bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spatial Disparity in Sanitation Facility: An Empirical Analysis
Authors: Shukla Rashmi 
Published: December 2018

Sanitation is a basic human need. Inadequate sanitation and poor hygienic practices lead to huge public health costs and diseases. This study highlights the interregional and interstate disparity in the coverage of sanitation facility in India based on census data. The best sanitation facilities are available in all states of Northeast India while the central region, followed by the eastern region, reports the lowest access to toilet facility. A disparity index has been worked out to measure the level of disparity in access to sanitation facilities over time. The regression analysis confirms that socio-economic variables such as female literacy rate (FLR) and population below poverty line (BPL) rate are significant determinants of improved sanitation facility. The study reveals the unsatisfactory condition of sanitation facility, especially in rural areas. Though the government is conscious about the construction of the toilets in rural areas, it is found not usable in many cases. Thus, there is a need to make constant efforts to improve the performance of the programmes by making them more responsive to the local needs and aspirations. The programmes should concentrate on changing behaviour and promoting latrine use.
General practitioners’ perspectives on care coordination in primary health care: A qualitative study
Authors: Vassbotn Ane Drougge , Sjøvik Hege , Tjerbo Trond , Frich Jan , Spehar Ivan 
Published: December 2018

Introduction To explore Norwegian general practitioners’ experiences with care coordination in primary health care. Methods Qualitative study using data from five focus groups with 32 general practitioners in Norway. We analysed the data using systematic text condensation, a descriptive and explorative method for thematic cross-case analysis of qualitative data. Results The general practitioners had different notions of care pathways. They expressed a wish and an obligation to be involved in planning and coordination of primary health-care services, but they experienced organisational and financial barriers that limited their involvement and contribution. General practitioners reported lack of information about and few opportunities for involvement in formal coordination initiatives, and they missed informal arenas for dialogue with other primary health-care professionals. They argued that the general practitioner’s role as coordinator should be recognised by other parties and that they needed financial compensation for contributions and attendance in meetings with the municipality. Discussion General practitioners need informal arenas for dialogue with other primary health-care professionals and access to relevant information to promote coordinated care. There might be an untapped potential for improving patient care involving general practitioners more in planning and coordinating services at the system level. Financial compensation of general practitioners contribution may promote increased involvement by general practitioners.
Changes in care coordination and health insurance in the population of US children with muscular dystrophy, 2005–2006 and 2009–2010
Authors: Shing Jaimie Z , Liu Tiebin , Valdez Rodolfo 
Published: December 2018

Introduction We aimed to assess changes in care coordination and health insurance coverage among US children with muscular dystrophy. Methods We used 2005–2006 and 2009–2010 data from the National Survey of Children with Special Health Care Needs. We examined the distribution of sociodemographic and health characteristics of children with muscular dystrophy by survey cycle. Multivariable regression was used to calculate odds of not receiving effective care coordination, not having adequate health insurance coverage, receiving no help coordinating care, and having problems obtaining referrals in each survey cycle. Results In the 2005–2006 and 2009–2010 survey cycles, there were 135 and 117 children with muscular dystrophy (representing 34,672 and 31,169 US children with muscular dystrophy), respectively. The percentage of children with muscular dystrophy who did not receive effective care coordination changed from 59.2% (95% confidence interval (CI), 45.6%–72.7%) in 2005–2006 to 53.4% (95% CI, 38.3%–68.6%) in 2009–2010. The odds of not receiving effective care coordination (adjusted odds ratio (aOR) = 0.77; 95% CI, 0.32–1.89) or having problems obtaining referrals (aOR = 0.52; 95% CI, 0.17–1.59) did not change significantly between the two periods, whereas odds of having inadequate insurance coverage decreased significantly (aOR = 0.41, 95% CI, 0.18–0.93) and odds of not receiving help coordinating care increased significantly (aOR = 4.22, 95% CI, 1.24–14.29) between the two periods. Conclusion Our results suggest key health care needs for many families with children with muscular dystrophy have remained unmet for a prolonged period. Although there were significant improvements in health insurance coverage, nearly one-third of children with muscular dystrophy still had inadequate health insurance coverage in 2009–2010; it is likely that this situation has not changed much since then.
A real-world comparison of relapse rates, healthcare costs and resource use among patients with multiple sclerosis newly initiating subcutaneous interferon beta-1a versus oral disease-modifying drugs
Authors: Bowen James D , Kozma Chris M , Grosso Megan M , Phillips Amy L 
Published: December 2018

Background Administrative-claims data enable comparative effectiveness assessment using large numbers of patients treated in real-world settings. Objective To evaluate real-world relapses, healthcare costs and resource use in patients with MS newly initiating subcutaneous interferon beta-1a (sc IFNβ-1a) v. oral disease-modifying drugs (DMDs: dimethyl fumarate, fingolimod, teriflunomide). Methods Patients from an administrative claims database (1 Jan 2012–31 Dec 2015) were selected if they: were 18–63 years old; had an MS diagnosis; had newly initiated sc IFNβ-1a, dimethyl fumarate, fingolimod, or teriflunomide (first claim = index); had no evidence of DMD 12-months pre-index; and had 12-month eligibility pre- and post-index. Relapse was defined as an MS-related inpatient stay, emergency room visit, or outpatient visit with a corticosteroid prescription ± 7 days. Outcomes were evaluated using logistic regression and generalized linear models. Results A total of 4475 patients met inclusion criteria: 21.9% sc IFNβ-1a, 51.0% dimethyl fumarate, 19.7% fingolimod, 7.4% teriflunomide. Teriflunomide patients had 1.357 (95% CI 1.000, 1.831; p = 0.0477) greater odds of 1-year relapse than sc IFNβ-1a patients. Estimated mean all-cause 1-year costs were higher after fingolimod (US$72,376) v. sc IFNβ-1a initiation (US$65,408; p < 0.0001). Non-DMD costs were not significantly different. Conclusion Patients initiating sc IFNβ-1a had better relapse outcomes v. teriflunomide, and lower all-cause costs v. fingolimod.
Treatment of bleeding complications in patients on anticoagulant therapy
Authors: Piran Siavash , Schulman Sam 
Published: December 2018

Abstract
Anticoagulant therapy is often refrained from out of fear of hemorrhagic complications. The most frequent type of major bleeding is gastrointestinal, but intracranial hemorrhage has the worst prognosis. Management of these complications in patients on anticoagulants should follow the same routines as for nonanticoagulated patients, as described here with the previously mentioned bleeds as examples. In addition, for life-threatening or massive hemorrhages, reversal of the anticoagulant effect is also crucial. Adequate reversal requires information on which anticoagulant the patient has taken and when the last dose was ingested. Laboratory data can be of some help, but not for all anticoagulants in the emergency setting. This is reviewed here for the different types of anticoagulants: vitamin K antagonists, heparins, fondaparinux, thrombin inhibitors and factor Xa inhibitors. Specific antidotes for the latter are becoming available, but supportive care and nonspecific support for hemostasis with antifibrinolytic agents or prothrombin complex concentrates, which are widely available, should be kept in mind.
Update on clinical gene therapy for hemophilia
Authors: Perrin George Q. , Herzog Roland W. , Markusic David M. 
Published: December 2018

Abstract
In contrast to other diverse therapies for the X-linked bleeding disorder hemophilia that are currently in clinical development, gene therapy holds the promise of a lasting cure with a single drug administration. Near-to-complete correction of hemophilia A (factor VIII deficiency) and hemophilia B (factor IX deficiency) have now been achieved in patients by hepatic in vivo gene transfer. Adeno-associated viral vectors with different viral capsids that have been engineered to express high-level, and in some cases hyperactive, coagulation factors were employed. Patient data support that sustained endogenous production of clotting factor as a result of gene therapy eliminates the need for infusion of coagulation factors (or alternative drugs that promote coagulation), and may therefore ultimately also reduce treatment costs. However, mild liver toxicities have been observed in some patients receiving high vector doses. In some but not all instances, the toxicities correlated with a T-cell response directed against the viral capsid, prompting use of immune suppression. In addition, not all patients can be treated because of preexisting immunity to viral capsids. Nonetheless, studies in animal models of hemophilia suggest that the approach can also be used for immune tolerance induction to prevent or eliminate inhibitory antibodies against coagulation factors. These can form in traditional protein replacement therapy and represent a major complication of treatment. The current review provides a summary and update on advances in clinical gene therapies for hemophilia and its continued development.
ACTH-Dependent Cyclic Cushing Syndrome Triggered by Glucocorticoid Excess Through a Positive-Feedback Mechanism
Authors: Seki Yasufumi , Morimoto Satoshi , Saito Fumiko , Takano Noriyoshi , Kimura Shihori , Yamashita Kaoru , Yoshida Naohiro , Bokuda Kanako , Sasaki Nobukazu , Yatabe Midori , Watanabe Daisuke , Yatabe Junichi , Ando Takashi , Amano Kosaku , Kawamata Takakazu , Ichihara Atsuhiro 
Published: December 2018

Abstract

Context
Cyclic Cushing syndrome is a rare variant of Cushing syndrome that demonstrates periodic cortisol excess. It has been thought that inhibition of a glucocorticoid positive-feedback loop is associated with remission of hypercortisolism in ACTH-dependent cyclic Cushing syndrome. However, the underlying mechanism that triggers the development of the hypercortisolism is still unknown. We observed a case of ACTH-dependent cyclic Cushing syndrome that was developed by exogenous glucocorticoids, possibly through a glucocorticoid positive-feedback loop.

Case Description
A 75-year-old woman had experienced cyclic ACTH and cortisol elevations six times in the previous 4 years. Her diagnosis was cyclic Cushing syndrome. During the hypercortisolemic phase, neither low-dose nor high-dose dexamethasone suppressed her plasma ACTH and cortisol levels. Daily metyrapone therapy decreased her plasma cortisol and ACTH levels during every hypercortisolemic phase. After the sixth remission of a hypercortisolemic phase, she took 25 mg of hydrocortisone for 4 weeks and developed ACTH-dependent hypercortisolemia. Treatment with 1 mg of dexamethasone gradually increased both plasma ACTH and cortisol levels over 2 weeks, resulting in the eighth hypercortisolemic phase. Treatment using a combination of dexamethasone and metyrapone did not increase plasma ACTH or cortisol level and successfully prevented development of ACTH-dependent hypercortisolism.

Conclusion
We present an interesting case of cyclic Cushing syndrome in which ACTH-dependent hypercortisolemic phases relapsed during exogenous glucocorticoid treatment. A glucocorticoid positive-feedback loop and endogenous glucocorticoid synthesis may play key roles in the periodicity of hypercortisolism in cyclic Cushing syndrome.
Glycosphingolipid metabolism in cell fate specification
Authors: Russo Domenico , Capolupo Laura , Loomba Jaipreet Singh , Sticco Lucia , D'Angelo Giovanni 
Published: December 2018

ABSTRACT
Glycosphingolipids (GSLs) are ubiquitous components of eukaryotic plasma membranes that consist of a ceramide backbone linked to a glycan moiety. Both the ceramide and the glycan parts of GSLs display structural variations that result in a remarkable repertoire of diverse compounds. This diversity of GSLs is exploited during embryogenesis, when different GSLs are produced at specific developmental stages and along several differentiation trajectories. Importantly, plasma membrane receptors interact with GSLs to modify their activities. Consequently, two otherwise identical cells can respond differently to the same stimulus owing to their different GSL composition. The metabolic reprograming of GSLs is in fact a necessary part of developmental programs, as its impairment results in developmental failure or tissue-specific defects. Moreover, single-cell variability is emerging as a fundamental player in development: GSL composition displays cell-to-cell variability in syngeneic cell populations owing to the regulatory gene expression circuits involved in microenvironment adaptation and in differentiation. Here, we discuss how GSLs are synthesized and classified and review the role of GSLs in the establishment and maintenance of cell identity. We further highlight the existence of the regulatory circuits that modify GSL pathways and speculate how GSL heterogeneity might contribute to developmental patterning.
Photodynamic therapy in infected venous and mixed leg ulcers: a pilot experience
Authors: Mosti Giovanni , Picerni Pietro , Licau Manuel , Mattaliano Vincenzo 
Published: December 2018

Objective: To assess the tolerability and efficacy of photodynamic therapy (PDT) with RLP068, a novel phthalocyanine-derived photosensitiser, in controlling the bacterial load in different leg ulcers, due to vascular pathophysiology. Method: An observational study of patients with infected leg ulcers of different pathophysiology, admitted to the hospital for a skin grafting procedure, were included. All patients underwent two sessions of PDT at time zero and after 72 hours. A semi-quantitative swab was taken before and 30 minutes after both sessions of PTD. During the time interval between the two treatments the ulcer was covered with foam dressing and compression therapy was applied to all patients. No systemic or topical antibiotics were administered. Statistical analysis of results was performed. Results: A total of 36 patients (13 males, 23 females; aged 72.4±8.6 years, range: 55-85 years) were recruited; two had ulcers on both legs. PDT was shown to be effective in reducing bacterial load after the first treatment. Before the second PDT treatment (72 hours after first PDT treatment), a slight increase of the bacterial load was observed in all ulcers. However, after the second PDT session, bacterial swab results were negative in all but two ulcers. The procedure was well tolerated in all but four patients, who reported a very severe pain at baseline, which increased during treatment. Conclusion: In this study, PDT was effective in reducing bacterial load in patients with infected vascular leg ulcers, and allowed successful skin grafting to take place in all patients. The treatment was generally well tolerated. Studies with a greater number of patients and a control group are planned to confirm these results.
An MMP/TIMP ratio scoring system as a potential predictive marker of diabetic foot ulcer healing
Authors: Luanraksa Sivat , Jindatanmanusan Punyanuch , Boonsiri Tanit , Nimmanon Thirayost , Chaovanalikit Thiti , Arnutti Pasra 
Published: December 2018

Objectives: The mechanism of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs) in diabetic foot ulcers (DFUs) is unclear. The purpose of this study was to describe changes in MMP-1, MMP-9, and TIMP-1 levels during DFU healing, and to search for any correlation in the changes in MMP levels with wound healing, in order to find possible predictors of healing. Methods: Patients with a DFU were recruited and placed into two groups, according to the degree of wound healing: ‘good healers’ and ‘poor healers’. Levels of MMP-1, MMP-9, and TIMP-1 were analysed by ELISA (enzyme-linked immunosorbent assay). Results: A total of 22 patients participated in the study. The MMP-1 level was significantly higher at weeks zero (W0) and 12 (W12) in ‘good healers’ than in ‘poor healers’ (p=0.045 and 0.008, respectively). In contrast, the MMP-9 level was significantly lower in ‘good healers’ than in ‘poor healers’ at W0, W4, and W12 (p=0.001, 0.001 and 0.028, respectively). Receiver operator curve (ROC) analysis of the MMP-9 level, MMP-1/TIMP-1 ratio, and MMP-9/TIMP-1 ratio at W0 provided cut-off levels of 0.38, 0.056, and 9.06, respectively, which were best predictive of a reduction in wound area at W4 (‘good healers’ versus ‘poor healers’; thereby predicting wound healing condition at W12) with a sensitivity of 81.8%, 81.8%, and 90.9%, and a specificity of 64.6%, 55%, and 64.6%, respectively. Conclusion: A ‘poor healing scoring system’ is therefore proposed that could be determined on patient admission, which has the potential to be used clinically as a predictor of healing, thus allowing an appropriate treatment plan to be developed.
Day surgery for anterior cruciate ligament reconstruction in children: A prospective study on feasibility and satisfaction
Authors: Barbier D. , N'Dele D. , Bennis M. , Thevenin-Lemoine C. , De Gauzy J. Sales , Accadbled F. 
Published: December 2018

Purpose To evaluate the feasibility of day surgery anterior cruciate ligament reconstruction (ACLR) in children. Our hypothesis was that proper patient selection, adequate information and a streamlined clinical pathway would allow for a safe and satisfactory procedure. Methods A total of 20 patients, seven girls and 13 boys, who underwent outpatient ACLR at mean age of 14 years (8 to 16) were included in this single institution prospective case series. Surgery took place under simple general anesthesia while analgesia protocol combined local anesthesia, oral analgesics for the postoperative period and compressive cryotherapy. The main failure criterion was the inability to return home the day of surgery or the need for rehospitalization during the first week after discharge. Secondary evaluation parameters were the rate of postoperative complications, postoperative pain, quality of life (QOL) and patients' satisfaction outcome questionnaire (PSOQ) at postoperative day 1, 7 and 31. Results Of the 20 patients included, only one failed the ambulatory mode. The mean PSOQ score was, respectively for children and parents, 91.4% and 90.7% at day 7 and 94.6% and 95.7% at one month. Postoperative QOL at day 7 was very satisfying for all patients. Two minor early complications were reported. Both of the late complications, which included one partial wound dehiscence and one persistent knee swelling, resolved spontaneously. Conclusion This study indicates that, in a targeted and well-informed population, day surgery for children ACLR yields high level of patient and family satisfaction in a safely manner. Level of evidence IV, prospective case series.
Dynamics of digital media in school music contexts
Authors: Nielsen Tess 
Published: December 2018

Abstract
This study focuses on participants’ behaviours and practices as they discovered, produced and shared music using digital devices. Three broad areas of engagement include students’ perception of digital music reception, self-production and transmission. A constructivist–interpretivist viewpoint frames the theoretical perspective of the study. Interviews and observations of four high school students and their music teacher comprise the data. Detailed accounts illustrate the perceptions of the participants, building a thick description. The study also considers what a music teacher understood about her students’ out-of-school musical interactions. The findings are represented in a visual model demonstrating the convergence and divergence of digital music engagement in a high school setting. Themes of experiencing music for personal identity, creativity and popular culture intermix in classroom and informal learning contexts. The outcomes may suggest possible paths for connecting in-school and out-of-school music learning with digital devices.
Finding pedagogical value in Australian contemporary popular music: A comparative case study of electric guitar compositional styles
Authors: Lee Daniel , Baker Bill , Haywood Nick 
Published: December 2018

Abstract
How do educators ascertain the pedagogical value of a musical composition for inclusion as curriculum exemplars? A number of factors contribute, including: canonic status, historical and cultural significance, popularity and aesthetic values. This comparative case study examines a number of Australian compositions from within the scope of contemporary popular music (CPM) looking for musical richness as a factor of pedagogical value in modern guitar curricula. Using The Beatles’ song ‘Eleanor Rigby’ as a comparative basis, musicological methodologies of theoretical analysis are applied to six Australian CPM compositions to evaluate their pedagogical value. Discussion of the musical richness discovered in each composition leads to conclusions regarding their value within a guitar programme of an Australian CPM school curriculum.
Blood Biochemical Components and Progesterone Hormone on Day of Estrus in Crossbred Cattle in Egypt
Authors: Mourad R. S. 
Published: December 2018

Deficiencies or excess minerals such as P, Cu, and Zn are associated with subnormal fertility and anoestrus conditions in cows. This study was conducted in a veterinary unit in Menufiya, Egypt. Eighteen head of crossbred cows were randomly selected at random at estrus time (estrus group) and as a control 14 head of crossbred cows were selected from newly-calving dams at about 6-12 hours after calving (control group). The aim of this study was to use the components of biochemistry and progesterone hormone on estrus day of crossbreeding cattle in Egypt. The information from this study will be used to confirm estrus time to improve mating percentage. In blood plasma, the concentrations of all biochemical components and progesterone concentrations in estrus animals are higher than control cows except globulin. The results showed that blood plasma from control animal obtained Mg, Ca / P ratio, Co, Cu, Zn, Se, and Mo concentration is higher than estrus cattle. On the other hand, blood plasma concentrations of Na, K, Ca, P, Mn, and Fe are higher in estrus cattle. The progesterone concentration of estrus cattle is lower during summer than in winter. In estrus cows, higher plasma macro-elements were found in winter than in summer except for K, Ca and Ca/P ratio. On the other side of estrus cattle, all trace elements of blood plasma are higher in winter than in summer except Zn, Mn, Se, and Fe.