bluuebunny/crossref_metadata_2025_split huggingface dataset:
Did expansion of health insurance coverage reduce horizontal inequity in healthcare finance? A decomposition analysis for China
Authors: Wang Zhonghua , Zhou Xue , Gao Yukuan , Chen Mingsheng , Palmer Andrew J , Si Lei 
Published: January 2019

Objectives‘Horizontal inequity’ in healthcare finance occurs when people with equal income contribute unequally to healthcare payments. Prior research is lacking on horizontal inequity in China. Accordingly, this study set out to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 through two rounds of national household health surveys.DesignTwo rounds of cross-sectional study.SettingHeilongjiang Province, China.ParticipantsAdopting a multistage stratified random sampling, 3841 households with 11 572 individuals in 2003 and 5530 households with 15 817 individuals in 2008 were selected.MethodsThe decomposition method of Aronsonet alwas used in the present study to measure the redistributive effects and horizontal inequity in healthcare finance.FindingsOver the period 2002–2007, the absolute value of horizontal inequity in total healthcare payments decreased from 93.85 percentage points to 35.50 percentage points in urban areas, and from 113.19 percentage points to 37.12 percentage points in rural areas. For public health insurance, it increased from 17.84 percentage points to 28.02 percentage points in urban areas, and decreased from 127.93 percentage points to 0.36 percentage points in rural areas. Horizontal inequity in out-of-pocket payments decreased from 79.92 percentage points to 24.83 percentage points in urban areas, and from 127.71 percentage points to 53.10 percentage points in rural areas.ConclusionsOur results show that horizontal inequity in total healthcare financing decreased over the period 2002–2007 in China. In addition, out-of-pocket payments contributed most to the extent of horizontal inequity, which were reduced both in urban and rural areas over the period 2002–2007.
Combined nitrous oxide 70% with intranasal fentanyl for procedural analgosedation in children: a prospective, randomised, double-blind, placebo-controlled trial
Authors: Seiler Michelle , Staubli Georg , Landolt Markus A. 
Published: January 2019

ObjectiveNitrous oxide 70% (N2O 70%) is an excellent medication for procedural analgosedation (PAS), yet the limit of its analgesic power remains uncertain; therefore, a combination with intranasal fentanyl (INF) was suggested. However, this combination seems to result in a higher rate of vomiting and deeper sedation. This study aimed at assessing the analgesic efficacy, sedation depth and rate of adverse events of PAS with N2O 70% with and without INF.MethodsPatients aged 2–16 years who qualified for PAS with N2O 70% were randomly assigned to receive either INF or placebo prior to N2O inhalation in this randomised, double-blind study, which was performed in a tertiary children’s hospital ED between September 2015 and October 2017. Behaviour during the procedure was evaluated using the Face, Leg, Activity, Cry and Consolability (FLACC) scale and the Modified Behavioural Pain Scale (MBPS); analgesic efficacy was assessed with a self-reported pain scale. Sedation depth using the validated University of Michigan Sedation Scale and adverse events in the ED and during the following 12 hours were documented.ResultsA total of 402 patients were included; 3 did not tolerate N2O and therefore had to be excluded. Overall, 399 patients were analysed, of whom 201 (50.4%) received INF. No significant group differences with regard to FLACC scale score, self-reported pain, MBPS score and sedation depth were found. In addition, the two groups did not differ with regard to all types of adverse events.ConclusionCombining N2O 70% with INF resulted in no differences with regard to FLACC scale score, self-reported pain, MBPS score, patient and parental satisfaction rate, sedation depth, and adverse events.Trial registration numberNCT02533908
Management of acute retrobulbar haemorrhage: a survey of non-ophthalmic emergency department physicians
Authors: Edmunds Matthew R , Haridas Anjana S , Morris Daniel S , Jamalapuram Kasyap 
Published: January 2019

IntroductionAcute retrobulbar haemorrhage (RBH) with orbital compartment syndrome is a sight-threatening ophthalmic emergency requiring treatment with lateral canthotomy and cantholysis (LC/C). However, such cases may present to non-ophthalmic emergency departments (ED) out-of-hours, when specialist intervention is not readily available. We completed a survey of ED physicians to explore experiences of RBH and confidence in undertaking LC/C.MethodsFrom February to April 2018, an online survey was sent to ED physicians of all training grades in seven UK locations. The survey comprised a case vignette of a patient presenting with clinical features of RBH with orbital compartment syndrome, with multiple choice questions on the diagnosis, management and onward referral of such cases. Additional questions explored the experience of RBH, LC/C and perspectives on current and future training of ED physicians in this area.Results190 ED doctors completed the survey (response rate 70%). While 82.8% correctly diagnosed RBH and 95.7% recognised irreversible visual loss as a consequence of untreated RBH with orbital compartment syndrome, 78.7% indicated that they would initially undertake CT imaging rather than performing LC/C. Only 38.9% had previously encountered a case of RBH and only 37.1% would perform LC/C themselves, with 91.4% indicating that this was due to lack of training. 92.2% felt that more training was required for ED physicians in RBH management and performing LC/C.ConclusionWhile cases of RBH with orbital compartment syndrome are infrequent, it is important that RBH management with the vital, sight-saving skill of LC/C is added to the United Kingdom Royal College of Emergency Medicine training curriculum. At present, though the majority of ED physicians can identify RBH, the minority are willing or able to undertake LC/C, potentially risking irreversible but avoidable visual loss.
Low levels of ideal cardiovascular health in a semi-urban population of Western Nepal: a population-based, cross-sectional study
Authors: Gyawali Bishal , Mishra Shiva Raj , Virani Salim S , Kallestrup Per 
Published: January 2019

BackgroundThe aim of this study was to assess the status of cardiovascular health among a semi-urban population of Nepal, and determine factors associated with ideal cardiovascular health.MethodsA population-based, cross-sectional study using a systematic random sample was conducted among 2310 adults aged ≥ 25 years in a semi-urban area of the Pokhara Metropolitan City previously named Lekthnath in Nepal. The ideal, intermediate and poor cardiovascular health were defined as the presence of 6–7, 4–5 or 1–3 health metrics, among a list of 7 health behaviours and healthfactors, namely smoking, body mass index, physical activity, fruits and vegetables intakes, harmful alcohol consumption, blood pressure, and fasting blood glucose. We used univariate and multivariate Poisson regression models adjusting for sex, age groups, ethnicity, educational level and socioeconomic status, and calculated the prevalence ratios with 95% CIs.ResultsOnly 14.3 % of the participants had ideal cardiovascular health, whereas 67.0% and 18.7% of the participants had intermediate and poor cardiovascular health, respectively. Age groups 45–54 years (prevalence ratio 0.88, 95% CI: 0.83 to 0.94, p<0.001) and 55–64 years (prevalence ratio 0.84, 95% CI: 0.79 to 0.90, p<0.001) were significantly associated with low prevalence of ideal cardiovascular health compared with the age group 35–44 years. Ethnic groups, including Janajati (prevalence ratio 0.89, 95% CI: 0.85 to 0.93, p<0.001) and Dalit (prevalence ratio 0.9, 95% CI: 0.84 to 0.95, p=0.001), were significantly associated with low prevalence of ideal cardiovascular health.ConclusionsPrevalence of ideal cardiovascular health is low in the semi-urban population in Nepal. Concerted efforts are needed to develop a population-based intervention to improve cardiovascular health in Nepal.
Effects of onabotulinumtoxinA treatment for chronic migraine on common comorbidities including depression and anxiety
Authors: Blumenfeld Andrew M , Tepper Stewart J , Robbins Lawrence D , Manack Adams Aubrey , Buse Dawn C , Orejudos Amelia , D Silberstein Stephen 
Published: January 2019

ObjectiveTo assess the effects of onabotulinumtoxinA treatment for chronic migraine (CM) on comorbid symptoms of depression, anxiety, fatigue and poor sleep quality.MethodsThe Chronic Migraine OnabotulinuMtoxinA Prolonged Efficacy open-Label (COMPEL) study is a multicentre, open-label, prospective study assessing the long-term safety and efficacy of onabotulinumtoxinA 155 U over nine treatments (108 weeks) in adults with CM. The Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder (GAD-7) scales were used to assess the effects of onabotulinumtoxinA on comorbid symptoms of depression and anxiety, respectively. A clinically meaningful improvement was assessed by the percentage of patients experiencing a ≥1 severity category reduction in PHQ-9 and GAD-7. The effects of onabotulinumtoxinA on associated sleep quality and fatigue were assessed using the Pittsburgh Sleep Quality Index and Fatigue Severity Scale, respectively.ResultsOnabotulinumtoxinA treatment was associated with sustained reduction in headache days and PHQ-9 and GAD-7 scores in the analysis population (n=715) over 108 weeks. PHQ-9 and GAD-7 scores were significantly reduced at all time points in patients with clinically significant symptoms of depression and/or anxiety at baseline. By week 108, 78.0% and 81.5% had clinically meaningful improvement in depression and anxiety symptoms, respectively. Sleep quality and symptoms of fatigue also improved; however, less is understood about clinically meaningful changes in these measures. No new safety concerns were identified.ConclusionIn addition to reducing headache frequency, onabotulinumtoxinA treatment for CM was associated with clinically meaningful reduction in symptoms of depression and anxiety, and improved associated symptoms of poor sleep quality and fatigue.Trial registration numberNCT01516892.
Adaptation of fluid inclusion techniques for investigating gas charge – examples from the Caswell Sub-basin, Browse Basin, Australia
Authors: Bourdet Julien F. R. , Heath Charles H. , Kempton Richard H. 
Published: January 2019

Abstract

Palaeoformation water trapped in quartz cements in sandstone during diagenesis is typically of interest for constraining the temperature history, cementation and timing of hydrocarbon charge. Recent progresses in developing methods for salinity measurement, gas detection (CH
4
, CO
2
, N
2
, H
2
S) and fluid modelling of the CH
4
–H
2
O–NaCl system by combining conventional microthermometry techniques with Raman spectroscopy provide powerful tools for investigating formation water and its evolution in gas-bearing basins. Samples from the aquifer, in the Plover Formation and in the Brewster Member in the Upper Vulcan Formation, underlying large gas accumulations in the Caswell Sub-basin provided an opportunity to test these new techniques and generate data on formation water evolution. Temperature of homogenization, salinity and gas content of water inclusions show that the salinity of the palaeoformation waters decreased with increasing methane content and temperature. Detection of CO
2
shows, however, that water inclusions with dissolved CO
2
, often in association with CH
4
, do not follow the same salinity trend. These inclusions are often associated with higher trapping temperatures. The salinities associated with water reaching methane saturation (coeval with free gas) are between 8500 and 24 000 ppm eq. NaCl (0.8–2.4 wt%). An influx of meteoric water from the Ashmore Platform in the north is presented as a hypothesis on the origin of the low salinities of the formation water in the Plover Formation in the Browse Basin, supported by the distribution of the lowest palaeowater salinities, but still remains problematic.
Histamine-mediated potentiation of transient receptor potential (TRP) ankyrin 1 and TRP vanilloid 4 signaling in submucosal neurons in patients with irritable bowel syndrome
Authors: Balemans D. , Aguilera-Lizarraga J. , Florens M. V. , Jain P. , Denadai-Souza A. , Viola M. F. , Alpizar Y. A. , Van Der Merwe S. , Vanden Berghe P. , Talavera K. , Vanner S. , Wouters M. M. , Boeckxstaens G. E. 
Published: January 2019

Previously, we showed histamine-mediated sensitization of transient receptor potential (TRP) vanilloid 1 (TRPV1) in patients with irritable bowel syndrome (IBS). Sensitization of TRP ankyrin 1 (TRPA1) and TRP vanilloid 4 (TRPV4) are also involved in aberrant pain perception in preclinical models of somatic pain. Here, we hypothesize that in parallel with TRPV1, histamine sensitizes TRPA1 and TRPV4, contributing to increased visceral pain in patients with IBS. Rectal biopsies were collected from patients with IBS and healthy subjects (HS) to study neuronal sensitivity to TRPA1 and TRPV4 agonists (cinnamaldehyde and GSK1016790A) using intracellular Ca2+ imaging. In addition, the effect of supernatants of rectal biopsies on patients with IBS and HS was assessed on TRPA1 and TRPV4 responses in murine dorsal root ganglion (DRG) sensory neurons. Finally, we evaluated the role of histamine and histamine 1 receptor (H1R) in TRPA1 and TRPV4 sensitization. Application of TRPA1 and TRPV4 agonists evoked significantly higher peak amplitudes and percentage of responding submucosal neurons in biopsies of patients with IBS compared with HS. In HS, pretreatment with histamine significantly increased the Ca2+ responses to cinnamaldehyde and GSK1016790A, an effect prevented by H1R antagonism. IBS supernatants, but not of HS, sensitized TRPA1 and TRPV4 on DRG neurons. This effect was reproduced by histamine and prevented by H1R antagonism. We demonstrate that the mucosal microenvironment in IBS contains mediators, such as histamine, which sensitize TRPV4 and TRPA1 via H1R activation, most likely contributing to increased visceral pain perception in IBS. These data further underscore H1R antagonism as potential treatment for IBS. NEW & NOTEWORTHY We provide evidence for histamine-mediated transient receptor potential (TRP) ankyrin 1 and TRP vanilloid 4 sensitization in irritable bowel syndrome (IBS) via histamine 1 receptor (H1R) activation, most likely contributing to increased visceral pain perception. Our results reveal a general role of sensory TRP channels as histamine effectors in the pathophysiology of IBS and provide novel mechanistic insights into the therapeutic potential of H1R antagonism in IBS.
Evaluating physiological signal salience for estimating metabolic energy cost from wearable sensors
Authors: Ingraham Kimberly A. , Ferris Daniel P. , Remy C. David 
Published: January 2019

Body-in-the-loop optimization algorithms have the capability to automatically tune the parameters of robotic prostheses and exoskeletons to minimize the metabolic energy expenditure of the user. However, current body-in-the-loop algorithms rely on indirect calorimetry to obtain measurements of energy cost, which are noisy, sparsely sampled, time-delayed, and require wearing a respiratory mask. To improve these algorithms, the goal of this work is to predict a user’s steady-state energy cost quickly and accurately using physiological signals obtained from portable, wearable sensors. In this paper, we quantified physiological signal salience to discover which signals, or groups of signals, have the best predictive capability when estimating metabolic energy cost. We collected data from 10 healthy individuals performing 6 activities (walking, incline walking, backward walking, running, cycling, and stair climbing) at various speeds or intensities. Subjects wore a suite of physiological sensors that measured breath frequency and volume, limb accelerations, lower limb EMG, heart rate, electrodermal activity, skin temperature, and oxygen saturation; indirect calorimetry was used to establish the ‘ground truth’ energy cost for each activity. Evaluating Pearson’s correlation coefficients and single and multiple linear regression models with cross validation (leave-one- subject-out and leave-one- task-out), we found that 1) filtering the accelerations and EMG signals improved their predictive power, 2) global signals (e.g., heart rate, electrodermal activity) were more sensitive to unknown subjects than tasks, while local signals (e.g., accelerations) were more sensitive to unknown tasks than subjects, and 3) good predictive performance was obtained combining a small number of signals (4–5) from multiple sensor modalities. NEW & NOTEWORTHY In this paper, we systematically compare a large set of physiological signals collected from portable sensors and determine which sensor signals contain the most salient information for predicting steady-state metabolic energy cost, robust to unknown subjects or tasks. This information, together with the comprehensive data set that is published in conjunction with this paper, will enable researchers and clinicians across many fields to develop novel algorithms to predict energy cost from wearable sensors.
Naïve T-cell Deficits at Diagnosis and after Chemotherapy Impair Cell Therapy Potential in Pediatric Cancers
Authors: Das Rajat K. , Vernau Lauren , Grupp Stephan A. , Barrett David M. 
Published: January 2019

AbstractTranslational data on chimeric antigen receptor (CAR) T-cell trials indicate that the presence of naïve T cells in the premanufacture product is important to clinical response and persistence. In anticipation of developing CAR trials for other tumors, we investigated the T-cell distribution from children with solid tumors and lymphomas at diagnosis and after every cycle of chemotherapy. We found that patients with T cells enriched for naïve and stem central memory cells expanded well in vitro, but the majority of tumor types showed chemotherapy-related depletion of early lineage cells with a corresponding decline in successful ex vivo stimulation response. Unexpectedly, many pediatric patients with solid tumors had low numbers of naïve T cells prior to any therapy. These data indicate the ex vivo manufacture of CAR T cells may need to be customized based on the nature of T cells available in each disease type.Significance:Cumulative chemotherapy cycles deplete naïve T cells in many pediatric cancer regimens, reducing expansion potential associated with successful adoptive cellular therapies. Naïve T-cell deficits can be seen at diagnosis as well, implying immune deficits that exist prior to chemotherapy, which may also affect the development of immune-based therapies.See related commentary by Leick and Maus, p. 466.This article is highlighted in the In This Issue feature, p. 453
The Effects of Oxytocin on Withdrawal, Craving and Stress Response in Heroin-Dependent Patients: A Randomized, Double-Blind Clinical Trial
Authors: Moeini Mina , Omidi Abdoallah , Sehat Mojtaba , Banafshe Hamid Reza 
Published: January 2019

Opioid dependence is an increasing clinical and public health problem. Current pharmacotherapies have limited efficacy and cause serious side effects. Increasing bodies of evidences suggest the neuropeptide, oxytocin (OT), as a potential treatment for drug abuse disorders. The current study was designed to evaluate the effect of OT on withdrawal, craving and anxiety scores, cortisol and dehydroepiandrosterone sulphate (DHEAS) blood level in heroin-dependent male patients. This randomized, double-blind placebo-controlled clinical trial was conducted on 58 males with opioid dependence by Abstinence Center of Addictive People in Iran. The participants were randomly allocated to receive intranasal OT (single dose; 40 IU, <i>n</i> = 29) or placebo (<i>n</i> = 29). Heroine withdrawal, craving and anxiety scores were measured using the Opioid Withdrawal Scale, Visual Analogue Scale and (Desire for Drug Questionnaire), and Hamilton checklist respectively. The cortisol and DHEAS levels at baseline and different post-intervention time were measured using a competitive immunoanalysis method. Acute OT administration reduced craving and withdrawal scores but did not change anxiety significantly. Single dose of OT decreased the level of cortisol and improved the cortisol/DHEAS ratio in the heroin users during abstinence (<i>p</i> &#x3c; 0.01). These results suggest that OT may be useful in the attenuation of craving, withdrawal symptom in heroin-dependent patients and might be considered a new potential treatment for heroin dependence where positive effects of OT on stress-related hormones may be involved in this effect of OT.
OSMANLI İKTİSAT ZİHNİYETİNDE KAMU HİZMETLERİNİN YERİNE GETİRİLMESİ VE VAKIFLAR
Authors: ÖZTÜRK Rahime Hülya 
Published: January 2019

Vakıflar Osmanlı iktisadi ve
sosyal yaşamında pek çok görevi yerine getiren kurumlar olmuştur. Fetihlerle
topraklarını genişletmeyi amaçlayan devlet ordunun ihtiyaçları için önemli
askeri harcamalar yaparken kamusal hizmetleri gerçekleştirme görevini vakıflara
devretmiştir. Padişahların bizzat kendileri, eşleri, çocukları ve önemli devlet
görevlileri tarafından pek çok vakfın kurulduğu, vakıfların toplumsal yaşamda
yaygınlaşması için vakıf kurulmasının desteklendiği görülmektedir. Kuruluş
amaçları açısından farklılık gösteren vakıfların odak noktası ekonomik
sorunların giderilmesini sağlamak ve yardımlaşmayı teşvik etmektir. Vakıfların
en önemli özelliği ise devletin yerine getirmesi gereken kamu hizmetlerini
üstlenmiş olmasıdır. Herhangi bir altyapı ya da bayındırlık hizmetinin yerine
getirilmesinde vakıflar doğrudan rol almıştır. Tüm bu nitelikleri nedeniyle
vakıflar Osmanlı
iktisadi ve sosyal yaşamında önemli bir kurum olarak varlıklarını
sürdürmüşlerdir. Bu çalışmanın birinci bölümünde Osmanlı Devleti’nde vakıfların
önemi üzerinde durulmuştur. İkinci bölümde vakıfların kuruluş şekilleri ve
vakıfların ekonomik boyutu ele alınmıştır. Üçüncü ve son bölümde ise para
vakıflarının yapısı ve ekonomik etkileri ortaya konmaya çalışılmıştır.
MEKÂNIN GEMEINSCHAFT İLİŞKİ AĞINA ETKİSİ: ÇIKMAZ SOKAK ÖRNEĞİ
Authors: KIZILTEPE Betül 
Published: January 2019

Bu makalede; çıkmaz sokaklar mekân
sosyolojisinin temel tartışmaları bağlamında incelenmiştir. Çalışma,
süreklilik-geçicilik boyutuyla birlikte toplumsallığın mekânı ne şekilde inşa
ettiğini ve dönüştürdüğünü, buna karşılık mekânın da toplumsal yaşamı hangi
yollardan etkilediğini, bireylerin eylemlerinde hangi değişikliklerin meydana
geldiğini çıkmaz sokak olgusu içinde sorgulamayı amaçlamaktadır. İstanbul/
Fatih ilçesindeki çıkmaz sokak sakinleri üzerine inşa edilen bu çalışmada, 18
çıkmaz sokak incelenmiştir ve bu sokaklarda ikamet eden 19 kadın 13 erkek olmak
üzere 32 kişi ile görüşülmüştür. Makalede çıkmaz sokak sakinlerinin mekân
algılarında ve mekânla bütünleşme pratiklerinde değişikliklerin yaşandığı ve bu
doğrultuda mekânsal süreklilikle birlikte mekânsal ve toplumsal dinamiklerin de
incelenmesi gerektiği ele alınmıştır. Buna ek olarak; mekânsal sürekliliğin
sakinler arasında gemeinschaft ilişkiyi etkilediği, sosyal bir gösterge olan
mekânın kalıcılık ve geçicilik durumları ile farklı eylemlere ev sahipliği
yaptığı tartışılmıştır.