bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le mariage à Lifou, une création missionnaire ?
Authors: Nicolas Hélène 
Published: May 2018

Résumé
Cet article souhaite montrer à quel point les rituels de mariage dits « coutumiers » et les normes de la relation conjugale à Lifou, île de la Kanaky-Nouvelle-Calédonie, ont été modifiés voire instaurés par les missionnaires protestants et catholiques, arrivés respectivement en 1842 et 1858. La réforme du mariage, centrale dans l’ œuvre missionnaire en pays kanak, a été impulsée à Lifou par l’ évangéliste polynésien Fao, et poursuivie par les missionnaires de la London Missionary Society et de la Société de Marie. Ils ont ainsi contribué à changer radicalement les rituels matrimoniaux et la « vie de foyer », les bases du mariage actuel ayant été littéralement inventées au XIXème siècle.
The Role of Individual Surface Flux Components in the Passive and Active Ocean Heat Uptake
Authors: Garuba Oluwayemi A. , Klinger Barry A. 
Published: May 2018

AbstractSurface flux perturbations (heat, freshwater, and wind) due to an increase of atmospheric CO2 cause significant intermodel spread in ocean heat uptake; however, the mechanism underlying their impact is not very well understood. Here, we use ocean model experiments to isolate the impact of each perturbation on the ocean heat uptake components, focusing on surface heat flux anomalies caused directly by atmospheric CO2 increase (passive) and indirectly by ocean circulation change (active). Surface heat flux perturbations cause the passive heat uptake, while all the surface flux perturbations influence ocean heat uptake through the active component. While model results have implied that the active component increases ocean heat uptake because of the weakening of the Atlantic meridional overturning circulation (AMOC), we find that it depends more on the shallow circulation change patterns. Surface heat flux perturbation causes most of the AMOC weakening, yet it causes a net global active heat loss (12% of the total uptake), which occurs because the active heat loss in the tropical Pacific through the subtropical cell weakening is greater than the active heat gain in the subpolar Atlantic through AMOC weakening. Freshwater perturbation weakens the AMOC a little more, but increases the subpolar Atlantic heat uptake a great deal through a large weakening of the subpolar gyre, thereby causing a large global active heat gain (34% of the total uptake). Wind perturbation also causes an active heat loss largely through the poleward shift of the Southern Hemisphere subtropical cells.
The Influence of Aerosol Absorption on the Extratropical Circulation
Authors: Shen Zhaoyi , Ming Yi 
Published: May 2018

AbstractThis study examines how aerosol absorption affects the extratropical circulation by analyzing the response to a globally uniform increase in black carbon (BC) simulated with an atmospheric general circulation model forced by prescribed sea surface temperatures. The model includes aerosol direct and semidirect effects, but not indirect or cloud-absorption effects. BC-induced heating in the free troposphere stabilizes the midlatitude atmospheric column, which results in less energetic baroclinic eddies and thus reduced meridional energy transport at midlatitudes. Upper-tropospheric BC also decreases the meridional temperature gradient on the equatorward flank of the tropospheric jet and yields a weakening and poleward shift of the jet, while boundary layer BC has no significant influence on the large-scale circulation since most of the heating is diffused by turbulence in the boundary layer. The effectiveness of BC in altering circulation generally increases with height. Dry baroclinic eddy theories can explain most of the extratropical response to free-tropospheric BC. Specifically, the decrease in vertical eddy heat flux related to a more stable atmosphere is the main mechanism for reestablishing atmospheric energy balance in the presence of BC-induced heating. Similar temperature responses are found in a dry idealized model, which further confirms the dominant role of baroclinic eddies in driving the extratropical circulation changes. The strong atmospheric-only response to BC suggests that absorbing aerosols are capable of altering synoptic-scale weather patterns. Its height dependence highlights the importance of better constraining model-simulated aerosol vertical distributions with satellite and field measurements.
In silico (computed) modelling of doses and dosing regimens associated with morphine levels above international legal driving limits
Authors: Boland Jason W , Johnson Miriam , Ferreira Diana , Berry David J 
Published: May 2018

Background: Morphine can cause central nervous system side effects which impair driving skills. The legal blood morphine concentration limit for driving is 20 µg/L in France/Poland/Netherlands and 80 µg/L in England/Wales. There is no guidance as to the morphine dose leading to this concentration. Aim: The in silico (computed) relationship of oral morphine dose and plasma concentration was modelled to provide dose estimates for a morphine plasma concentration above 20 and 80 µg/L in different patient groups. Design: A dose–concentration model for different genders, ages and oral morphine formulations, validated against clinical pharmacokinetic data, was generated using Simcyp®, a population-based pharmacokinetic simulator. Setting/participants: Healthy Northern European population parameters were used with age, gender and renal function being varied in the different simulation groups. In total, 36,000 simulated human subjects (100 per modelled group of different ages and gender) received repeated simulated morphine dosing with modified-release or immediate-release formulations. Results: Older age, women, modified-release formulation and worse renal function were associated with higher plasma concentrations. Across all groups, morphine doses below 20 mg/day were unlikely to result in a morphine plasma concentration above 20 µg/L; this was 80 mg/day with the 80 µg/L limit. Conclusion: This novel study provides predictions of the in silico (computed) dose–concentration relationship for international application. Individualised morphine prescribing decisions by clinicians must be informed by clinical judgement considering the individual patient’s level of impairment and insight irrespective of the blood morphine concentration as people who have impaired driving will be breaking the law. Taking into account expected morphine concentrations enables improved individualised decision making.
Pharmacists’ Perceptions of Feasibility and Development of a Weight Management Program for Implementation in Community Pharmacies
Authors: Rong Yiran , Ward Lori M. , Haines Seena , Rosenthal Meagen 
Published: May 2018

Background: Community pharmacists-directed weight management programs have demonstrated positive impacts. Objective: To explore the feasibility of developing a community pharmacy-based weight management program by examining pharmacists’ perceptions of the implementation of such a program in their practice setting. Methods: This study employed a cross-sectional online survey design. The respondents were registered community pharmacists in the southeastern United States. The survey contained 5 sections including demographics and questions gauging pharmacists interest in the proposed program. Survey findingswere examined using descriptive statistics, and analysis of variance (ANOVA). Results: A total of 426 surveys were completed and returned. Over half (53.3%) of the respondents obtained a BSc in Pharmacy. Several respondents were already providing prescription (44.1%) or over-the-counter (OTC) product (30.4%) recommendations to patients interested in weight management. Approximately 35% of respondents were at least somewhat interested in starting a weight management program. Pharmacists self-identifying as practicing in chain pharmacy or rural settings or as being staff pharmacists were less in favor of implementing a program than the other groups. Conclusions: Community pharmacists’ respondents appeared interested in implementing a weight management program. The information gathered herein will be used to design a weight management program specifically for community pharmacies.
Zombies vs. Anxiety: An Augmentation Study of Prescribed Video Game Play Compared to Medication in Reducing Anxiety Symptoms
Authors: Fish Matthew T. , Russoniello Carmen V. , O’Brien Kevin 
Published: May 2018

Objective. Anxiety is a typical reaction to stress and when uncontrolled, clinical anxiety disorders may develop. Traditional anxiety interventions have established efficacy; however, they are often costly and stigmatizing. This study examined prescribed casual video game (CVG) play added to an SSRI prescription in reducing symptoms of anxiety compared to a two-medication treatment group. Materials and methods. We used data from a larger study examining depression and CVGs. The Quick Inventory of Depressive Symptomology screened participants for depression using a score of ≥ 5 (mild depression). Participants chose to participate in the alternative (n = 30) or traditional (n = 24) group. Alternative group participants were prescribed CVG play four times per week for 30-45 minutes over a one-month period. Traditional intervention group participants were prescribed a second medication. The State-Trait Anxiety Inventory was used to test hypotheses. Results. Repeated-measures ANOVA demonstrated a significant decrease in state anxiety scores after the one-month prescription and a medium to large effect for the alternative group. Trait anxiety results did not demonstrate significance; however, the group had a medium effect size. Conclusion. Clinicians should consider these non-stigmatizing and low-cost CVGs as a feasible intervention for patients who wish not to take additional medication.
An evaluation of proximal femur bone density in young, active patients undergoing total hip arthroplasty at one year postoperatively
Authors: Nam Denis , Salih Rondek , Barrack Robert L , Nunley Ryan M 
Published: May 2018

Background: Prior investigations have shown a decrease in periprosthetic bone mineral density (BMD) of the calcar following total hip arthroplasty (THA). The purpose of this investigation was to study proximal femur BMD in a cohort of young, active patients following THA at 1 year postoperatively using a recently introduced stem design. Methods: This was a prospective, IRB-approved investigation of patients with an age <65 years, BMI <35 kg/m2, and presymptomatic UCLA score of >6 undergoing a primary THA for a diagnosis of osteoarthritis. All patients received a titanium, proximally coated, tapered cementless femoral stem (ACCOLADE II, Stryker Inc, Mahwah, NJ, USA). Dual energy X-ray absorptiometry scans were performed at 6 weeks, 6 months, and 1 year postoperatively. Bone density was analyzed for 7 traditional Gruen zones with BMD ratios calculated for change in BMD compared with the baseline. Results: 31 patients (mean age of 52.6 + 6.5 years, BMI of 27.9 + 3.9 kg/m2, and UCLA activity score of 7.3 + 1.9) were included. The mean BMD ratio decreased at the 6 months and 1 year interval in zones 1 and 2. However, the mean BMD ratio was maintained in Gruen zones 3 thru 7 with zone 7 (medial calcar) demonstrating 100% maintenance of the baseline BMD at 1 year. Conclusion: This study demonstrates the maintenance of medial calcar bone density at 1 year postoperatively in young, active patients undergoing THA. Further longitudinal analysis of this stem design is necessary to elucidate the significance of this finding.
Effectiveness of a Day Rehabilitation Program in Improving Functional Outcome and Reducing Mortality and Readmission of Elderly Patients With Fragility Hip Fractures
Authors: Wong Tak Man , Leung Frankie K. L. , Lau Tak Wing , Fang Christian , Chan Felix H. W. , Wu Jun 
Published: May 2018

Introduction: The incidence of hip fracture is projected to increase in the next 25 years as the world population ages. Hip fracture is often associated with subsequent readmission and mortality. Nevertheless, elderly patients often may not achieve the same level of functional ability as prior to their injury. Several studies have shown that close collaboration between orthopedic surgeons and geriatricians can improve such outcomes and Geriatric Day Hospital (GDH) is one of the examples of collaboration to improve such outcomes. The aim of this descriptive retrospective study is to review the effectiveness of the day rehabilitation program provided by a GDH on functional outcomes, mortality, and readmission rate, among a sample of elderly patients with hip fracture. Methods: The medical records of patients from January 1, 2009, to December 31, 2012, were collected and evaluated. Demographic data of the patients and Charlson Comorbidity Index were collected. The Barthel Index, Elderly Mobility Scale, and Mini-Mental State Examination were measured on admission and at discharge of the patients to evaluate both physical and cognitive functions. Results: The results showed that the majority of patients benefited from rehabilitation in the GDH. The 12-month mortality rate of patients taking full-course rehabilitation in the GDH was improved. The age of patient was the most important factor influencing the rehabilitation outcomes. Gender was the only risk factor for 12-month mortality and 6-month readmission. Discussion: Since patients were selected to attend GDH, there was a bias during the selection of patients. Furthermore, it was difficult to compare patients attended GDH with patients who did not because outcomes of the latter were difficult to be recorded. Conclusions: Our study shows that postoperative geriatric hip fracture patients definitely can benefit from rehabilitation service offered by GDH in terms of functional and cognitive outcomes.
Defining success with cellular therapeutics: the current landscape for clinical end point and toxicity analysis
Authors: Kean Leslie S. 
Published: May 2018

Abstract
Cellular therapies play a major and expanding role in the treatment of hematologic diseases. For each of these therapies, a narrow therapeutic window exists, where efficacy is maximized and toxicities minimized. This review focuses on one of the most established cellular therapies, hematopoietic stem cell transplant, and one of the newest cellular therapies, chimeric antigen receptor–T cells. In this review, I will discuss the current state of the field for clinical end point analysis with each of these therapeutics, including their critical toxicities, and focus on the major elements of success for each of these complex treatments for hematologic disease.
Single-inhaler triple therapy in symptomatic COPD patients: FULFIL subgroup analyses
Authors: Halpin David M.G. , Birk Ruby , Brealey Noushin , Criner Gerard J. , Dransfield Mark T. , Hilton Emma , Lomas David A. , Zhu Chang-Qing , Lipson David A. 
Published: May 2018

Triple inhaled corticosteroid (ICS)/long-acting muscarinic antagonist (LAMA)/long-acting β2-agonist (LABA) therapy is recommended for symptomatic patients with chronic obstructive pulmonary disease (COPD) and at risk of exacerbations. However, the benefitsversusside-effects of triple inhaled therapy for COPD, based on distinct patient clinical profiles, are unclear.FULFIL, a phase III, randomised, double-blind study, compared 24 weeks of once-daily fluticasone furoate/umeclidinium/vilanterol (FF/UMEC/VI) 100/62.5/25 µg using the Ellipta inhaler with twice-daily budesonide/formoterol (BUD/FOR) 400/12 µg using the Turbuhaler. Subgroup analyses of forced expiratory volume in 1 s (FEV1), St George's Respiratory Questionnaire (SGRQ) Total score and exacerbation rates were carried out. Subgroups were defined by COPD medication at screening (ICS+LABA, BUD+FOR, ICS+LABA+LAMA, LAMA alone, tiotropium alone and LAMA+LABA), by disease severity (lung function and exacerbations) and by exacerbation history (exacerbation severity and frequency).In the intent-to-treat population (n=1810) at week 24, FF/UMEC/VI (n=911)versusBUD/FOR (n=899) improved FEV1and SGRQ Total score and reduced mean annual exacerbation rates in all disease severity and exacerbation history subgroups. FF/UMEC/VIversusBUD/FOR improved FEV1and SGRQ Total score in all medication subgroups and reduced mean annual exacerbation rates in all medication subgroups, except LAMA+LABA. Adverse events were similar across subgroups.These findings support the benefit of FF/UMEC/VI compared with dual ICS/LABA therapy in patients with symptomatic COPD regardless of disease severity or prior treatment and may help to inform clinical decision making.
What leads to innovation in mental healthcare? Reflections on clinical expertise in a bureaucratic age
Authors: Armstrong Neil 
Published: May 2018

SummaryThis paper considers a witness seminar in which healthcare professionals discussed working on an acute admissions ward run along therapeutic community lines from the 1960s to the 1980s. Participants remarked that older styles of working are ‘unimaginable’ today. This paper discusses why. Literature from the humanities and social sciences suggest healthcare is reactive, reflecting wider cultural changes, including a preference for a more bureaucratic, standardised, explicit style of reasoning and a high valuation of personal autonomy. Such a reflection prompts questions about the nature of professional expertise, the role of evidence and the importance of the humanities and social sciences.Declaration of interestNone.
Association of Perfluoroalkyl and Polyfluoroalkyl Substances With Premature Ovarian Insufficiency in Chinese Women
Authors: Zhang Suyun , Tan Rongrong , Pan Rui , Xiong Jianwei , Tian Ying , Wu Jie , Chen Ling 
Published: May 2018

Abstract

Context
Perfluoroalkyl and polyfluoroalkyl substances (PFASs), a group of ubiquitous environmental chemicals with properties of endocrine disruption, are often detectable in humans.

Objective
The current study investigated the association between exposure to PFAS and primary ovarian insufficiency (POI).

Design, Patients, Interventions, and Main Outcome Measures
Levels of plasma PFAS were measured in 120 Chinese women with overt POI and 120 healthy control subjects from 2013 to 2016. Associations between PFAS levels and odds of POI, as well as hormonal profiles, were evaluated using multiple logistic regression and multiple linear regression models.

Results
Levels of perfluorooctanate (PFOA), perfluorooctane sulfonate (PFOS), and perfluorohexanesulfonate (PFHxS) were positively associated with the risks of POI (highest vs. lowest tertile, PFOA: OR, 3.80; 95% CI, 1.92–7.49; PFOS: OR, 2.81; 95% CI, 1.46–5.41; PFHxS: OR, 6.63; 95% CI, 3.22–13.65). In patients with POI, levels of PFOS and PFHxS exposure were positively associated with FSH (PFOS: adjusted β, 0.26; 95% CI, 0.15 to 0.38; PFHxS: adjusted β, 0.16; 95% CI, 0.04 to 0.28) and negatively associated with estradiol (PFOS: adjusted β, −0.30; 95% CI, −0.47 to −0.12; PFHxS: adjusted β, −0.19; 95% CI, −0.37 to −0.02). Exposure to PFOS and PFOA was associated with elevation of prolactin (PFOS: adjusted β, 0.17; 95% CI, 0.06 to 0.29; PFOA: adjusted β, 0.16; 95% CI, 0.01 to 0.30) or with a decrease of free triiodothyronine (PFOS: adjusted β, −0.88; 95% CI, −1.64 to −0.09; PFOA: adjusted β, −0.90; 95% CI, −1.88 to 0.09) and thyroxine (PFOS: adjusted β, −2.99; 95% CI, −4.52 to −1.46; PFOA: adjusted β, −3.42; 95% CI, −5.39 to −1.46).

Conclusion
High exposure to PFOA, PFOS, and PFHxS is associated with increased risk of POI in humans.
Ensino universitário como meta-profissão
Authors: Aranha Francisco 
Published: May 2018

Apesar do aumento do número de professores com formação universitária no Brasil, nota-se, frequentemente, a falta de preparo para a docência. A atividade de ensino passou a exigir habilidades complexas e hoje não bastam conhecimentos a respeito de uma determinada disciplina. Sobre esta base necessária, mas insuficiente, assenta-se uma profissão inteiramente nova.
AVALIAÇÃO DA QUALIDADE DA DIETA DE CRIANÇAS E ADOLESCENTES COM EXCESSO DE PESO ATENDIDOS NO AMBULATÓRIO DE NUTRIÇÃO DE UM HOSPITAL PÚBLICO DO RECIFE - PE
Authors: Araújo Lizelda Maria de , Barros Marina Hortência da Silva , Andrade Maria Izabel Siqueira de , Araújo Edvânia César de , Santos Cláudia Mota dos , Dourado Keila Fernandes 
Published: May 2018

Objetivos: Avaliar a qualidade da dieta de crianças e adolescentes com excesso de peso atendidos no ambulatório de nutrição de um hospital público de Recife, Pernambuco. Métodos: Estudo transversal, com crianças e adolescentes com diagnóstico de excesso de peso, atendidos no ambulatório de nutrição de um hospital público de Recife. No período de março a setembro de 2015, foram coletadas variáveis sociodemográficas, comportamentais, antropométricas e dietéticas. A qualidade da dieta foi avaliada através do Índice de Alimentação Saudável Adaptado (IASad) e do Fator Inflamatório (FI). As análises estatísticas foram feitas no programa Statistical Package for the Social Sciences (SPSS), versão 20.0, sendo confirmada significância estatística quando p < 0,05. Resultados: Dos 30 pacientes estudados, houve maior percentagem de adolescentes (66,7%) e do sexo masculino (63,3%). Nenhum paciente avaliado apresentou dieta de boa qualidade. O IASad se associou com sexo, consulta com nutricionista, atividade física, refeições com a família, refeições na frente da TV e circunferência do pescoço. Já o FI se associou apenas com o consumo de fibras. Conclusões: Evidenciou-se elevada proporção de dieta pró-inflamatória entre os pacientes com excesso de peso, verificando-se que nenhum deles obteve uma dieta de boa qualidade.DOI: 10.12957/demetra.2018.28913
Treatment of osteoporosis: whom, how and for how long?
Authors: Dede Anastasia D , Callan Margaret 
Published: May 2018

Identification of patients at risk for fragility fractures is the first important step in the management of osteoporosis. Bisphosphonates have been the mainstay of treatment for decades, whereas denosumab and selective oestrogen receptor modulators are other available licensed antiresorptive drugs. Currently teriparatide is the only approved anabolic agent in Europe, while abaloparatide and romosozumab are awaiting approval and might be available in the near future. For bisphosphonates, current guidance suggests an initial treatment course of 3–5 years and more prolonged treatment should be pursued in patients with higher fracture risk. For patients with lower risk, a period off treatment might be considered after this initial course to minimize the risks associated with more prolonged treatment, but this only applies to bisphosphonates and not denosumab or teriparatide. This review discusses strategies for case finding of patients at risk, currently available treatment options, recent developments in pharmacological management and duration of treatment.
Anaesthesia: what a surgeon needs to know
Authors: Valsamis EM , Sadler J , Kennedy T , Thornhill C , Carey C , Ricketts D 
Published: May 2018

Surgeons and anaesthetists work closely together, sometimes in challenging circumstances. To help surgeons cooperate with anaesthetists to deliver high quality care for patients, a working knowledge of modern anaesthetic practice is useful. The specialty of anaesthetics is developing rapidly, and periodic updating of this knowledge is likely to be required. This article provides an update of anaesthetic practice for surgeons, covering the varied roles of anaesthetists, preoperative assessment, management on the day of surgery (induction, maintenance and reversal of anaesthetic), general anaesthesia, the role of regional blocks and sedation. It also discusses safety issues, the management of frail patients and future challenges.