bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression in Emergency Department Patients and Association With Health Care Utilization
Authors: Beiser David G. , Ward Charlotte E. , Vu Milkie , Laiteerapong Neda , Gibbons Robert D. 
Published: March 2019

AbstractBackgroundDepression is one of the most common illnesses in the United States, with increased prevalence among people with lower socioeconomic status and chronic mental illness who often seek care in the emergency department (ED). We sought to estimate the rate and severity of major depressive disorder (MDD) in a nonpsychiatric ED population and its association with subsequent ED visits and hospitalizations.MethodsThis prospective cohort study enrolled a convenience sample of English‐speaking adults presenting to an urban academic medical center ED without psychiatric complaints between January 1, 2015, and September 21, 2015. Patients completed a computerized adaptive depression diagnostic screen (CAD‐MDD) and dimensional depression severity measurement test (CAT‐DI) via tablet computer. Primary outcomes included number of ED visits and hospitalizations assessed from index visit until January 1, 2016. Negative binomial regression modeling was performed to assess associations between depression, depression severity, clinical covariates, and utilization outcomes.ResultsOf 999 enrolled patients, 27% screened positive for MDD. The presence of MDD conveyed a 61% increase in the rate of ED visits (incidence rate ratio [IRR] = 1.61, 95% confidence interval [CI] = 1.27 to 2.03) and a 49% increase in the rate of hospitalizations (IRR = 1.49, 95% CI = 1.06–2.09). For each 10% increase in MDD severity, there was a 10% increase in the relative rate of subsequent ED visits (IRR = 1.10, 95% CI = 1.04 to 1.16) and hospitalizations (IRR = 1.10, 95% CI = 1.02 to 1.18). Across the range of the severity scale there was over a 2.5‐fold increase in the rate of ED visits and hospitalization rates.ConclusionsRates of depression were high among a convenience sample of English‐speaking adult ED patients presenting with nonpsychiatric complaints and independently associated with increased risk of subsequent ED utilization and hospitalization. Standardized assessment tools that provide rapid, accurate, and precise classification of MDD severity have the potential to play an important role in identifying ED patients in need of urgent psychiatric resource referral.
Community trial of silver fluoride treatment for deciduous dentition caries in remote Indigenous communities
Authors: Roberts‐Thomson KF , Ha DH , Wooley S , Meihubers S , Do LG 
Published: March 2019

AbstractBackgroundSilver fluoride 40% followed by 10% stannous fluoride (AgF) has been used in dental practice in some parts of Australia for many years. This study compared the effectiveness of application of AgF with atraumatic restorative technique (ART) in managing cavitated carious primary molars.MethodsThe study was a community effectiveness trial in two remote Aboriginal communities where AgF has been used for some time. Children between 4 and 8 years of age with caries on primary molars were randomized by birth date to receive AgF or ART. There were 210 children who were included in the study with 384 eligible teeth. Children were followed up for periods between 9 months and 4 years. Negative outcomes such as dental pain, extraction, use of antibiotics and more extensive restorative treatment were considered as the primary outcomes of the study.ResultsThose negative outcomes were infrequent in both treatment groups. The prevalence ratio of negative sequelae for children treated with AgF compared with those treated with ART was lower at 0.18.ConclusionsSilver fluoride was well accepted, easy to use and at least as effective a treatment as ART for dental caries in primary molars in young Aboriginal children in remote areas.
Elevation has contrasting effects on avian and mammalian nest traits in the Andean temperate mountains
Authors: Altamirano Tomás A. , Honorato María Teresa , Ibarra José Tomás , de la Maza Mariano , de Zwaan Devin R. , Bonacic Cristián , Martin Kathy 
Published: March 2019

AbstractNest building is a widespread breeding strategy across taxa. Nest composition and structure can play a critical role in the breeding success and/or adult survival of nest‐building vertebrates. Although nest traits are expected to vary adaptively across elevational gradients, few studies address this relationship. We studied the variation in nest traits (composition and structure) across elevation for two taxa with two different functions in the Andean temperate forests of southern Chile: a bird (Aphrastura spinicauda, Furnariidae, 170 breeding nests) and a marsupial mammal (Dromiciops gliroides, Microbiotheriidae, 91 winter torpor nests). ForA. spinicauda, we further assessed how nest traits influenced clutch size and hatching success. Both species used fewer types of nest materials (items) with increasing elevation, and a greater proportion of leaves were used in highland compared to lowland forests.Aphrastura spinicaudaused feathers and hair, andD. gliroidesused bryophytes more frequently in lowland forests. The mass and volume of nests decreased with increasing elevation forA. spinicaudaand increased forD. gliroides. Nest traits had subsequent fitness consequences forA. spinicauda, such that: (i) greater cup volume and depth were associated with larger clutch sizes, (ii) more items used during nest building were linked to improved clutch size at high elevation only, and (iii) nest wall thickness was negatively associated with hatching success. Thus, in temperate mountain ecosystems, elevation may be an important factor influencing nest‐building behaviour for cavity‐using vertebrates. However, the direction of the elevational effects may vary among taxa and nest functions in these ecosystems.
Referral patterns for genetic counselling of women diagnosed with tubo‐ovarian or peritoneal high‐grade serous carcinoma (HGSC) within the Auckland Gynaecological Oncology Centre
Authors: Burling Michael J , Gamet Kimberly , Eva Lois , Tan Ai Ling 
Published: March 2019

BackgroundGermline BRCA1/2 mutations account for approximately 15% of invasive ovarian carcinomas. Referral of all women with non‐mucinous epithelial tubo‐ovarian and peritoneal cancer, especially high‐grade serous carcinoma (HGSC) to genetic services for genetic counselling and subsequent BRCA testing, has become standard of care in many countries. Publicly funded BRCA testing was restricted to women ≤70 years old with HGSC in New Zealand for most of our study period. Referral rates of women with HGSC for BRCA mutation testing in New Zealand have not previously been reported.AimsTo determine the proportion of eligible patients with tubo‐ovarian or peritoneal HGSC referred to Auckland Gynaecologic Oncology Centre who were referred for genetic counselling. To determine the number of patients who underwent BRCA1/2 genetic testing and the rate of germline BRCA mutations.MethodsEligible cases were identified from Auckland Gynaecologic Oncology multidisciplinary meetings database from 1 January 2012 to 31 December 2014. Genetic referrals sent were checked against the genetic services database to ensure that referrals were received. Genetic counselling clinic attendance, uptake and results of genetic testing were also collected.ResultsOne hundred and four eligible patients were identified with 58 patients referred. Referral rates increased from 37.5% in 2012 to 64.3% in 2014. Of the 58 patients referred, 53 attended genetic counselling, and 49 underwent BRCA mutation testing, of whom 10 (20.4%) tested positive for a germline BRCA mutation.ConclusionOverall, 55.8% of eligible patients were referred for genetic testing; however, referral rates increased with time. This BRCA mutation‐positive rate is comparable with current international data.
Pre‐eclampsia causing severe maternal morbidity – A national retrospective review of preventability and opportunities for improved care
Authors: MacDonald Evelyn Jane , Lepine Sam , Pledger Megan , Geller Stacie E. , Lawton Bev , Stone Peter 
Published: March 2019

IntroductionPre‐eclampsia and related sequelae are a leading cause of severe maternal and neonatal morbidity and mortality. A significant proportion of these poor outcomes may be preventable with improvements along the continuum of maternal and neonatal care.AimsThe aim of this study was to review cases of pre‐eclampsia resulting in severe maternal morbidity, describing the maternal and neonatal outcomes and the potential preventability of severe maternal morbidity (SMM).Materials and MethodsThis was a retrospective cohort study of cases of SMM associated with severe pre‐eclampsia – a subset of a national SMM review study. Inclusion criteria for this subset were women who were pregnant or within 42 days of delivery with severe pre‐eclampsia as the main reason for admission to an intensive care unit or high dependency unit in New Zealand between 1 August 2013 and 31 January 2015 inclusive. A multidisciplinary expert panel reviewed cases for preventability using a validated preventability tool.ResultsOf the 89 severe morbidities that were reviewed, 10 had eclampsia (11%) and there were four neonatal mortalities (4.3%). Multidisciplinary committees assessed the severe morbidity as potentially preventable in 31% (28) of cases with the majority due to delays in diagnosis and suboptimal treatment.ConclusionWe found a high level of preventable morbidity in cases of severe pre‐eclampsia with a concerning number of preventable eclampsia. Implementation of evidence‐based guidelines reinforced with education would assist clinicians to improve risk recognition, timely diagnosis and treatment and decrease potentially preventable severe morbidity associated with pre‐eclampsia.
Measuring and Explaining Political Sophistication through Textual Complexity
Authors: Benoit Kenneth , Munger Kevin , Spirling Arthur 
Published: March 2019

AbstractPolitical scientists lack domain‐specific measures for the purpose of measuring the sophistication of political communication. We systematically review the shortcomings of existing approaches, before developing a new and better method along with software tools to apply it. We use crowdsourcing to perform thousands of pairwise comparisons of text snippets and incorporate these results into a statistical model of sophistication. This includes previously excluded features such as parts of speech and a measure of word rarity derived from dynamic term frequencies in the Google Books data set. Our technique not only shows which features are appropriate to the political domain and how, but also provides a measure easily applied and rescaled to political texts in a way that facilitates probabilistic comparisons. We reanalyze the State of the Union corpus to demonstrate how conclusions differ when using our improved approach, including the ability to compare complexity as a function of covariates.
Are Biased Media Bad for Democracy?
Authors: Wolton Stephane 
Published: March 2019

AbstractThis article assesses the normative and positive claims regarding the consequences of biased media using a political agency framework that includes a strategic voter, polarized politicians, and news providers. My model predicts that voters are always better informed with unbiased than with biased outlets even when the latter have opposite ideological preferences. However, biased media may improve voter welfare. Contrary to several scholars' fears, partisan news providers are not always bad for democracy. My theoretical findings also have important implications for empirical analyses of the electoral consequences of changes in the media environment. The impact of left‐wing and right‐wing biased outlets depends on the partisan identity of officeholders. Empirical findings may, thus, not be comparable across studies or even over time within a study. Existing empirical works are unlikely to measure the consequences of biased media, as researchers never observe and can rarely approximate the adequate counterfactual: elections with unbiased news outlets.
Mathematical model of the risk of drug error during anaesthesia: the influence of drug choices, injection routes, operation duration and fatigue
Authors: Sivia D. S. , Pandit J. J. 
Published: March 2019

SummaryThe incidence of an anaesthetic drug error can be directly observed in large trials. In an alternative approach, we developed a probabilistic mathematical model in which the anaesthetist is modelled as a ‘fallible entity’ who makes repeated drug administration choices during an operation. This fallibility was factored in the model as an initial ‘intrinsic error rate’. The choices faced included: dose; timing of administration; and the routes available for injection (e.g. venous, arterial, epidural, etc.). Additionally, we modelled the effect of fatigue as a factor that magnifies the cumulative error rate. For an initial intrinsic error rate of 1 in 1000 (which from first principles we consider a reasonable estimate), our model predicted a cumulative probability of error over a ~12 h operation of ~10%; that is, 1 in 10 operations this long results in some drug error. This is similar to the rate reported by large observational trials. Serious errors constitute a small fraction of all errors; our model predicts a Poisson distribution for the uncommon serious errors, also consistent with independent observations. Even modest assumptions for the development of fatigue had a dramatic and adverse impact on the cumulative error rate. The practice implications of our modelling include: exercising caution or avoiding starting work if under par; added vigilance in unfamiliar environments; keeping anaesthetic recipes simple; and recognising that operation durations > 5–6 h constitute a time of exaggerated risk. These implications are testable predictions in observational trials. If validated, our model could serve as a potential research tool to investigate the impact of safety interventions on the rate of intrinsic error using simulation.
Open reduction through a posterior incision in the surgical treatment of shoulder posterior dislocation associated with proximal humeral fractures
Authors: Shen Longxiang , Jiang Chaolai , An Zhiquan 
Published: March 2019

BackgroundWe explored the surgical technique of reducing the humeral head and repairing the fractures through a combined approach in the treatment of this complex injury.MethodsSix patients with posterior shoulder dislocations associated with proximal humerus fractures were enrolled in this study. The posteriorly dislocated head was first reduced through a shoulder posterior incision and the ruptured posterior capsular tissues were repaired simultaneously using a suture anchor. The fractures were then reduced and fixed with a PHILOS through a deltopectoral approach. The affected shoulders were immobilized in a neutral position for 6 weeks postoperatively with a customized orthosis and then permitted active shoulder exercises after removal of the orthosis. At the last visit, union of the fractures was evaluated. Degrees of anterior forward of the affected shoulder were recorded. Outcomes were evaluated according to UCLA and Constant criteria.ResultsSix patients were followed up for an average of 24.5 ± 7.4 (range 13–35) months. At the last visit, the mean degree of anterior forward was 171.7 ± 7.5 (range 160–180) degrees. An average of 32.9 ± 1.2 (range 31–34) points was obtained according to UCLA criteria, demonstrating excellent and good results in two and four cases, respectively. The mean Constant score was 87.3 ± 4.1 (range 83–92) points.ConclusionsThe dislocated humeral head can be reduced through a posterior approach, while fractures can be reduced and fixed through a deltopectoral approach. This technique has the advantages of simplicity and its minimally invasive approach for reducing the dislocation.
Automated pose estimation captures key aspects of General Movements at eight to 17 weeks from conventional videos
Authors: Marchi Viviana , Hakala Anna , Knight Andrew , D'Acunto Federica , Scattoni Maria Luisa , Guzzetta Andrea , Vanhatalo Sampsa 
Published: March 2019

AbstractAimGeneral movement assessment requires substantial expertise for accurate visual interpretation. Our aim was to evaluate an automated pose estimation method, using conventional video records, to see if it could capture infant movements using objective biomarkers.MethodsWe selected archived videos from 21 infants aged eight to 17 weeks who had taken part in studies at the IRCCS Fondazione Stella Maris (Italy), from 2011 to 2017. Of these, 14 presented with typical low‐risk movements, while seven presented with atypical movements and were later diagnosed with cerebral palsy. Skeleton videos were produced using a computational pose estimation model adapted for infants and these were blindly assessed to see whether they contained the information needed for classification by human experts. Movements of skeletal key points were analysed using kinematic metrics to provide a biomarker to distinguish between groups.ResultsThe visual assessments of the skeleton videos were very accurate, with Cohen's K of 0.90 when compared with the classification of conventional videos. Quantitative analysis showed that arm movements were more variable in infants with typical movements.ConclusionIt was possible to extract automated estimation of movement patterns from conventional video records and convert them to skeleton footage. This could allow quantitative analysis of existing footage.
Species abundance distributions should underpin ordinal cover‐abundance transformations
Authors: McNellie Megan J. , Dorrough Josh , Oliver Ian 
Published: March 2019

AbstractQuestionsThe cover and abundance of individual plant species have been recorded on ordinal scales for millions of plots world‐wide. Ordinal cover data often need to be transformed to a quantitative form (0%–100%), especially when scrutinising summed cover of multiple species. Traditional approaches to transforming ordinal data often assume that data are symmetrically distributed. However, skewed abundance patterns are ubiquitous in plant community ecology. The questions this paper addresses are (a) how can we estimate transformation values for ordinal data that account for the underlying right‐skewed distribution of plant cover; (b) do different plant groups require different transformations; and (c) how do our transformations compare to other commonly used transformations within the context of exploring the aggregate properties of vegetation?LocationGlobal.MethodsWe assigned Braun‐Blanquet cover‐abundance ordinal values to continuous cover observations. We fitted a Bayesian hierarchical beta regression to estimate the predicted mean (PM) cover of each of six plant growth forms within six ordinal classes. We illustrate our method using a case study (2,809 plots containing 95,812 observations), compare the model‐derived estimates to other commonly used transformations and validate our model using an independent dataset (2,227 plots containing 51,497 observations) accessed through the VegBank database.ResultsOur model found that PM estimates differed by growth form and that previous methods overestimated cover, especially of smaller growth forms such as forbs and grasses. Our approach reduced the cumulative compounding of errors and was robust when validated against an independent dataset.ConclusionsBy accounting for the right‐skewed distribution of cover data, our alternate approach for estimating transformation values can be extended to other ordinal scales. A more robust approach to transforming floristic data and aggregating cover estimates can strengthen ecological analyses to support biodiversity conservation and management.
Pharmacokinetics and subjective effects of a novel oral LSD formulation in healthy subjects
Authors: Holze Friederike , Duthaler Urs , Vizeli Patrick , Müller Felix , Borgwardt Stefan , Liechti Matthias E. 
Published: March 2019

AimsThe aim of the present study was to characterize the pharmacokinetics and exposure–subjective response relationship of a novel oral solution of lysergic acid diethylamide (LSD) that was developed for clinical use in research and patients.MethodLSD (100 μg) was administered in 27 healthy subjects using a placebo‐controlled, double‐blind, cross‐over design. Plasma levels of LSD, nor‐LSD, and 2‐oxo‐3‐hydroxy‐LSD (O‐H‐LSD) and subjective drug effects were assessed up to 11.5 hours.ResultsFirst‐order elimination kinetics were observed for LSD. Geometric mean maximum concentration (Cmax) values (range) of 1.7 (1.0–2.9) ng/mL were reached at a tmax (range) of 1.7 (1.0–3.4) hours after drug administration. The plasma half‐life (t1/2) was 3.6 (2.4–7.3) hours. The AUC∞ was 13 (7.1–28) ng·h/mL. No differences in these pharmacokinetic parameters were found between male and female subjects. Plasma O‐H‐LSD but not nor‐LSD (< 0.01 ng/mL) concentrations could be quantified in all subjects. Geometric mean O‐H‐LSD Cmax values (range) of 0.11 (0.07–0.19) ng/mL were reached at a tmax (range) of 5 (3.2–8) hours. The t1/2 and AUC∞ values of O‐H‐LSD were 5.2 (2.6–21) hours and 1.7 (0.85–4.3) ng·h/mL, respectively. The subjective effects of LSD lasted (mean ± SD) for 8.5 ± 2.0 hours (range: 5.3–12.8 h), and peak effects were reached 2.5 ± 0.6 hours (range 1.6–4.3 h) after drug administration. EC50 values were 1.0 ± 0.5 ng/mL and 1.9 ± 1.0 ng/mL for “good” and “bad” subjective drug effects, respectively.ConclusionThe present study characterized the pharmacokinetics of LSD and its main metabolite O‐H‐LSD. The subjective effects of LSD were closely associated with changes in plasma concentrations over time.
Conflicting demands on a modern healthcare service: Can Rawlsian justice provide a guiding philosophy for the NHS and other socialized health services?
Authors: Fritz Zoë , Cox Caitríona 
Published: March 2019

AbstractWe explore whether a Rawlsian approach might provide a guiding philosophy for the development of a healthcare system, in particular with regard to resolving tensions between different groups within it. We argue that an approach developed from some of Rawls’ principles – using his ‘veil of ignorance’ and both the ‘difference’ and ‘just savings’ principles which it generates – provides a compelling basis for policy making around certain areas of conflict. We ask what policies might be made if those making them did not know if one was patient, doctor, nurse or manager – in this generation or the next.We first offer a brief summary of Rawls’ approach and how we intend to extrapolate from it. We examine how this adapted Rawlsian framework could be applied to specific examples of conflict within healthcare; we demonstrate how this framework can be used to develop a healthcare service which is both sustainable (in its training and treatment of staff, and in encouraging research and innovation) and open (to protect the powers and opportunities of those using the health service). We conclude that while Rawls’ approach has previously been rejected as a means to address specific healthcare decisions, an adapted veil of ignorance can be a useful tool for the consideration of how a just health service should be constructed and sustained. Turning the theoretical into the practical (and combining Rawls’ thought experiment with Scanlonian contractarianism), managers, doctors, patients, carers and nurses could come together and debate conflicting issues behind a hypothetical veil.