bluuebunny/crossref_metadata_2025_split huggingface dataset:
Point‐of‐Care Ocular Ultrasound for the Diagnosis of Retinal Detachment: A Systematic Review and Meta‐Analysis
Authors: Gottlieb Michael , Holladay Dallas , Peksa Gary D. 
Published: January 2019

AbstractBackgroundOcular complaints are common presentations to the emergency department (ED). Among these, retinal detachment can cause significant vision loss if not rapidly diagnosed and referred for appropriate treatment. Point‐of‐care ultrasound has been suggested to identify the diagnosis rapidly when the ocular examination is limited or the ophthalmology service is not readily available. However, prior studies were limited by small sample sizes, resulting in wide ranges of potential accuracy. The primary outcome for this review was to determine the test characteristics of point‐of‐care ocular ultrasound for the diagnosis of retinal detachment.MethodsPubMed, CINAHL, Scopus, LILACS, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, and bibliographies of selected articles were assessed for all prospective and randomized controlled trials assessing the accuracy of point‐of‐care ultrasound for identifying retinal detachment. Data were dual extracted into a predefined worksheet and quality analysis was performed using the QUADAS‐2 tool. Data were summarized and a meta‐analysis was performed with planned subgroup analyses by location and provider specialty. This review was registered with PROSPERO CRD42018097288. There was no funding for this review.ResultsEleven studies (n = 844 patients) were identified. Overall, ultrasound was 94.2% (95% confidence interval [CI] = 78.4% to 98.6%) sensitive and 96.3% (95% CI = 89.2% to 98.8%) specific for the diagnosis of retinal detachment with a positive likelihood ratio of 25.2 (95% CI = 8.1 to 78.0) and a negative likelihood ratio of 0.06 (95% CI = 0.01 to 0.25). Subgroup analysis found that ultrasound was more accurate among ED patients, but was not significantly different when performed by ED or non‐ED providers.ConclusionsPoint‐of‐care ocular ultrasound is sensitive and specific for the diagnosis of retinal detachment. Future studies should determine the ideal training protocol and the influence of color Doppler and contrast‐enhanced ultrasound on diagnostic accuracy.
The Birth of a Return to work Policy for New Resident Parents in Emergency Medicine
Authors: Gordon Alexandra June , Sebok‐Syer Stefanie S. , Dohn Ann M. , Smith‐Coggins Rebecca , Ewen Wang N. , Williams Sarah R. , Gisondi Michael A. 
Published: January 2019

AbstractObjectiveWith the rising number of female physicians, there will be more children than ever born in residency, and the current system is inadequate to handle this increase in new resident parents. Residency is stressful and rigorous in isolation, let alone when pregnant or with a new child. Policies that ease these stressful transitions are generally either insufficient or do not exist. Therefore, we created a comprehensive return‐to‐work policy for resident parents and piloted its implementation. Our policy aims to: 1) establish a clear, shared understanding of the regulatory and training requirements as they pertain to parental leave; 2) facilitate a smooth transition for new parents returning to work; and 3) summarize the local and institutional resources available for both males and females during residency training.MethodIn Fall 2017, a task force was convened to draft a return‐to‐work policy for new resident parents. The task force included nine key stakeholders (i.e., residents, faculty, and administration) at our institution and was made up of three graduate medical education (GME) program directors, a vice chair of education, a designated institutional official (DIO), a chief resident, and three members of our academic department's faculty affairs committee. The task force was selected because of individual expertise in gender equity issues, mentorship of resident parents, GME, and departmental administration.ResultsAfter development, the policy was piloted from November 2017 to June 2018. Our pilot implementation period included seven new resident parents. All of these residents received schedules that met the return‐to‐work scheduling terms of our return‐to‐work policy including no overnight shifts, no sick call, and no more than three shifts in a row. Of equal importance, throughout our pilot, the emergency department schedules at all of our clinical sites remained fully staffed and our sick call pool was unaffected.ConclusionOur return‐to‐work policy for new resident parents provides a comprehensive guide to training requirements and family leave policies, an overview of available resources, and a scheduling framework that makes for a smooth transition back to clinical duties.
Gender Differences in Faculty Rank Among Academic Emergency Physicians in the United States
Authors: Bennett Christopher L. , Raja Ali S. , Kapoor Neena , Kass Dara , Blumenthal Daniel M. , Gross Nate , Mills Angela M. 
Published: January 2019

AbstractBackgroundThe purpose of this study was to complete a comprehensive analysis of gender differences in faculty rank among U.S. emergency physicians that reflected all academic emergency physicians.MethodsWe assembled a comprehensive list of academic emergency medicine (EM) physicians with U.S. medical school faculty appointments from Doximity.com linked to detailed information on physician gender, age, years since residency completion, scientific authorship, National Institutes of Health (NIH) research funding, and participation in clinical trials. To estimate gender differences in faculty rank, multivariable logistic regression models were used that adjusted for these factors.ResultsOur study included 3,600 academic physicians (28%, or 1,016, female). Female emergency physicians were younger than their male colleagues (mean [±SD] age was 43.8 [±8.7] years for females and 47.4 [±9.9] years for males [p < 0.001]), had fewer years since residency completion (12.4 years vs. 15.6 years, p < 0.001), had fewer total and first/last author publications (4.7 vs. 8.6 total publications, p < 0.001; 4.3 vs. 7.1 first or last author publications, p < 0.001), and were less likely to be principal investigators on NIH grants (1.2% vs. 2.9%, p = 0.002) or clinical trials (1.8% vs. 4.4%, p < 0.001). In unadjusted analysis, male physicians were more likely than female physicians to hold the rank of associate or full professor versus assistant professor (13.7 percentage point difference, p < 0.001), a relationship that persisted after multivariable adjustment (5.5 percentage point difference, p = 0.001).ConclusionsFemale academic EM physicians are less likely to hold the rank of associate or full professor compared to male physicians even after detailed adjustment for other factors that may influence faculty rank.
Vaping characteristics and expectancies are associated with smoking cessation propensity among dual users of combustible and electronic cigarettes
Authors: Brandon Karen O. , Simmons Vani N. , Meltzer Lauren R. , Drobes David J. , Martínez Úrsula , Sutton Steven K. , Palmer Amanda M. , Bullen Christopher R. , Harrell Paul T. , Brandon Thomas H. 
Published: January 2019

AbstractBackground and AimsMost e‐cigarette users who also smoke combustible cigarettes (dual users) begin vaping to quit smoking, yet only a subset succeeds. We hypothesized that reinforcing characteristics of e‐cigarettes (vaping reinforcement) would positively predict smoking cessation propensity (SCP) among dual users.DesignSecondary analysis of cross‐sectional baseline data from dual users in an ongoing smoking cessation trial. Exploratory and confirmatory factor analysis (EFA and CFA) created latent variables for vaping reinforcement and SCP. A structural equation modeling (SEM) approach was used to test the hypothesis.SettingUnited States.ParticipantsA national sample of dual users of combustible and electronic cigarettes who smoke and vape at least once per week (n = 2896) were enrolled (63% male; mean age = 29.9 years) into a randomized controlled trial in which they would receive either smoking cessation materials or no smoking cessation materials.MeasurementsVaping reinforcement was indexed by vaping frequency (days/week vaping, times/day vaping, puffs/e‐cigarette use), e‐cigarette characteristics [numbers of modifications and tobacco or non‐tobacco flavors, nicotine content (mg) and positive e‐cigarette expectancies]. SCP was measured by items of confidence, commitment to being smoke‐free, cessation motivation (contemplation ladder), change in cigarettes per day since beginning e‐cigarette use and negative smoking expectancies.FindingsFour factors emerged from the EFA: vaping propensity (vaping frequency, positive expectancies), vaping enthusiasm (e‐cigarette modifications, using non‐tobacco flavors, puffs per use), nicotine/tobacco flavor (nicotine strength, tobacco flavors) and SCP (negative expectancies about smoking, motivation to quit smoking, reduction in smoking). A CFA upheld the exploratory factor structure [root mean square error of approximation (RMSEA) = 0.046, CFI = 0.91]. An SEM with the three vaping latent variables directly predicting SCP had good model fit (RMSEA = 0.030, CFI = 0.97) with a positive relationship of vaping propensity (0.509, P < 0.001), and small negative relationships of vaping enthusiasm (−0.158, P = 0.014) and nicotine/tobacco flavor (−0.230, P < 0.001).ConclusionsAmong e‐cigarette users who also smoke combustible cigarettes, frequent vaping combined with positive e‐cigarette expectancies appears to predict greater smoking cessation propensity. However, vaping enthusiasm (measured by e‐cigarette modifications, using non‐tobacco flavors and puffs per use), higher nicotine content and use of tobacco flavored solution may reduce cessation propensity.
Retracted: Short lipopeptides specifically inhibit the growth of Propionibacterium acnes with dual antibacterial and anti‐inflammatory action
Authors: Yang Guang , Wang Jingyu , Lu Shengsheng , Chen Zhao , Fan Sheng , Chen Daiwei , Xue Huanxin , Shi Wenyuan , He Jian 
Published: January 2019

Background and PurposePropionibacterium acnes (P. acnes) is a Gram‐positive bacterium associated with the skin disorder acne. In this study, we determined the importance of fatty acids in the life habitat of P. acnes; we tested our lipopeptide library in an attempt to create potent P. acnes‐specific antimicrobial agents.Experimental ApproachAntimicrobial activity was determined by the minimal inhibitory concentration (MIC). Lipids from P. acnes were used to explore the mode of action. RAW264.7 cells respectively stimulated with LPS and P. acnes were used to measure the anti‐inflammatory activity. Mice ears injected with P. acnes were used to assess the antimicrobial and anti‐inflammatory effects of the peptides tested in vivo.Key ResultsThe most potent candidate, C16‐KWKW, was observed to be more active against P. acnes, with an MIC of 2 μg·ml−1, than against other non‐targeted bacterial strains, such as Streptococcus mutans, Staphylococcus aureus, and Escherichia coli. The mode of action of C16‐KWKW was observed to be through interference with the integrity of bacterial membrane, thereby impairing membrane permeability and causing leakage of the inner contents of bacterial cells. In addition, C16‐KWKW inhibited the expression of pro‐inflammatory cytokines, such as IL‐1β, TNF‐α, and inducible NOS, stimulated by both LPS and P. acnes, thus showing potential anti‐inflammatory activity, which was further assessed in animal studies in vivo.Conclusions and ImplicationsC16‐KWKW is a lipopeptide displaying both anti‐P. acnes and anti‐inflammatory effects in vitro and in vivo, and exhibits potential as a treatment for acne vulgaris induced by P. acnes.
Questioning cultural narratives of economic development: An investigation of Kitchener‐Waterloo
Authors: Spigel Ben , Bathelt Harald 
Published: January 2019

Key Messages

The cultural narrative of how German immigrants have shaped today's technology economy and entrepreneurial culture in Kitchener‐Waterloo appears questionable.
Members of Kitchener‐Waterloo's German community neither have strong professional ties with other members of that community, nor close connections with other regional communities.
Kitchener‐Waterloo's German community has been absorbed into the region's self‐image and creates common reference points for joint initiatives.
Unravelling identities on archaeological borderlands: Late Woodland Western Basin and Ontario Iroquoian Traditions in the Lower Great Lakes region
Authors: St. John Amy , Ferris Neal 
Published: January 2019

AbstractBorders, boundaries, frontiers, and borderlands are complex things and processes which have become important foci in social sciences over the last two decades. Using archaeological border theory, grounded in anthropological border theory, which focuses on the cultural dimensions of borders, the nature and function of borders and boundaries in the archaeological record of societies indigenous to the Lower Great Lakes can be explored. An archaeological border theory examines how notions of identity, ethnicity, and material culture interplay with borders, allowing for more complex interpretations of archaeological materials and sites. Applying this theory to archaeological evidence from the interaction zones, or borderlands, between archaeologically defined Late Woodland traditions illustrates how these concepts can lead to more complete understandings of the way people lived in the past. Examining borders in the past allows social scientists to recognize their historically situated, fluid nature and will lead to greater consideration of the socially constructed nature of borders in the present.
Does tax competition make mobile firms more footloose?
Authors: Ferrett Ben , Hoefele Andreas , Wooton Ian 
Published: January 2019

AbstractWe examine a two‐period regional model with evolving economic geography, potentially creating incentives for firm relocation between periods. We argue that tax competition makes firms more footloose, but that this increases efficiency relative to the laissez‐faire outcome. We establish that: (i) tax competition leads to efficient investment outcomes and (ii) firm mobility is greater with tax competition than with a laissez‐faire regime. When relocation is costly, there can be too little mobility over time, as firms do not take into account the impact of FDI on social welfare in each country. With lump‐sum taxes or transfers, firms capture these benefits and internalize them, such that tax competition leads to the efficient outcomes. When more time periods are examined, tax competition induces firm relocation sooner than in its absence.
Good + Bad = ? Developmental Differences in Balancing Gains and Losses in Value‐Based Decisions From Memory
Authors: Horn Sebastian S. , Mata Rui , Pachur Thorsten 
Published: January 2019

Value‐based decisions often involve comparisons between benefits and costs that must be retrieved from memory. To investigate the development of value‐based decisions, 9‐ to 10‐year olds (N = 30), 11‐ to 12‐year olds (N = 30), and young adults (N = 30) first learned to associate gain and loss magnitudes with symbols. In a subsequent decision task, participants rapidly evaluated objects that consisted of combinations of these symbols. All age groups achieved high decision performance and were sensitive to gain–loss magnitudes, suggesting that required core cognitive abilities are developed early. A cognitive‐modeling analysis of performance revealed that children were less efficient in object evaluation (drift rate) and had longer nondecision times than adults. Developmental differences, which emerged particularly for objects of high positive net value, were linked to mnemonic and numerical abilities.
Exploration of the role of anti‐Mullerian hormone and LH/FSH ratio in diagnosis of polycystic ovary syndrome
Authors: Le Minh Tam , Le Viet Nguyen Sa , Le Dinh Duong , Nguyen Vu Quoc Huy , Chen Chen , Cao Ngoc Thanh 
Published: January 2019

SummaryObjectiveThis study explores the role of anti‐Mullerian hormone (AMH) and LH/FSH ratio in diagnosis of polycystic ovary syndrome (PCOS).MethodsIn this multicentre cross‐sectional descriptive study, a total of 863 infertile women between 18 and 45 years were evaluated at three infertility centres in Vietnam and were recruited from June 2016 to June 2017. The patients were classified into two groups: Group I included 441 patients with PCOS (based on Rotterdam criteria consensus) and Group II included 422 non‐PCOS women. Diagnosis of PCOS was established based on Rotterdam 2003 consensus, and exclusion criteria were ovarian disease (ovary cyst/tumour), history of ovarian surgery and ovarian failure.ResultsAt an optimum cut‐off level of 32.79 pmol/L, AMH showed sensitivity and specificity of 78.50% and 75.83%, respectively, with the AUC 0.852 (95% CI: 0.826‐0.875). The LH/FSH ratio had a similar AUC at the optimum cut‐off of 1.33 (AUC = 0.867, 95% CI 0.842‐0.889), which demonstrated a similar diagnosis value to AMH (P = 0.340). By using multiple logistic regression analysis, 1 ng/mL increase in AMH levels was associated with an increased risk of PCOS (OR = 1.63, 95% CI: 1.506‐1.764; P < 0.001). Similarly, one unit increase in LH/FSH ratio was associated with 14.433 times increased (95% CI: 9.302‐22.395; P < 0.001) risk of PCOS. There were no significant differences between values of AMH and LH/FSH ratio in PCOS diagnosis, as the difference between the two AUCs was 0.013, 95% CI: −0.024 to 0.028 and P = 0.897.ConclusionThe value of serum AMH concentration has been found not significantly superior to LH/FSH ratio in PCOS diagnosis. Although these biomarkers separately are not adequate for PCOS diagnosis based on their own value, the combination of different endocrine factors including AMH, LH and LH/FSH ratio together with BMI and other anthropometric and clinical characteristics may offer extra value to establish the diagnosis of PCOS.
Priority areas for conservation of Old World vultures
Authors: Santangeli Andrea , Girardello Marco , Buechley Evan , Botha Andre , Minin Enrico Di , Moilanen Atte 
Published: January 2019

AbstractThe prosperity and well‐being of human societies relies on healthy ecosystems and the services they provide. However, the biodiversity crisis is undermining ecosystems services and functions. Vultures are among the most imperiled taxonomic groups on Earth, yet they have a fundamental ecosystem function. These obligate scavengers rapidly consume large amounts of carrion and human waste, a service that may aid in both disease prevention and control of mammalian scavengers, including feral dogs, which in turn threaten humans. We combined information about the distribution of all 15 vulture species found in Europe, Asia, and Africa with their threats and used detailed expert knowledge on threat intensity to prioritize critical areas for conserving vultures in Africa and Eurasia. Threats we identified included poisoning, mortality due to collision with wind energy infrastructures, and other anthropogenic activities related to human land use and influence. Areas important for vulture conservation were concentrated in southern and eastern Africa, South Asia, and the Iberian Peninsula, and over 80% of these areas were unprotected. Some vulture species required larger areas for protection than others. Finally, countries that had the largest share of all identified important priority areas for vulture conservation were those with the largest expenditures related to rabies burden (e.g., India, China, and Myanmar). Vulture populations have declined markedly in most of these countries. Restoring healthy vulture populations through targeted actions in the priority areas we identified may help restore the ecosystem services vultures provide, including sanitation and potentially prevention of diseases, such as rabies, a heavy burden afflicting fragile societies. Our findings may guide stakeholders to prioritize actions where they are needed most in order to achieve international goals for biodiversity conservation and sustainable development.
Serum cardiac troponin elevation predicts mortality in patients with pulmonary hypertension: A meta‐analysis of eight cohort studies
Authors: Xu Shuang‐Lan , Yang Jiao , Zhang Chun‐Fang , Xu Shuang‐Yan , Zhao Fang‐Yun , Liu Li‐Qiong , Xie Chun‐Lin , Xing Xi‐Qian , Zhu Yun 
Published: January 2019

AbstractObjectiveTo determine the association of serum cardiac troponin (cTn) with the mortality of pulmonary hypertension (PH) patients via a meta‐analysis.Date SourceWe searched PubMed and EMBASE from inception to October 25, 2017.Study SelectionThe reference lists of the retrieved articles were also consulted. The Q test and I2 test were used for to assess heterogeneity. The relationship between cTn elevation and mortality was analysed. Studies were stratified according to type of troponin (cTnT vs cTnI), region (Europe vs America) and follow‐up length (≤3 years vs >3 years).ResultsEight studies with 739 patients were included in the meta‐analysis. Cardiac troponin elevation ranged from 14.3% to 94.5%. Overall, 48.8% (39/80) of patients with elevated cTn died compared to 18.6% (45/242) of patients with normal cTn levels. These findings showed cTn elevation was significantly related to an increased mortality risk in PH patients [hazard ratio (HR) = 3.05, 95% confidence interval (95% CI) = 2.16‐4.32, I2 = 24.9%]. cTnI was better at predicting mortality than cTnT (HR = 3.37, 95%CI = 2.05‐5.55 vs HR = 2.80, 95%CI = 1.97‐3.98, respectively). American populations had increased mortality compared to European populations (HR = 4.23, 95%CI = 2.29‐7.80 vs HR = 2.70, 95% CI = 1.95‐3.74, respectively). This finding was independent of the follow‐up length of the studies (≤3 years: HR = 2.36, 95%CI = 1.65‐3.38; >3 years: HR = 4.55, 95%CI = 2.80‐7.39).ConclusionsAlthough different studies detected the expression cTnT or cTnI by various methods, the mortality in the cTn‐positive group was higher than that in the cTn‐negative group. Serum cTn elevation emerged as an independent predictor of increased risk of mortality in PH patients.
Free triiodothyronine is associated with the occurrence and remission of nonalcoholic fatty liver disease in euthyroid women
Authors: Chen Peizhu , Hou Xuhong , Wei Li , Feng Liang , Zhong Lichang , Jiao Lei , Wang Hongmei , Bao Yuqian , Jia Weiping 
Published: January 2019

AbstractBackgroundThe association between nonalcoholic fatty liver disease (NAFLD) and free triiodothyronine (FT3) in euthyroid subjects was in dispute. We aimed to investigate this issue in a population‐based cohort study.Materials and methodsA total of 3144 euthyroid subjects at baseline from the Shanghai Nicheng Atherosclerosis Study were selected for the cross‐sectional analysis, and 2089 subjects being followed up after 2.2 years were selected for the longitudinal analysis. NAFLD was diagnosed by ultrasound. The cut‐off point of elevated alanine aminotransferase (ALT) level was 40 U/L. The FIB‐4 index was used to assess the risk of advanced liver fibrosis.ResultsAge‐adjusted mean levels of FT3 and FT3/free thyroxine (FT4) ratio were higher in subjects with NAFLD than those without NAFLD and linearly increased with a higher risk of NAFLD progression (assessed by levels of ALT and FIB‐4 index) in euthyroid women but not in men. After adjustment for confounding variables, FT3 levels significantly increased with the presence of NAFLD (β = 0.1, P < 0.001) and linearly increased with a higher risk of NAFLD progression in euthyroid women. After a 2.2‐year follow‐up, FT3 levels increased with the occurrence of NAFLD (mean change percentage: 1.4%) and decreased with the remission of NAFLD (mean change percentage: −2.7%) in euthyroid women.ConclusionsThere are positive associations of FT3 levels with NAFLD and the risk of NAFLD progression in euthyroid women. The changes in FT3 levels with the alteration of NAFLD status may be an adaptive response to maintain energy and metabolic homeostasis.