bluuebunny/crossref_metadata_2025_split huggingface dataset:
Out-of-hospital endotracheal intubation experience, confidence and confidence-associated factors among Northern Japanese emergency life-saving technicians: a population-based cross-sectional study
Authors: Ono Yuko , Tanigawa Koichi , Kakamu Takeyasu , Shinohara Kazuaki , Iseki Ken 
Published: July 2018

ObjectiveClinical procedural experience and confidence are both important when performing complex medical procedures. Since out-of-hospital endotracheal intubation (ETI) is a complex intervention, we sought to clarify clinical ETI experience among prehospital rescuers as well as their confidence in performing ETI and confidence-associated factors.DesignPopulation-based cross-sectional study conducted from January to September 2017.SettingNorthern Japan, including eight prefectures.ParticipantsEmergency life-saving technicians (ELSTs) authorised to perform ETI.Outcome measuresAnnual ETI exposure and confidence in performing ETI, according to a five-point Likert scale. To determine factors associated with ETI confidence, differences between confident ELSTs (those scoring 4 or 5 on the Likert scale) and non-confident ELSTs were evaluated.ResultsQuestionnaires were sent to 149 fire departments (FDs); 140 agreed to participate. Among the 2821 ELSTs working at responding FDs, 2620 returned the questionnaire (response rate, 92.9%); complete data sets were available for 2567 ELSTs (complete response rate, 91.0%). Of those 2567 respondents, 95.7% performed two or fewer ETI annually; 46.6% reported lack of confidence in performing ETI. Multivariable logistic regression analysis showed that years of clinical experience (adjusted OR (AOR) 1.09; 95% CI 1.05 to 1.13), annual ETI exposure (AOR 1.79; 95% CI 1.59 to 2.03) and the availability of ETI skill retention programmes including regular simulation training (AOR 1.31; 95% CI 1.02 to 1.68) and operating room training (AOR 1.44; 95% CI 1.14 to 1.83) were independently associated with confidence in performing ETI.ConclusionsETI is an uncommon event for most ELSTs, and nearly half of respondents did not have confidence in performing this procedure. Since confidence in ETI was independently associated with availability of regular simulation and operating room training, standardisation of ETI re-education that incorporates such methods may be useful for prehospital rescuers.
Evaluating the validity of the selection measures used for the UK’s foundation medical training programme: a national cohort study
Authors: Smith Daniel T , Tiffin Paul A 
Published: July 2018

ObjectivesCurrently relative performance at medical school (educational performance measure (EPM) decile), additional educational achievements and the score on a situational judgement test (SJT) are used to rank applicants to the UK Foundation Years postgraduate medical training programme. We sought to evaluate whether these three measures were predictive of subsequent successful completion of the programme, and thus were valid selection criteria.MethodsData were obtained from the UK Medical Education Database (UKMED) on 14 131 UK applicants to the foundation programme starting in 2013 and 2014. These data included training outcomes in the form of Annual Reviews of Competency Progression (ARCPs), which indicated whether the programme was successfully completed. The relationship between applicants’ performance on the three selection measures to the odds of successful programme completion were modelled.ResultsOn univariable analyses, all three measures were associated with the odds of successful completion of the programme. Converting the SJT score to deciles to compare the effect sizes suggested that one decile increase in the EPM increased the odds of completing the programme by approximately 15%, whereas the equivalent value was 8% for the SJT scores. On multivariable analyses (with all three measures included in the model), these effects were only independently and statistically significant for EPM decile (OR 1.14, 95% CI 1.10 to 1.18, p<0.001) and SJT z-score decile (OR 1.05, 95% CI 1.01 to 1.09, p=0.02).ConclusionsThe EPM decile and SJT scores may be effective selection measures for the foundation programme. However, educational achievements does not add value to the other two measures when predicting programme completion. Thus, its usefulness in this context is less clear. Moreover, our findings suggest that the weighting for the EPM decile score, relative to SJT performance, should be increased.
Gut commensal Parabacteroides goldsteinii plays a predominant role in the anti-obesity effects of polysaccharides isolated from Hirsutella sinensis
Authors: Wu Tsung-Ru , Lin Chuan-Sheng , Chang Chih-Jung , Lin Tzu-Lung , Martel Jan , Ko Yun-Fei , Ojcius David M , Lu Chia-Chen , Young John D , Lai Hsin-Chih 
Published: July 2018

ObjectiveThe medicinal fungus Ophiocordyceps sinensis and its anamorph Hirsutella sinensis have a long history of use in traditional Chinese medicine for their immunomodulatory properties. Alterations of the gut microbiota have been described in obesity and type 2 diabetes. We examined the possibility that H. sinensis mycelium (HSM) and isolated fractions containing polysaccharides may prevent diet-induced obesity and type 2 diabetes by modulating the composition of the gut microbiota.DesignHigh-fat diet (HFD)-fed mice were treated with HSM or fractions containing polysaccharides of different molecular weights. The effects of HSM and polysaccharides on the gut microbiota were assessed by horizontal faecal microbiota transplantation (FMT), antibiotic treatment and 16S rDNA-based microbiota analysis.ResultsFraction H1 containing high-molecular weight polysaccharides (>300 kDa) considerably reduced body weight gain (∼50% reduction) and metabolic disorders in HFD-fed mice. These effects were associated with increased expression of thermogenesis protein markers in adipose tissues, enhanced gut integrity, reduced intestinal and systemic inflammation and improved insulin sensitivity and lipid metabolism. Gut microbiota analysis revealed that H1 polysaccharides selectively promoted the growth of Parabacteroides goldsteinii, a commensal bacterium whose level was reduced in HFD-fed mice. FMT combined with antibiotic treatment showed that neomycin-sensitive gut bacteria negatively correlated with obesity traits and were required for H1’s anti-obesogenic effects. Notably, oral treatment of HFD-fed mice with live P. goldsteinii reduced obesity and was associated with increased adipose tissue thermogenesis, enhanced intestinal integrity and reduced levels of inflammation and insulin resistance.ConclusionsHSM polysaccharides and the gut bacterium P. goldsteinii represent novel prebiotics and probiotics that may be used to treat obesity and type 2 diabetes.
Paternal uniparental disomy of chromosome 19 in a pair of monochorionic diamniotic twins with dysmorphic features and developmental delay
Authors: Yeung Kit San , Ho Matthew Sai Pong , Lee So Lun , Kan Anita Sik Yau , Chan Kelvin Yuen Kwong , Tang Mary Hoi Yin , Mak Christopher Chun Yu , Leung Gordon Ka Chun , So Po Lam , Pfundt Rolph , Marshall Christian R , Scherer Stephen W , Choufani Sanaa , Weksberg Rosanna , Hon-Yin Chung Brian 
Published: July 2018

BackgroundWe report here clinical, cytogenetic and molecular data for a pair of monochorionic diamniotic twins with paternal isodisomy for chromosome 19. Both twins presented with dysmorphic features and global developmental delay. This represents, to our knowledge, the first individual human case of paternal uniparental disomy for chromosome 19 (UPD19).MethodsWhole-exome sequencing, together with conventional karyotype and SNP array analysis were performed along with genome-wide DNA methylation array for delineation of the underlying molecular defects.ResultsConventional karyotyping on amniocytes and lymphocytes showed normal karyotypes for both twins. Whole-exome sequencing did not identify any pathogenic sequence variants but >5000 homozygous exonic variants on chromosome 19, suggestive of UPD19. SNP arrays on blood and buccal DNA both showed paternal isodisomy for chromosome 19. Losses of imprinting for known imprinted genes on chromosome 19 were identified, including ZNF331, PEG3, ZIM2 and MIMT1. In addition, imprinting defects were also identified in genes located on other chromosomes, including GPR1-AS, JAKMP1 and NHP2L1.ConclusionImprinting defects are the most likely cause for the dysmorphism and developmental delay in this first report of monozygotic twins with UPD19. However, epigenotype-phenotype correlation will require identification of additional individuals with UPD19 and further molecular analysis.
Electronic Cigarette Use Prevalence, Associated Factors, and Pattern by Cigarette Smoking Status in the United States From NHANES (National Health and Nutrition Examination Survey) 2013–2014
Authors: Jaber Rana M. , Mirbolouk Mohammadhassan , DeFilippis Andrew P. , Maziak Wasim , Keith Rachel , Payne Thomas , Stokes Andrew , Benjamin Emelia , Bhatnagar Aruni , Blankstein Ron , Saxena Anshul , Blaha Michael J. , Nasir Khurram 
Published: July 2018

Background

To examine the prevalence and patterns of recent electronic cigarette (e‐cigarette) use in a nationally representative sample of
US
adults and adolescents.

Methods and Results

Using tobacco information from NHANES (National Health and Nutrition Examination Survey) 2013–2014, 5423 adults and 895 adolescents (aged 13–17 years) were included in this analysis. Demographic, tobacco use, and drug use information were self‐reported. Recent e‐cigarette use (within the previous 5 days) was stratified by smoking status. Of 125 e‐cigarette users, 116 participants were aged ≥18 years, corresponding to 2.6% (95% confidence interval [
CI
], 2.0–3.1) and 1.21% (95%
CI
, 0.3–2.1) prevalence of e‐cigarette use among
US
adults and adolescents, respectively. E‐cigarette adult users were current smokers (68.1%), former smokers (23.7%), and never smokers (8.2%). The highest prevalence of e‐cigarette use was among current smokers (8.2%; 95%
CI
, 6.3–10.1), followed by former smokers (2.7%; 95%
CI
, 1.4–4.1), and then never smokers (0.4%; 95%
CI
, 0.2–0.6). After adjusting for age, sex, and ethnicity, e‐cigarette users had higher odds of being exposed to secondhand smoke (odds ratio: 6.3; 95%
CI
, 3.6–11.1) and drinking alcohol (odds ratio: 4.2; 95%
CI,
1.8–10.0) and lower odds of having at least a college education or a higher income, compared with tobacco nonusers.

Conclusions
Between 2013 and 2014, e‐cigarette use in the United States was more common among younger people, those with low socioeconomic status, and current and former smokers. These findings will help inform future research as well as public policy and regulatory actions.
Phenotypes of Pregnant Women Who Subsequently Develop Hypertension in Pregnancy
Authors: McLaughlin Kelsey , Zhang Jianhong , Lye Stephen J. , Parker John D. , Kingdom John C. 
Published: July 2018

Background
Hypertensive disorders complicating pregnancy are a major cause of maternal death. Our objective was to evaluate maternal clinical, hemodynamic, and placental prognostic indicators in a consolidated manner to identify women who develop hypertension in pregnancy.

Methods and Results

Twenty‐six normotensive pregnant women from a specialized Placenta Clinic at increased risk of developing de novo hypertension and 20 normotensive healthy pregnant controls were recruited at 22 to 26 weeks' gestation. Fourteen maternal clinical, hemodynamic, and placental characteristics were assessed in the second trimester and aggregated. Principal component analysis of this combined data set determined that 3 dimensions accounted for 56% of the cohort variability. The first dimension accounted for 31% of the cohort variability, with significant contributions from total peripheral resistance, endoglin, and cardiac output. The second dimension was predominantly influenced by body mass index and mean arterial pressure, while uric acid and myeloperoxidase mainly contributed to the third dimension. Unsupervised clustering identified 3 groups within this combined data set. Total peripheral resistance was the most significant distinguishing parameter between these groups (
P
<0.0001), followed by placental growth factor, endoglin, and cardiac output (
P
<0.0001). Using these 4 parameters, a receiver operating curve was constructed with an area under the curve of 0.975 (95% confidence interval 0.93–1) for the prediction of developing hypertension in pregnancy.

Conclusions
Consolidated assessment of prognostic indicators in the second trimester of pregnancy may be useful to characterize and distinguish pathways by which women may develop hypertension in pregnancy. This approach could contribute to the development of pathway‐specific preventative and antihypertensive treatment strategies.
Carotid endarterectomy: neither shunting nor patching technique
Authors: Baram Aram , Majeed Goran , Subhi Abdel-Majeed Allaa 
Published: July 2018

Introduction The role of carotid shunting in carotid endarterectomy is controversial. Many studies have concluded that patch angioplasty is preferable to primary closure, while others found that it had no value. The aim of this study was to report the results of our first series of patients undergoing carotid endarterectomy with a non-shunting technique and primary closure of the arteriotomy. Methods From October 2014 to October 2017, 63 patients with unilateral or bilateral carotid artery stenosis underwent carotid endarterectomy. There were 48 males and 15 females, the mean age was 63.16 years, and all were symptomatic. Conventional endarterectomy was performed without a shunt in all cases. All arteriotomies were closed primarily. We analysed the early and late outcomes of this procedure with at least 18 months of follow-up. Results Diabetes was the most frequent comorbidity. Most of the patients had a history of transient ischemic attack (49.2%) or stroke (44.4%). All patients had significant (moderate to severe) carotid artery stenosis. Postoperatively, 2 (3.2%) patients developed ischemic stroke, one (1.6%) suffered hypoglossal nerve injury, and one had a postoperative cervical hematoma. During follow-up, one patient developed asymptomatic total occlusion of the endartrectomized carotid artery at 18 months. Conclusion Carotid endarterectomy without shunting is a safe procedure. The short- and longer-term outcomes are not significantly inferior to those of the routine or selective shunting technique, and the rate of restenosis is not higher than that of patch angioplasty closure.
Children’s services in the age of information technology: What matters most to frontline professionals
Authors: Sarwar Atif , Harris Martin 
Published: July 2018

Summary The last two decades have seen information systems featuring prominently in calls for the modernisation of the UK social care system. However, critics have maintained that these systems are of limited value to social care professionals whose design and implementation is driven by a preoccupation with performance management and a culture of professional audit and accountability, precepts of ‘managerialism’. However, this area of research has often suffered from lack of focus on how technological changes affect public administration and service delivery and often characterises technology as a politically neutral tool detached from its socio-political context whilst also ignoring the strategic predispositions of human service professionals. Findings This research was conducted in three local authorities in England. Using the ‘technological affordance’ perspective, we contend that the way social workers interact with Integrated Children’s System is shaped by the discord between socio-historically evolved professional values epitomising the social work profession and managerialist reforms promoting standardised ways of performing it. Application Integrated Children’s System has transformed social work from an art to a technical activity, dominated by unimaginative and routinised working practices. Social workers are becoming peripheral figures and this is where social work needs to be reclaimed. Policymakers need to rethink taken for granted assumptions that practitioners would replace their professional expertise with technology and realise that the effective use of Integrated Children’s System depends on bureau-professionalised judgements of social workers. Whilst specific patterns of technology usage can be developed and institutionalised, real objectives of children’s social services should not be sacrificed.
Human Resource Development for Racial/Ethnic Diversity: Do School Systems Value Teachers of Color?
Authors: Gist Conra D. 
Published: July 2018

The Problem The small representation of Teachers of Color in comparison with their White counterparts continues to trouble the teaching profession. Since Teachers of Color often have a vital impact on student engagement and academic outcomes, there is a pressing need to identify policies and practices that increase recruitment and retention. The Solution Given the current state of racial/ethnic teacher diversity in the United States, human resource development scholarship can be informative for addressing teacher retention. The Diversity Intelligence (DQ) and People as Technology (PT) Conceptual Model, as human resource development conceptual tools, are useful for understanding ways to support the academic and professional growth of Teachers of Color. These models are positioned to advance educational leaders’ and human resource professionals’ understandings of the ways in which the education field works to increase the number of Teachers of Color who enter and remain in the profession. The Stakeholders School leaders, policymakers, human resource development professionals and researchers, and reformers can better understand how school systems value (or do not value) Teachers of Color.
Human placental membrane as a wound cover for chronic diabetic foot ulcers: a prospective, postmarket, CLOSURE study
Authors: Pacaccio Douglas J. , Cazzell Shawn M. , Halperin Gabriel J. , Kasper Maria A. , Neutel Joel M. , O'Carroll Brian D. , Reyzelman Alexander M. 
Published: July 2018

Objective: To evaluate the safety and efficacy of a chorioamniotic allograft, used as a wound cover for chronic foot ulcers, in patients with diabetes. Methods: A multicentre, prospective, postmarket study where eligible patients received up to 11 weekly wound cover applications. Computerised planimetry was used to calculate the diabetic foot ulcer (DFU) area each week. The primary endpoint of the study was wound closure assessment. Secondary endpoints included DFU recurrence and morbidity. Results: A total of 63 patients with 64 ulcers were enrolled, after successful completion of a two-week run-in period. Patients were predominantly male and had risk factors for delayed healing. Mean baseline DFU area was 3.8cm2 (standard deviation (SD): 4.8). After 12 weeks, a total of 19 (40%) DFUs had closed. Results varied by size category, ‘small’ (≤2.0cm2), ‘medium’ (>2.0–4.0 cm2), and ‘large’ (>4.0–25.0 cm2), with higher percentage closure in the ‘small’ DFU group, compared with the ‘medium’ and ‘large’ DFUs (57%, 33%, and 10%, respectively). Of those DFUs that closed, the average closure time was 6.5 weeks. There were no unanticipated adverse events. Conclusion: Known risk factors for healing, including DFU size, location and duration, affected the outcomes. However, the results are in line with the literature and support the use of the chorioamniotic allograft in chronic and complex cases.
Self-styling an emotionally intelligent avatar
Authors: Lawler-Dormer Deborah 
Published: July 2018

Abstract
Leah, created over the last three years, is a self-styled, autonomous avatar collaboratively developed with Dr Mark Sagar at the Laboratory for Animate Technologies, Auckland Bioengineering Institute at the University of Auckland, New Zealand. Using ‘Leah’ as a technoscientific art case study, this paper will address the practical and theoretical considerations underlying the project, showing complex posthuman and bioethical relations. Leah is exhibited as an intra-active screen-based installation. It is the product of a shifting transdisciplinary collaborative process, involving artists, engineers, computer scientists and neuroscientists. Leah was developed as part of the Auckland Face Simulator project where adult faces are realistically and precisely modelled to show accurate expression. These can be used for neurophysiological and neuropsychological research into emotion, agency and empathy. This artwork engages with a deep questioning of the posthuman through bioengineering self-imaging practices and reflects on our co-evolution with technology.
Sei traizio
Authors: Korta Kepa 
Published: July 2018

«Traduttore, traditore» dio italiar esaerak. Itzultzaile, traidore. Horrenarabera, GOGOAren lehen aleetan sartzeko artikulu klasiko baten itzulpenaegin genuenero, traizioa egiten ari gintzaizkion jatorrizko testuari —edo harenegileari, edo biei; esaerak ez du zehazten hori—. Eta traizio bikoitza egiteragoaz, orain, itzulpen zaharren bertsio berriekin osatutako GOGOArenale honekin. Traizio mesedegarria, ordea. Hala espero dugu behintzat.
Euskararen eta gaztelaniaren erabilera ingeleseko irakaskuntza-saioetan
Authors: Arocena Egaña Elizabet 
Published: July 2018

Ikerketa honek H1 eta H2k H3ko ikasgelan duten presentzia eta jokatzen duten rola aztertzen ditu, kode-alternantzia oraindik hizkuntza-jabekuntzarako kaltegarritzat jotzen den garaiotan. Ikerketa testuinguru eleaniztun batean egin zen, Euskal Herrian hain zuzen, non hizkuntzak bereiztearen aldeko iritzi eta usteak sakon sustraiturik dauden. Gero eta ikerketa gehiagok nabarmentzen dute atzerriko hizkuntzaren irakaskuntzan H1 modu sistematiko eta funtzionalean erabiltzea onuragarria izan daitekeela; hala ere, testuinguru eleaniztunetan, hizkuntzen irakaskuntzari dagokionez bere horretan diraute hainbat urtez nagusi izan diren elebakartasunean oinarritutako irizpideak. Ikerketa honetarako datuak biltzeko, astebetez behaketak egin ziren ingelesa atzerriko hizkuntza gisa ematen den klaseetan eta ingelesa irakats-hizkuntza den klaseetan, eta, horrez gain, ingeleseko irakasleei elkarrizketak egin zitzaizkien. Bestalde, galde-sorten bidez ikasleei buruzko oinarrizko informazio orokorra bildu zen. Parte-hartzaileak bi ikastetxetako bigarren hezkuntzako irakasleak eta haien 134 ikasleak izan ziren. Datuen analisiak erakusten duenez, hala irakasleek nola ikasleek H1 eta H2 erabiltzen dituzte, neurri batean, H3ko ikasgelan, helburu eta funtzio jakin batzuekin. Emaitzek agerian uzten dute, halaber, irakasleak, beren esperientziaren argitan, elebakartasunaren hesiak apurtzearen onurak antzematen hasiak direla.