bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fixed‐dose combination of umeclidinium and vilanterol for patients with chronic obstructive pulmonary disease: A systematic review
Authors: Ramadan Wijdan H. , Al Masri Sarah , Rizk John 
Published: August 2019

AbstractChronic obstructive pulmonary disease (COPD) is a common respiratory disease that is predicted to be one of the leading causes of death worldwide. Pharmacologic treatment options of COPD are bronchodilators, using either long‐acting β2‐agonists (LABAs), or long‐acting muscarinic antagonists (LAMAs), or a combination of two. Anoro Ellipta (umeclidinium + vilanterol) dry powder inhaler, a fixed‐dose combination of LAMA and LABA, was Food and Drug Administration (FDA) approved in 2013 for COPD. The objective of this study is to evaluate the efficacy and safety of once daily umeclidinium/vilanterol (62.5 mcg/25 mcg) in COPD patients, focusing on pharmacodynamic and pharmacokinetic characteristics, efficacy and safety in clinical studies and cost. Literature search was done through PubMed (2004‐2017) using the terms umeclidinium, vilanterol, COPD, LABA and LAMA. Recent and significant clinical trials about the monocomponents and their combination were identified, in addition to reviews, guidelines for COPD, data from manufacturer and FDA product labels. The search was limited to English language studies on human subjects. Clinical data published on the combination of umeclidinium/vilanterol in patients with COPD have shown greater improvements in lung function compared to monotherapies. However, further studies comparing umeclidinium/vilanterol FDC (ANORO) to other LABA/LAMA combinations are needed.
A pilot study on the non‐invasive management of tracheobronchial secretions in tracheostomised patients
Authors: Belli Stefano , Cattaneo Davide , D'Abrosca Francesco , Prince Ilaria , Savio Gloria , Balbi Bruno 
Published: August 2019

AbstractIntroduction/ObjectivesThe aim of our study was to assess the safety, efficacy and feasibility of an Expiratory Flow Accelerator (EFA) device, Free Aspire, in reducing the need for daily suctions in tracheostomised (TCS) patients.MethodsTwenty‐five patients (13 males, 12 females, aged 69.88 ± 9.06 years) were investigated. The number of superficial/deep suctions, shallows, arterial blood gas (ABG) analysis, perception of mucus encumbrance (Visual Numeric Scale, VNS) and adverse event were recorded for five days. On the first two days (T1‐T2), suctioning was performed as usual, on the following three days (T3, T4, T5), patients were treated also with Free Aspire (20 min, 3 times a day).Results/ConclusionThe use of the non‐invasive device was associated with a decrease of total number of aspirations from T2 to T5 (8.48 ± 2.62 vs 4.48 ± 3.08, P = 0.0003). Total number of daily aspirations decreased over the five days (8.68 ± 3.64 vs 4.48 ± 3.08, P = 0.0009). Deep aspirations decreased from T1 to T5 (6.16 ± 3.53 vs 1.80 ± 1.50, P = 0.0001). ABG data confirmed that no significant side effects occurred. VNS score decreased from 7.03 ± 1.42 at T1 to 4.05 ± 1.80 at T5 (P < 0.0001).These data suggest that EFA may be useful for managing secretions in TCS patients, as it can reduce the number of daily suctions, particularly the deep ones, and may improve the perception of mucus encumbrance, without side effects. More studies are needed to confirm these data and to understand in which categories of TCS patients this device can be introduced.
Segmenting urban populations for greater conservation gains: A new approach targeting cobenefits is required
Authors: MacDonald Edith , Harbrow Michael , Jack Sandra , Kidd Julie , Wright Andrew , Tuinder Pieter , Balanovic Jovana , Medvecky Fabien , Poutasi Markerita 
Published: August 2019

AbstractEngaging urban residents in greater proconservation behaviors is essential to mitigate the biodiversity crisis. To date, most behavior‐change campaigns have been based on a one‐size‐fits‐all “think‐care‐act” approach resulting in insufficient, sometimes counterproductive, conservation gains. In our study, we assess the “think‐care‐act” paradigm and also consider a range of cobenefits that may motivate different segments of urban populations to take greater conservation action for reasons other than biodiversity gains. We surveyed a representative sample of Auckland, New Zealand (n= 2,124) and four clusters emerged through clustering analysis. The first segment (Environmentally Active; 32%), exhibited the “think‐care‐act” paradigm. The second segment (Well Informed; 28%), was highly knowledgeable and concerned about conservation problems but exhibited lower conservation behaviors. The third segment (Active Outdoors; 19%) was actively engaged in outdoor activities, but exhibited low conservation knowledge, concern, and behaviors. The fourth segment (Socially Motivated; 21%), demonstrated high levels of conservation behaviors but lower knowledge and concern about conservation issues. We discuss potential ways to engage with each segment based on cobenefits and the need to move away from the traditional “think‐care‐act” paradigm and instead work with existing values systems and foster greater conservation behavior based on existing cobenefits.
Assimilate or Differentiate? Contributors’ Choice of Subjects in User‐Generated Content
Authors: Ke Zhihong , Liu De , Gupta Alok , Brass Daniel Joseph 
Published: August 2019

ABSTRACTA key to the content diversity on user‐generated content platforms is what subject users choose to contribute on. This research investigates how two factors can shape contributors’ subject choice decisions, namely, the amount of existing content and content contributed by online friends or “friend content.” Our experimental findings show that both the amount of existing content and friend content can shape a contributor's subject choice decisions: ceteris paribus, contributors prefer subjects with less existing content and ones with friend content when the amount of existing content is the same. In addition, contributors’ preference for subjects with friend content weakens as the amount of existing content on other subject's decreases. Our findings hold important implications for research and practice in user‐generated content platforms and beyond.
Giraffe (Giraffa camelopardalis) social networks in areas of contrasting human activity and lion density
Authors: Muller Zoe , Cuthill Innes C. , Harris Stephen 
Published: August 2019

AbstractThe adaptive value of close social bonds and social networks has been demonstrated in a variety of vertebrate taxa. While the effect of predators on populations is well established, disturbance by humans is increasingly being identified as affecting the behaviour and reproductive success of animals and can have significant impacts on their survival. We used a concurrent analysis of two adjacent giraffeGiraffa camelopardalispopulations in Kenya to determine whether human activities and high predation affected their social networks. One study site was a premier tourist destination with a high volume of human activity in the form of tourist traffic and lodge infrastructure, alongside a high density of lions which preferentially prey on giraffe calves; the other was a private wildlife conservancy with minimal human activity and no lion population. Giraffes in both networks showed preferred associations and avoidances of other individuals, which were independent of space use. Bond strength was lower in the population exposed to high levels of human activity and lions, and the network had lower density and clustering, and shorter path lengths, suggesting that it was more fragmented. We suggest that human activity and predator density may influence the patterns of social interactions in giraffes and highlight the importance of understanding the impact of tourism and management on the survival and success of wild animal populations.
Flexibility in a changing arctic food web: Can rough‐legged buzzards cope with changing small rodent communities?
Authors: Fufachev Ivan A. , Ehrich Dorothee , Sokolova Natalia A. , Sokolov Vasiliy A. , Sokolov Aleksandr A. 
Published: August 2019

AbstractIndirect effects of climate change are often mediated by trophic interactions and consequences for individual species depend on how they are tied into the local food web. Here we show how the response of demographic rates of an arctic bird of prey to fluctuations in small rodent abundance changed when small rodent community composition and dynamics changed, possibly under the effect of climate warming. We observed the breeding biology of rough‐legged buzzards (Buteo lagopus) at the Erkuta Tundra Monitoring Site in southern Yamal, low arctic Russia, for 19 years (1999–2017). At the same time, data on small rodent abundance were collected and information on buzzard diet was obtained from pellet dissection. The small rodent community experienced a shift from high‐amplitude cycles to dampened fluctuations paralleled with a change in species composition toward less lemmings and more voles. Buzzards clearly preferred lemmings as prey. Breeding density of buzzards was positively related to small rodent abundance, but the shift in small rodent community lead to lower numbers relative to small rodent abundance. At the same time, after the change in small rodent community, the average number of fledglings was higher relative to small rodent abundance than earlier. These results suggest that the buzzard population adapted to a certain degree to the changes in the major resource, although at the same time density declined. The documented flexibility in the short‐term response of demographic rates to changes in structure and dynamics of key food web components make it difficult to predict how complex food webs will be transformed in a warmer Arctic. The degree of plasticity of functional responses is indeed likely to vary between species and between regions, depending also on the local food web context.
Recent global changes have decoupled species richness from specialization patterns in North American birds
Authors: Mimet Anne , Buitenwerf Robert , Sandel Brody , Svenning Jens‐Christian , Normand Signe 
Published: August 2019

AbstractAimTheory suggests that increasing productivity and climate stability towards the tropics favours specialization, thus contributing to the latitudinal richness gradient. A positive relationship between species richness and specialization should therefore emerge as a fundamental biogeographical pattern. However, land‐use and climate changes disproportionally increase the local extirpation risk for specialists, potentially weakening the relationship between richness and specialization. Here, we quantify empirically the richness–specialization prediction and test how 50 years of climate and land‐use change has affected the richness–specialization relationship.LocationUSA.Time period1966–2015.Major taxa studiedBirds.MethodsWe used the North American Breeding Bird Survey to quantify bird community richness and specialization to habitat and climate. We (a) quantify temporal change in the slope of the richness–specialization relationship, using a generalized mixed model; (b) assess how this change translates spatially, using generalized additive models; and (c) attribute spatio‐temporal change in the richness–specialization relationship to land use, climate and topographic drivers.ResultsWe found evidence for a positive but weak richness–specialization relationship in bird communities that greatly weakened over time. Given that specialization was not the main driver of richness, this relationship did not translate spatially into a linear spatial covariation between richness and specialization. Instead, the spatial covariation in richness and specialization followed a unimodal pattern, the peak of which shifted towards less specialized communities over time. These temporal changes were associated with precipitation change, decreasing temperature stability and land use.Main conclusionsRecent climate and land‐use changes have induced two contrasting types of community responses. In human‐dominated areas, the decoupling of richness and specialization drove a general trend for biotic homogenization. In areas of low human impact experiencing increasing climate harshness, specialization increased, whereas richness decreased. Our results offer new support for specialization as a key driver of macroecological diversity patterns and show that global changes are weakening this fundamental macroecological pattern.
Ambiguous medical abbreviation study: challenges and opportunities
Authors: Holper Sarah , Barmanray Rahul , Colman Blake , Yates Christopher J. , Liew Danny , Smallwood David 
Published: August 2019

AbstractBackgroundHealthcare workers often abbreviate for convenience, but ambiguous abbreviations may cause miscommunication, which jeopardises patient care. Robust large‐scale research to quantify abbreviation frequency and ambiguity in medical documents is lacking.AimsTo calculate the frequency of abbreviations used in discharge summaries, the proportion of these abbreviations that are ambiguous and the potential utility of auto‐expansion software.MethodsWe designed a software programme to extract all instances of abbreviations from every General Medical Unit discharge summary from the Royal Melbourne Hospital in 2015. We manually expanded abbreviations using published inventories and clinical experience, logging multiple expansions for any abbreviation if identified. Abbreviations were classified based on well defined criteria as standardised and likely to be well understood, or ambiguous. Outcome measures included the range and frequency of standardised and ambiguous abbreviations, and the feasibility of electronic auto‐expansion software based on these measures.ResultsOf the 1 551 537 words analysed from 2336 documents, 137 997 (8.9%) were abbreviations with 1741 distinct abbreviations identified. Most abbreviations (88.7%) had a single expansion. The most common abbreviation was PO (per os/orally), followed by BD (bis in die/twice daily) and 68.1% of abbreviations were standardised, largely pertaining to pathology/chemicals. This meant, however, that a large proportion (31.9%) of abbreviations (2.8% of all words) were ambiguous. The most common ambiguous abbreviation was Pt (patient/physiotherapy), followed by LFT (liver function test/lung function test).ConclusionsClose to one‐third of abbreviations used in general medical discharge summaries were ambiguous. Electronic auto‐expansion of ambiguous abbreviations is likely to reduce miscommunication and improve patient safety.
Optimising the response to acute clinical deterioration: the role of observation and response charts
Authors: O'Connell Alice , Flabouris Arthas , Thompson Campbell H. 
Published: August 2019

AbstractWe sought the role of the hospital inpatient observation and response chart (ORC) in reducing adverse outcomes. We sourced articles written in English and published in PubMed. Track, trigger and response systems can be tiered and use single parameter or aggregate scoring systems, the latter being more prone to error. The documentation and detection of abnormal vital signs can be affected by choice of trigger and response and by ORC design. There is considerable variation in the design of ORC and of rapid response systems (RRS) in general, and this impairs assessment of their efficacy. A high rate of modification of pre‐determined triggers and poor sensitivity of measured outcomes further compromise systematic review. The best‐designed ORC and RRS should optimise the frequency of response team activation to minimise adverse patient outcomes without excess resource utilisation. The role and the risks of electronic data recording are under‐explored. Detecting and responding to deteriorating patients relies on accurate and clear documentation of vital signs. ORC design and staff education on ORC implementation and usage are integral to minimising ALF and optimising patient outcomes. Standardisation of the design of both the ORC and the hospital RRS are overdue.
Determination of interdiffusion coefficients of Si and Al in Ti3SiC2–Ti3AlC2 diffusion couple at 1373‐1673 K
Authors: Zhang Zerong , Yin Xiaohui , Qian Yuhai , Xu Jingjun , Zuo Jun , Li Meishuan 
Published: August 2019

AbstractIn the diffusion couple of Ti3SiC2 and Ti3AlC2, only interdiffusion of Si and Al occurred during diffusion treatment process. Based on the concentration profiles of Si and Al measured by electron probe microanalysis (EPMA), the interdiffusion coefficients of Si and Al at 1373‐1673 K in Ti3SiC2–Ti3AlC2 diffusion couple were determined by both the Boltzmann‐Matano (B‐M) method and the Saucer‐Freise (S‐F) method. At the position of Matano plane with the composition of Ti3Al0.5Si0.5C2, the interdiffusion coefficient could be expressed as Dint (m2/s) = 5.6 × 10−4⋅exp [−246 ± 14 (kJ/mol)/RT]. Based on the two methods, the calculated interdiffusion coefficients increased with increasing temperature, and the magnitudes of their absolute values were on the order of 10–13‐10–11 m2/s at 1373‐1673 K. At 1373‐1573 K, the calculated interdiffusion coefficients decreased monotonously with the increase of Si concentration, that is, xSi/(xAl + xSi). But at 1673 K, the variation trend of interdiffusion coefficients with xSi/(xAl + xSi) was no longer monotonous, probably due to the presence of Ti5Si3 phase and voids on Ti3AlC2 side.
Peptide and non‐peptide mimetics as potential therapeutics targeting oral bacteria and oral biofilms
Authors: Sztukowska Maryta N. , Roky Mohammad , Demuth Donald R. 
Published: August 2019

AbstractThe development of the oral biofilm requires a complex series of interactions between host tissues and the colonizing bacteria as well as numerous interspecies interactions between the organisms themselves. Disruption of normal host–microbe homoeostasis in the oral cavity can lead to a dysbiotic microbial community that contributes to caries or periodontal disease. A variety of approaches have been pursued to develop novel potential therapeutics that are active against the oral biofilm and/or target specific oral bacteria. The structure and function of naturally occurring antimicrobial peptides from oral tissues and secretions as well as external sources such as frog skin secretions have been exploited to develop numerous peptide mimetics and small molecule peptidomimetics that show improved antimicrobial activity, increased stability and other desirable characteristics relative to the parent peptides. In addition, a rational and minimalist approach has been developed to design small artificial peptides with amphipathic α‐helical properties that exhibit potent antibacterial activity. Furthermore, with an increased understanding of the molecular mechanisms of beneficial and/or antagonistic interspecies interactions that contribute to the formation of the oral biofilm, new potential targets for therapeutic intervention have been identified and both peptide‐based and small molecule mimetics have been developed that target these key components. Many of these mimetics have shown promising results in in vitro and pre‐clinical testing and the initial clinical evaluation of several novel compounds has demonstrated their utility in humans.
Not as a Means: Killing as a Side Effect in Self‐defense
Authors: Gordon‐Solmon Kerah 
Published: August 2019

AbstractA person drives her well‐maintained car cautiously and alertly to the movies. Freak circumstances send the car out of control. It veers in the direction of a pedestrian whom it will kill unless she, or a third party, blows it up with a grenade.Whether the driver is liable to be thusly killed polarizes debates about the ethics of self‐defense. But debaters frequently conflate the questions of whether and by what means the driver is liable to be killed. The paper separates these questions: it argues the driver's liability to lethal harm need not entail her liability to the grenade.
Portable Innovation, Policy Wormholes, and Innovation Diffusion
Authors: Yi Hongtao , Chen Wenna 
Published: August 2019

AbstractThis article explores the effects of city managers' career paths on the diffusion of climate policy innovation among municipal governments in the United States. Using the agent network diffusion (AND) model, the authors hypothesize that local climate policy innovations are portable and that cities may learn from distant jurisdictions to which they are connected through the career paths of managers, a phenomenon termed the “policy wormhole” effect. Employing a dyadic panel data set of more than 400 Florida cities from 2005 to 2010, these hypotheses are tested using dyadic event history analysis. The results support both the portable innovation hypothesis and the policy wormhole hypothesis. Cities can facilitate the diffusion of policy innovations by paying special attention to the recruitment process of city managers.
Clostridioides difficile on Ohio swine farms (2015): A comparison of swine and human environments and assessment of on‐farm risk factors
Authors: O’Shaughnessy Rory A. , Habing Gregory G. , Gebreyes Wondwossen A. , Bowman Andrew S. , Weese J. Scott , Rousseau Joyce , Stull Jason W. 
Published: August 2019

AbstractSwine are known reservoirs for Clostridioides difficile, formerly known as Clostridium difficile, and transmission from swine to human farm workers is strongly suggested by previous studies. This cross‐sectional study evaluated the potential role of farm environmental surfaces, including those in worker breakrooms and swine housing areas, in the possible transmission of C. difficile from swine to farm workers. Environmental surfaces and piglet faeces at 13 Ohio swine farms were sampled in 2015. Typical culturing techniques were performed to isolate C. difficile from samples, and amplification of toxin genes (tcdA, tcdB and cdtB) and PCR‐ribotyping were used to genetically characterize recovered isolates. In addition, sequencing of toxin regulatory gene, tcdC, was done to identify the length of identified deletions in some isolates. A survey collected farm‐level management risk factor information. Clostridioides difficile was recovered from all farms, with 42% (188/445) of samples testing positive for C. difficile. Samples collected from all on‐farm locations recovered C. difficile, including farrowing rooms (60%, 107/178), breakrooms (50%, 69/138) and nursery rooms (9%, 12/129). Three ribotypes recovered from both swine and human environments (078, 412 and 005) have been previously implicated in human disease. Samples taken from farrowing rooms and breakrooms were found to have greater odds of C. difficile recovery than those taken from nursery rooms (OR = 40.5, OR = 35.6, p < .001 respectively). Farms that weaned ≥23,500 pigs per year had lower odds of C. difficile recovery as compared to farms that weaned fewer pigs (OR = 0.4, p = .01) and weekly or more frequent cleaning of breakroom counters was associated with higher odds of C. difficile recovery (OR = 11.7, p < .001). This study provides important insights into the presence and characterization of C. difficile found in human environments on swine farms and highlights how these areas may be involved in transmission of C. difficile to swine farm workers and throughout the facility.