bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Department Interventions for Older Adults: A Systematic Review
Authors: Hughes Jaime M. , Freiermuth Caroline E. , Shepherd‐Banigan Megan , Ragsdale Luna , Eucker Stephanie A. , Goldstein Karen , Hastings S. Nicole , Rodriguez Rachel L. , Fulton Jessica , Ramos Katherine , Tabriz Amir Alishahi , Gordon Adelaide M. , Gierisch Jennifer M. , Kosinski Andrzej , Williams John W. 
Published: March 2019

OBJECTIVESTo evaluate the effect of emergency department (ED) interventions on clinical, utilization, and care experience outcomes for older adults.DESIGNA conceptual model informed, protocol‐based systematic review.SETTINGEmergency Department (ED).PARTICIPANTSOlder adults 65 years of age and older.METHODS AND MEASUREMENTMedline, Embase, CINAHL, and PsycINFO were searched for English‐language studies published through December 2017. Studies evaluating the use of one or more eligible intervention strategies (discharge planning, case management, medication safety or management, and geriatric EDs including those that cited the 2014 Geriatric ED Guidelines) with adults 65 years of age and older were included. Studies were classified by the number of intervention strategies used (ie, single strategy or multi‐strategy) and key intervention components present (ie, assessment, referral plus follow‐up, and contact both before and after ED discharge [“bridge”]). The effect of ED interventions on clinical (functional status, quality of life [QOL]), patient experience, and utilization (hospitalization, ED return visit) outcomes was evaluated.RESULTSA total of 2000 citations were identified; 17 articles describing 15 unique studies (9 randomized and 6 nonrandomized) met eligibility criteria and were included in analyses. ED interventions showed a mixed pattern of effects. Overall, there was a small positive effect of ED interventions on functional status but no effects on QOL, patient experience, hospitalization at or after the initial ED index visit, or ED return visit.CONCLUSIONStudies using two or more intervention strategies may be associated with the greatest effects on clinical and utilization outcomes. More comprehensive interventions, defined as those with all three key intervention components present, may be associated with some positive outcomes.
Cushion and shrub ecosystem engineers contribute differently to diversity and functions in alpine ecosystems
Authors: Chen Jian‐Guo , He Xiao‐Fang , Wang Song‐Wei , Yang Yang , Sun Hang 
Published: March 2019

AbstractQuestionsAs ecosystem engineers, alpine cushion and shrub species have been widely documented, but their roles as co‐existing nurse plants have not been explicitly compared. In this study, our questions were: (1) what are the differences in engineering effects between cushions and shrubs in alpine ecosystems in southwestern China? (2) what are the differences in their influences on the attributes of alpine plant communities? and (3) can we detect the effects of changes in environmental stress with elevation on the engineering effects of cushions and shrubs?Study SiteThree plant communities along an elevational gradient on Baima Snow Mountain, SW China.MethodsField measurements were carried out to assess effects of cushion (Arenaria polytrichoides) and shrub (Rhododendron rupicola) species on soil temperature, soil nutrient and water availabilities, the species richness of co‐existing vascular species and their abundance, above‐ground production and the percentages of grazed individuals.ResultsShrub and cushion species modify micro‐environmental conditions, especially at higher elevations, but in different ways. Grazing pressures are highest for plants in the surroundings, followed by within cushions, and finally under shrubs. This indicates that both cushion and shrub species can protect beneficiary species from grazing by livestock. The presence of cushion plants increased species richness, abundance and above‐ground production in the higher community but not in the middle and lower communities. However, the presence of shrubs consistently increased those measurements across the elevational gradient. In addition, some species exclusively and some others preferentially occur within cushions or beneath shrubs.ConclusionThe results clearly suggest that alpine cushion and shrub species in the Hengduan Mountains both act as ecosystem engineers and contribute positively to community attributes. However, their engineering effects vary with environmental stresses. Cushions could facilitate other species under severe abiotic stress, but showed much weaker or even competitive effects in benign conditions; shrubs’ facilitation may remain consistently strong under different stresses.
Systematic analysis of Type I‐E Escherichia coli CRISPR‐Cas PAM sequences ability to promote interference and primed adaptation
Authors: Musharova Olga , Sitnik Vasily , Vlot Marnix , Savitskaya Ekaterina , Datsenko Kirill A. , Krivoy Andrey , Fedorov Ivan , Semenova Ekaterina , Brouns Stan J. J. , Severinov Konstantin 
Published: March 2019

SummaryCRISPR interference occurs when a protospacer recognized by the CRISPR RNA is destroyed by Cas effectors. In Type I CRISPR‐Cas systems, protospacer recognition can lead to «primed adaptation» – acquisition of new spacers from in cis located sequences. Type I CRISPR‐Cas systems require the presence of a trinucleotide protospacer adjacent motif (PAM) for efficient interference. Here, we investigated the ability of each of 64 possible trinucleotides located at the PAM position to induce CRISPR interference and primed adaptation by the Escherichia coli Type I‐E CRISPR‐Cas system. We observed clear separation of PAM variants into three groups: those unable to cause interference, those that support rapid interference and those that lead to reduced interference that occurs over extended periods of time. PAM variants unable to support interference also did not support primed adaptation; those that supported rapid interference led to no or low levels of adaptation, while those that caused attenuated levels of interference consistently led to highest levels of adaptation. The results suggest that primed adaptation is fueled by the products of CRISPR interference. Extended over time interference with targets containing «attenuated» PAM variants provides a continuous source of new spacers leading to high overall level of spacer acquisition.
A dual functional redox enzyme maturation protein for respiratory and assimilatory nitrate reductases in bacteria
Authors: Pinchbeck Benjamin J. , Soriano‐Laguna Manuel J. , Sullivan Matthew J. , Luque‐Almagro Victor M. , Rowley Gary , Ferguson Stuart J. , Roldán M. Dolores , Richardson David J. , Gates Andrew J. 
Published: March 2019

SummaryNitrate is available to microbes in many environments due to sustained use of inorganic fertilizers on agricultural soils and many bacterial and archaeal lineages have the capacity to express respiratory (Nar) and assimilatory (Nas) nitrate reductases to utilize this abundant respiratory substrate and nutrient for growth. Here, we show that in the denitrifying bacterium Paracoccus denitrificans, NarJ serves as a chaperone for both the anaerobic respiratory nitrate reductase (NarG) and the assimilatory nitrate reductase (NasC), the latter of which is active during both aerobic and anaerobic nitrate assimilation. Bioinformatic analysis suggests that the potential for this previously unrecognized role for NarJ in functional maturation of other cytoplasmic molybdenum‐dependent nitrate reductases may be phylogenetically widespread as many bacteria contain both Nar and Nas systems.
Avoidance of Cutter Retracting Interference in Noncircular Gear Shaping Through 4-Linkage Model
Authors: Zheng Fangyan , Lin Hua , Han Xinghui , Zhang Mingde , Zhang Weiqing , Guo Xiaodong 
Published: March 2019

Gear shaping, a widely used machining method for circular gears, was generalized to noncircular gears in recent works using a 3-linkage machine tool. As the pitch curve normals of noncircular gears change constantly in processing, angles may exist between the pitch curve normals and the cutter relieving direction, bringing in turn cutter retracting interference.
Regarding this, the paper proposes a 4-linkage shaping method. Through linkage motion of 4 machine tool axes, noncircular gear pitch normals are along the cutter relieving direction, avoiding completely cutter retracting interference. On such basis, a mathematical model is first established, the cutting process is then discussed and a cutting experiment is finally carried out, proving the validity of the proposed method.
Impact of Chaining Method and Level of Completion on Accuracy of Function Structure-Based Market Price Prediction Models
Authors: Gill Amaninder Singh , Summers Joshua D. , Sen Chiradeep 
Published: March 2019

AbstractThe goal of this paper is to explore how different modeling approaches for constructing function structure models and different levels of model completion affect the ability to make inferences (reason) on the resulting information within the respective models. Specifically, the function structure models are used to predict market prices of products, predictions that are then compared based on their accuracy and precision. This work is based on previous studies on understanding how function modeling and the use of topological information from design graphs can be used to predict information with historical training. It was found that forward chaining was the least favorable chaining type irrespective of the level of completion, whereas the backward-chaining models performed relatively better across all completion levels. Given the poor performance of the nucleation models at the highest level of completion, future research must be directed toward understanding and employing the methods yielding the most accuracy. Moreover, the results from this simulation-based study can be used to develop modeling guidelines for designers or students, when constructing function models.
Tibial nerve decompression for the prevention of the diabetic foot: a cost–utility analysis using Markov model simulations
Authors: Sarmiento Samuel , Pierre Jr James A , Dellon A Lee , Frick Kevin D 
Published: March 2019

ObjectiveTo determine whether tibial neurolysis performed as a surgical intervention for patients with diabetic neuropathy and superimposed tibial nerve compression in the prevention of the diabetic foot is cost-effective when compared with the current prevention programme.DesignA baseline analysis was built on a 5-year model to determine the cumulative incidence of foot ulcers and amputations with each strategy. Subsequently, a cost-effectiveness analysis and cohort-level Markov simulations were conducted with a model composed of 20 6-month cycles. A sensitivity analysis was also performed.SettingA Markov model was used to simulate the effects of standard prevention compared with tibial neurolysis on the long-term costs associated with foot ulcers and amputations. This model included eight health states.ParticipantsEach cohort includes simulated patients with diabetic neuropathy at different levels of risk of developing foot ulcers and amputations.Primary and secondary outcome measuresThe primary outcome was the long-term trends concerning the development of ulcers and amputations with each strategy. The secondary outcome measures were quality adjusted life years (QALYs), incremental cost-effectiveness and net monetary benefits of the optimal strategy.ResultsWhen compared with standard prevention, for a patient population of 10 000, surgery prevented a simulated total of 1447 ulcers and 409 amputations over a period of 5 years. In a subsequent analysis that consisted of 20 6-month cycles (10 years), the incremental cost of tibial neurolysis compared with current prevention was $12 772.28; the incremental effectiveness was 0.41 QALYs and the incremental cost-effectiveness ratio was $31 330.78. Survival was 73% for those receiving medical prevention compared with 95% for those undergoing surgery.ConclusionThese results suggest that among patients with diabetic neuropathy and superimposed nerve compression, surgery is more effective at preventing serious comorbidities and is associated with a higher survival over time. It also generated greater long-term economic benefits.
The effect of intranasal oxytocin on the perception of affective touch and multisensory integration in anorexia nervosa: protocol for a double-blind placebo-controlled crossover study
Authors: Crucianelli Laura , Serpell Lucy , Paloyelis Yannis , Ricciardi Lucia , Robinson Paul , Jenkinson Paul , Fotopoulou Aikaterini 
Published: March 2019

IntroductionAnorexia nervosa (AN) is an eating disorder characterised by restriction of energy intake, fears of gaining weight and related body image disturbances. The oxytocinergic system has been proposed as a pathophysiological candidate for AN. Oxytocin is a neuropeptide involved in bodily processes (eg, breast feeding) and in the onset of social behaviours (eg, bonding). Studies investigating the effect of intranasal oxytocin (IN-OT) in AN showed that it can improve attentional bias for high-calorie food and fat bodies stimuli, and related stress. However, less is known about the effect of IN-OT on bodily awareness and body image distortions, key features of the disorder linked to its development, prognosis and maintenance. Here, we aim to investigate the effect of IN-OT on the perception of affective, C-tactile-optimal touch, known to be impaired in AN and on multisensory integration processes underlying a body ownership illusion (ie, rubber hand illusion). For exploratory purposes, we will also investigate the effect of IN-OT on another interoceptive modality, namely cardiac awareness and its relationship with affective touch.Design, methods and analysisForty women with AN and forty matched healthy controls will be recruited and tested in two separate sessions; self-administering IN-OT (40 IU) or placebo, intranasally, in a pseudo-randomised manner. The data from this double-blind, placebo-controlled, cross-over study will be analysed using linear mixed models that allow the use of both fixed (treatment levels) and random (subjects) effects in the same analysis. To address our main hypotheses, separate analyses will be run for the affective touch task, where the primary outcome dependent variable will be the pleasantness of the touch, and for the rubber hand illusion, where we will investigate multisensory integration quantified as subjective embodiment towards the rubber hand. In the latter, we will manipulate the synchronicity of touch and the size of the hand.Ethics and disseminationEthics approval has been obtained by National Research Ethics Service NRES Committee London (Queen’s Square Committee, ref number 14/LO/1593). The results will be disseminated through conference presentations and publication in peer-reviewed journals.
Association between caesarean section delivery and obesity in childhood: a longitudinal cohort study in Ireland
Authors: Masukume Gwinyai , McCarthy Fergus P , Baker Philip N , Kenny Louise C , Morton Susan MB , Murray Deirdre M , Hourihane Jonathan O’B , Khashan Ali S 
Published: March 2019

ObjectivesTo investigate the association between caesarean section (CS) birth and body fat percentage (BF%), body mass index (BMI) and being overweight or obese in early childhood.DesignProspective longitudinal cohort study.SettingBabies After Screening for Pregnancy Endpoints: Evaluating the Longitudinal Impact on Neurological and Nutritional Endpoints cohort.ParticipantsInfants born to mothers recruited from the Screening for Pregnancy Endpoints study, Cork University Maternity Hospital between November 2007 and February 2011.Outcome measureOverweight or obese defined according to the International Obesity Task Force criteria.ResultsOf the 1305 infants, 362 (27.8%) were delivered by CS. On regression analysis, BF% at 2 months did not differ significantly by delivery mode. Infants born by CS had a higher mean BMI at 6 months compared with those born vaginally (adjusted mean difference=0.24; 95% CI 0.06 to 0.41, p value=0.009). At 2 years, no difference was seen across the exposure groups in the risk of being overweight or obese. At 5 years, the association between prelabour CS and the risk of overweight or obesity was not statistically significant (adjusted relative risk ratio, aRRR=1.37; 95% CI 0.69 to 2.69) and the association remained statistically nonsignificant when children who were macrosomic at birth were excluded from the model (aRRR=0.86; 95% CI 0.36 to 2.08).ConclusionAt 6 months of age, children born by CS had a significantly higher BMI but this did not persist into future childhood. There was no evidence to support an association between mode of delivery and long-term risk of obesity in the child.
Observational study protocol for evaluating control of hypertension and the effects of social determinants
Authors: Angier Heather , Huguet Nathalie , Marino Miguel , Green Beverly , Holderness Heather , Gold Rachel , Hoopes Megan , DeVoe Jennifer 
Published: March 2019

IntroductionHypertension is a common chronic health condition. Having health insurance reduces hypertension risk; health insurance coverage could improve hypertension screening, treatment and management. The Medicaid eligibility expansion of the Affordable Care Act was ruled not to be required by the US Supreme Court. Subsequently, a ‘natural experiment’ was produced with some states expanding Medicaid eligibility while others did not. This presents a unique opportunity to learn whether and to what extent Medicaid expansion can affect healthcare access and services for patients at risk for and diagnosed with hypertension, and patients with undiagnosed hypertension. Additionally, social determinants of health (SDH), at both the individual- and community-level, influence diagnosis and care for hypertension and it is important to understand how they interact with health insurance coverage changes.Methods/designWe will use electronic health record (EHR) data fromtheAccelerating Data Value Across a National Community Health Center Network clinical data research network, which has data from community health centres in 22 states, some that did and some that did not expand Medicaid. Data include information on changes in health insurance, service receipt and health outcomes from 2012 through the most recent data available. We will include patients between the ages of 19 and 64 years (n=1 524 241) with ≥1 ambulatory visit to a community health centre. We will estimate differences in outcomes using difference-in-difference and difference-in-difference-in-difference approaches. We will test three-way interactions with insurance group, time and social determinants of health factors to compare the potential effect of gaining insurance on our proposed outcomes.Ethics and disseminationThis study uses secondary data analysis and therefore approval for consent to participate was waived. The Institutional Review Board for OHSU approved this study. Approval reference number is: IRB00011858. We plan to disseminate our findings at relevant conferences, meetings and through peer-reviewed journals.Trial registration numberNCT03545763.
Critical appraisal of adverse effects reporting in the ‘Treatment for Adolescents With Depression Study (TADS)’
Authors: Westergren Tone , Narum Sigrid , Klemp Marianne 
Published: March 2019

ObjectiveTo identify all publications from the ‘Treatment for Adolescents With Depression Study (TADS)’ and assess the findings regarding occurrence of any adverse effects in the treatment groups both for the short-term and long-term study stages.DesignDescriptive analysis of TADS publications with any information on adverse effects.ResultsWe identified 48 publications describing various aspects of the TADS, in which 439 adolescent patients received treatment with fluoxetine, cognitive–behavioural therapy, cognitive–behavioural therapy plus fluoxetine or placebo. Eight publications were assessed as providing some data on adverse effects. Risk of suicidal behaviour was the only adverse effect that was addressed in all publications. Several psychiatric and physical adverse effects were reported during the first 12 weeks, but not mentioned in reports from later study stages. Common adverse effects of fluoxetine, such as weight changes or sexual problems, were not identified or mentioned in the publications.ConclusionsThe TADS publications do not present a comprehensive assessment of treatment risk with fluoxetine in adolescents, especially for more than 12 weeks of treatment. Risk of suicidality was the only adverse effect that was reported over time. Reporting of adverse effects was incomplete with regard to the long-term safety profile of fluoxetine.
Dislocated distal radial fractures in adult patients: 4 weeks versus 6 weeks of cast immobilisation following reduction, a multicentre randomised controlled trial, study protocol
Authors: van Delft Eva A K , Bloemers Frank W , Sosef Nico L , Bonjer H J , Schep Niels W L , Vermeulen Jefrey 
Published: March 2019

IntroductionUp to 30% of patients with a dislocated distal radial fracture (DRF) treated with closed reduction and cast immobilisation suffer from long-term functional restrictions. It remains unclear, whether duration of cast immobilisation influences functional outcome. The aim of this study is to evaluate whether the functional outcome of dislocated DRFs could be improved by shortening the period of immobilisation.Methods and analysisA single blinded multicentre randomised controlled trial is initiated. Four weeks of plaster cast immobilisation is compared with six week plaster cast immobilisation in adult patients with adequate reduced DRFs. Primary outcome parameters are functional outcome measured with the Patient Rated Wrist Evaluation after 1 year of follow-up (FU). Secondary outcomes are: Disability of Arm, Shoulder and Hand Score after 1 year, 36-Item Short Form Health Survey after 1 year, functional outcome earlier in FU (6 weeks, 12 weeks and 6 months), range of motion, pain level and complications: number of re-interventions, secondary dislocation, delayed and non-union.Ethics and disseminationThe medical ethical committee VUmc approved the study protocol (2018.004, NL62861.029.17). The expectation of this study is that a shorter duration of plaster cast immobilisation is beneficial. This risk of specific complications is low and generally similar in both treatment options. FU is standardised according to current trauma guidelines. Present literature indicates that both treatment options that are used within this study are accepted protocols for treatment of dislocated DRFs. This trial will provide Level-I evidence for the comparison of functional outcome between the two treatment options for dislocated DRFs. Results of this study are expected to be published as a prospective, multicentre, randomised controlled trial article in 2021.Trial registrationThe Netherlands National Trial Register: NTR 6600, ABR: NL62861.029.17. Medical Ethical Committee VUmc registration number: 2018.004.