
.

We also show how to speed up the preprocessing in a previously proposed point-location structure in SINR diagram for uniform-power sites, by almost a full order of magnitude. For this, we obtain results on the sensitivity of the reception regions to slight changes in the reception threshold, which are of independent interest.
Finally, these results demonstrate the (so far underutilized) power of combining algebraic tools with those of computational geometry and other fields.
Strengthening Nutrition-Specific Policies for Adolescents in Indonesia: A Qualitative Policy Analysis
Authors: Soekarjo Damayanti D. , Roshita Airin , Thow Anne-Marie , Li Mu , Rah Jee Hyun 
Published: August 2018

Background: There is a growing recognition of the importance of adolescent health and well-being. Yet, little attention has been paid to adolescent nutrition, and few policies and programs are targeting to improve adolescent nutrition in Indonesia. Objective: This analysis aimed to identify (1) the extent to which adolescents are considered in nutrition policy in Indonesia and (2) opportunities to improve nutrition policy content to effectively target adolescents. Methods: We collected data on policy content through a desk review of national and subnational level nutrition-specific strategic plans, laws, regulations, and program guidelines. We then conducted 74 key informant interviews with policy makers and program experts in health, education, and related sectors using semistructured interview guides based on policy theory to examine policy context and implementation. The policy content and interview data were analyzed using thematic synthesis and narrative analysis. Results: Currently, 2 nutrition-specific policies and programs are designed to improve adolescent nutrition in Indonesia, one focusing on iron–folic acid supplementation for adolescent girls and another on obesity prevention and management in schools. These programs are yet to be implemented at scale. Overall, adolescent nutrition is not yet considered a priority in the national development agenda. An opportunity exists to improve action on adolescent nutrition in Indonesia through scaling up of district-level policies and through improving coordination mechanisms across sectors. Conclusions: Few policies and programs exist to support adolescent nutrition in Indonesia. Coordinated efforts across relevant sectors and levels of government should be made to mainstream adolescent nutrition into relevant policies.
Incidence of cardiovascular risk factors in female patients with systemic lupus erythematosus: a 3-year follow-up cohort
Authors: Monção C S A , Martins L N , Penteado M P S , Reis R C P , Santos F M M , Lanna C C D , Ribeiro A L , Telles R W 
Published: August 2018

Objectives To evaluate the incidence and variability of traditional coronary artery disease (CAD) risk factors in a cohort of lupus patients and to investigate if prednisone use predicts an increase in the number of risk factors. Methods A total of 151 women, 37.8 ± 11.1 (mean ± SD) years old at baseline, were reevaluated after a median period of 39 (interquartile range 36.5–42.0) months. The cumulative incidence of traditional risk factors, the incidence rate (with 95% confidence interval) of hypertension, diabetes, dyslipidemia and hypertriglyceridemia, and the frequency of the risk factors’ disappearance were calculated. Metabolic syndrome (MetS) and Framingham risk score (FRS) were computed. Logistic regression was used to investigate if maximum or cumulative prednisone dose used during follow-up predicted an increase in the cardiometabolic risk factors’ number. Results The cumulative incidence of risk factors varied from 39.1% (abdominal obesity) to zero (smoking), and the incidence rate varied from 133.2 (87.8–178.6) per 1000 person-years (dyslipidemia) to 10.4 (1.3–19.5) per 1000 person-years (diabetes). The cumulative incidence for MetS was 18.8%, and 11.7% of 143 patients with low FRS at baseline (T1) were classified in the high-risk category at the end of the study (T2). Dyslipidemia was the most variable risk factor, with 43.5% disappearance at T2. The maximum prednisone dose used during follow-up was borderline ( p = 0.050) for prediction of an increase in the number of cardiometabolic risk factors in an adjusted model for antimalarial use, modified Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and age. Conclusion The authors described high incidence and variability of CAD risk factors in female lupus patients, with higher prednisone dose being borderline for an increase in the number of cardiometabolic risk factors.
Prophylactic and therapeutic effects of twice-daily famciclovir administration on infectious upper respiratory disease in shelter-housed cats
Authors: Cooper Ann E , Thomasy Sara M , Drazenovich Tracy L , Kass Philip H , Potnis Sanskruti S , Leutenegger Christian M , Maggs David J 
Published: August 2018

Objectives In humans with herpetic disease, early or pre-emptive famciclovir therapy reduces disease duration and severity. This prospective, masked, placebo-controlled study tested therapeutic and prophylactic effects of two famciclovir doses given to cats for 7 days following shelter entry. Methods Cats were assigned to prophylactic or therapeutic study arms based on clinical evidence of herpetic disease at study entry. Cats in the therapeutic arm received no treatment (n = 19), placebo (lactose; n = 18) or famciclovir at ~30 (n = 21) or ~90 mg/kg (n = 20) PO q12h for 7 days. Cats in the prophylactic arm received no treatment (n = 25) or famciclovir at ~30 (n = 28) or ~90 mg/kg (n = 27) PO q12h for 7 days. Disease scores, body weight, conjunctival feline herpesvirus 1 (FHV-1) shedding, and adoption rates were recorded on days 1 (admission), 8 (end of therapy) and 15 (1 week after cessation of therapy). Results No significant differences in clinical scores were observed among groups in the prophylactic or therapeutic arms at any of the three time points. However, within the therapeutic arm, viral shedding on day 8 was significantly higher in cats receiving no treatment than in those receiving ~30 or ~90 mg/kg famciclovir, and this effect persisted 1 week after famciclovir was stopped (day 15) only in cats receiving ~30 mg/kg, although this approached significance in cats receiving ~90 mg/kg. No significant differences in adoption rates were detected among groups in either arm throughout the study. Conclusions and relevance Although we did not demonstrate a statistically or clinically significant effect of famciclovir administration upon clinical signs of infectious upper respiratory disease or adoption, when it was administered at ~30 or ~90 mg/kg q12h for 1 week famciclovir reduced conjunctival FHV-1 shedding. This suggests a potential role in interrupting the infectious cycle within a shelter population; however, cost in time and resources, and stress and pathogen transmission induced by oral administration should be considered.
Identification and characterization of mushroom body neurons that regulate fat storage in Drosophila
Authors: Al-Anzi Bader , Zinn Kai 
Published: August 2018

Abstract
Background
In an earlier study, we identified two neuronal populations, c673a and Fru-GAL4, that regulate fat storage in fruit flies. Both populations partially overlap with a structure in the insect brain known as the mushroom body (MB), which plays a critical role in memory formation. This overlap prompted us to examine whether the MB is also involved in fat storage homeostasis.

Methods
Using a variety of transgenic agents, we selectively manipulated the neural activity of different portions of the MB and associated neurons to decipher their roles in fat storage regulation.

Results
Our data show that silencing of MB neurons that project into the α’β’ lobes decreases de novo fatty acid synthesis and causes leanness, while sustained hyperactivation of the same neurons causes overfeeding and produces obesity. The α’β’ neurons oppose and dominate the fat regulating functions of the c673a and Fru-GAL4 neurons. We also show that MB neurons that project into the γ lobe also regulate fat storage, probably because they are a subset of the Fru neurons. We were able to identify input and output neurons whose activity affects fat storage, feeding, and metabolism. The activity of cholinergic output neurons that innervating the β’2 compartment (MBON-β’2mp and MBON-γ5β’2a) regulates food consumption, while glutamatergic output neurons innervating α’ compartments (MBON-γ2α’1 and MBON-α’2) control fat metabolism.

Conclusions
We identified a new fat storage regulating center, the α’β’ lobes of the MB. We also delineated the neuronal circuits involved in the actions of the α’β’ lobes, and showed that food intake and fat metabolism are controlled by separate sets of postsynaptic neurons that are segregated into different output pathways.
Germs of thrones - spontaneous decolonization of Carbapenem-Resistant Enterobacteriaceae (CRE) and Vancomycin-Resistant Enterococci (VRE) in Western Europe: is this myth or reality?
Authors: Davido Benjamin , Moussiegt Aurore , Dinh Aurélien , Bouchand Frédérique , Matt Morgan , Senard Olivia , Deconinck Laurene , Espinasse Florence , Lawrence Christine , Fortineau Nicolas , Saleh-Mghir Azzam , Caballero Silvia , Escaut Lelia , Salomon Jérome 
Published: August 2018

Abstract
Background
In France, Carbapenem-Resistant Enterobacteriaceae (CRE) and Vancomycin-Resistant Enterococci (VRE) are considered as Extensively Drug-Resistant (XDR) bacteria. Their management requires reinforcement of hospital’s hygiene policies, and currently there is few consistent data concerning the spontaneous decolonization in XDR colonized patients. Our aim is to study the natural history of decolonization of XDR carriers over time in a hospital setting in a low prevalence country.

Material and methods
Retrospective multicenter study over 2 years (2015–2016) in 2 different tertiary care hospital sites and units having an agreement for permanent cohorting of such XDR carriers. We gathered the type of microorganisms, risk factors for colonization and rectal swabs from patient’s follow-up. We also evaluated patient care considering isolation precautions.

Results
We included 125 patients, aged 63+/−19y, including 72.8% of CRE (n = 91), 24.8% of VRE (n = 31) and 2.4% (n = 3) co-colonized with CRE and VRE. CRE were mainly E. coli (n = 54), K. pneumoniae (n = 51) and E. cloacae (n = 6). Mechanisms of resistance were mainly OXA-48 (n = 69), NDM-1 (n = 11), OXA-232 (n = 8) and KPC (n = 3).
Prior antibiotic therapy was reported in 38.4% (n = 48) of cases. Conversely, 17.6% (n = 22) received antibiotics during follow-up.
Spontaneous decolonization occurred within the first 30 days in 16.4% (n = 19/116) of cases and up to 48.2% after day-90 with a median follow-up of 96 days (0–974).
We estimated that XDR carriage was associated with a larger care burden in 13.6% (n = 17) of cases, especially due to a prolongation of hospitalization of 32.5 days (15–300).

Conclusions
Our study shows that spontaneous decolonization is increasing over time (up to 48.2%). We can regret that only few patients underwent screening after 1 year, emphasizing the need for more monitoring and prospective studies.
Deprescribing antipsychotics: a guide for clinicians
Authors: Gupta Swapnil , Cahill John Daniel , Miller Rebecca 
Published: August 2018

SUMMARYPolypharmacy and the risks of long term use of antipsychotic medications point toward the need for identifying practices for deprescribing in psychiatry. The following article gives a brief overview of key points around deprescribing antipsychotic medications in psychiatry, including identifying risks and benefits, considerations around timing, and steps involved.LEARNING OBJECTIVES•Be able to define the concept of deprescribing as it relates to antipsychotic medications•Know how to perform a risk–benefit analysis for a patient on antipsychotic medication•Be able to identify the key steps involved in deprescribing antipsychotic medicationsDECLARATION OF INTERESTNone.
HYDROGEN-OXYGEN STEAM GENERATOR FOR A CLOSED HYDROGEN COMBUSTION CYCLE
Authors: Aminov R. Z. , Egorov A. N. 
Published: August 2018

The paper analyzes the problems of combustion hydrogen in an oxygen medium for produce high-temperature steam that can be used to produce electricity at various power plants. For example, at the nuclear power plants, the use of a H2-O2 steam generator as part of a hydrogen energy complex makes it possible to increase its power and efficiency in the operational mode due to steam-hydrogen overheating of the main working fluid of a steam-turbine plant. In addition, the use of the hydrogen energy complex makes it possible to adapt the nuclear power plants to variable electric load schedules in conditions of increasing the share of nuclear power plants and to develop environmentally friendly technologies for the production of electricity. The paper considers a new solution of the problem of effective and safe use of hydrogen energy at NPPs with a hydrogen energy complex.Technical solutions for the combustion of hydrogen in the oxygen medium using direct injection of cooling water or steam in the combustion products have a significant drawback – the effect of “quenching” when injecting water or water vapor which leads to a decrease in the efficiency of recombination during cooling of combustion products that is expressed in an increase fraction of non-condensable gases. In this case, the supply of such a mixture to the steam cycle is unsafe, because this can lead to a dangerous increase in the concentration of unburned hydrogen in the flowing part of the steam turbine plant. In order to solve this problem, the authors have proposed a closed hydrogen cycle and a hydrogen vapor overheating system based on it, and carried out a study of a closed hydrogen combustion system which completely eliminates hydrogen from entering the working fluid of the steam cycle and ensures its complete oxidation due to some excess of circulating oxygen.The paper considers two types of hydrogen-oxygen combustion chambers for the system of safe generating of superheated steam using hydrogen in nuclear power plant cycle by using a closed system for burning hydrogen in an oxygen medium. As a result of mathematical modeling of combustion processes and heat and mass transfer, we have determined the required parameters of a hydrogen-oxygen steam generator taking into account the temperature regime of its operation, and a power range of hydrogen-oxygen steam generators with the proposed combustion chamber design.
MATHEMATICAL MODELING OF EVAPORATION CONSEQUENCES OF TOXIC SUBSTANCE EMERGENCY SPILLAGE AT RAILWAY TRANSPORT
Authors: Y. O. Skob  , M. L. Ugryumov  
Published: August 2018

Purpose. The main purpose of the article is calculation of spatial distribution fields of the conditional probability of lethal damage to the railway station personnel, caused by the inhalation of toxic gas, which is dissipated in the surface layer of the atmosphere under the conditions of a given wind situation, for a numerical assessment of the safety level of the technogenic object. Methodology. The authors developed a three-dimensional mathematical model of the evaporation processes of toxic chemical substance from the surface of the spillage stain as a result of emergency destruction of the storage or transportation capacity of liquefied gas and further dispersion of the gaseous admixture in the ground layer of the atmosphere, taking into account the cluttering of space by buildings. Also it was developed a calculation technology for determining the conditional probability of human injury by toxic gas on the basis of probit-analysis of the impact degree of damaging factor (inhalation toxodose) on human body. To automate the calculation process, the tabular dependence «probit-function-injury probability» is replaced by a generalized piecewise cubic spline. Findings. Based on the developed model we obtained the results of calculations of the space-time fields of the conditional probability of lethal injury to the railway station personnel who underwent inhalation exposure of a cloud of hydrogen cyanide gas. We also determined that the presence of buildings on the way of the toxic cloud dispersion increases the concentration area and the time of cloud passage along the calculated area, which, accordingly, increases the exposure time of station personnel to harmful impact. Originality. The developed mathematical model takes into account: the flow compressibility, the complex terrain (cluttering of the calculation space by the buildings of technogenic object), the three-dimensional nature of dispersion process of the gaseous admixture, the evaporation of a toxic substance with a variable intensity depending on the wind conditions, physical characteristics of admixture and the roughness grade of atmosphere surface layer. The mathematical model makes it possible to obtain spatio-time distributions of a dangerous parameter – the relative mass concentration of toxic gas and the damaging factor – inhalation toxodose, which are necessary to determine the nonstationary three-dimensional fields of the conditional probability of injury to the technogenic object personnel on the basis of the probit-analysis apparatus. Practical value. The developed calculation technology allows the expert at the decision-making stage to perform automated numerical analysis and forecast in time and space of the conditional probability of lethal injury to service personnel exposed to the inhalation effect of toxic gas as an integral part of the safety index of a technogenic object - individual risk.