bluuebunny/crossref_metadata_2025_split huggingface dataset:
Demand, capacity, and access of the outpatient clinic: A framework for analysis and improvement
Authors: van Bussel Erik Martijn , van der Voort Marc Boudewijn Victor Rouppe , Wessel Ronald N. , van Merode Godefridus G. 
Published: April 2018

AbstractRationaleWhile theoretical frameworks for optimization of the outpatient processes are abundant, practical step‐by‐step analyses to give leads for improvement, to forecast capacity, and to support decision making are sparse.Aims and objectivesThis article demonstrates how to evaluate and optimize the triad of demand, (future) capacity, and access time of the outpatient clinic using a structured six‐step method.MethodsAll individual logistical patient data of an orthopaedic outpatient clinic of one complete year were analysed using a 6‐step method to evaluate demand, supply, and access time. Trends in the data were retrospectively analysed and evaluated for potential improvements. A model for decision making was tested. Both the analysis of the method and actual results were considered as main outcomes.ResultsMore than 25 000 appointments were analysed. The 6‐step method showed to be sufficient to result in valuable insights and leads for improvement. While the overall match between demand and capacity was considered adequate, the variability in capacity was much higher than in demand, thereby leading to delays in access time. Holidays and subsequent weeks showed to be of great influence for demand, capacity, and access time. Using the six‐step method, several unfavourable characteristics of the outpatient clinic were revealed and a better match between demand, supply, and access time could have been reached with only minor adjustments. Last, a clinic specific prediction and decision model for demand and capacity was made using the 6‐step method.ConclusionsThe 6‐step analysis can successfully be applied to redesign and improve the outpatient health care process. The results of the analysis showed that national holidays and variability in demand and capacity have a big influence on the outpatient clinic. Using the 6‐step method, practical improvements in outpatient logistics were easily found and leads for future decision making were contrived.
How do we know if a clinical practice guideline is good? A response to Djulbegovic and colleagues' use of fast‐and‐frugal decision trees to improve clinical care strategies
Authors: Mercuri Mathew 
Published: April 2018

AbstractClinical practice guidelines (CPGs) and clinical pathways have become important tools for improving the uptake of evidence‐based care. Where CPGs are good, adherence to the recommendations within is thought to result in improved patient outcomes. However, the usefulness of such tools for improving patient important outcomes depends both on adherence to the guideline and whether or not the CPG in question is good. This begs the question of what it is that makes a CPG good? In this issue of the Journal, Djulbegovic and colleagues offer a theory to help guide the development of CPGs. The “fast‐and‐frugal tree” (FFT) heuristic theory is purported to provide the theoretical structure needed to quantitatively assess clinical guidelines in practice, something that the lack of theory to guide CPG development has precluded. In this paper, I examine the role of FFTs in providing an adequate theoretical framework for developing CPGs. In my view, positioning guideline development within the FFT framework may help with problems related to adherence. However, I believe that FTTs fall short in providing panel members with the theoretical basis needed to justify which factors should be considered when developing a CPG, how information on those factors derived from research studies should be interpreted, and how those factors should be integrated into the recommendation.
Ostreolysin induces browning of adipocytes and ameliorates hepatic steatosis
Authors: Nimri Lili , Staikin Katerina , Peri Irena , Yehuda‐Shnaidman Einav , Schwartz Betty 
Published: April 2018

AbstractBackground and AimNon‐alcoholic fatty liver disease (NAFLD) is associated with all features of the metabolic syndrome. Deposition of excess triglycerides in liver cells, a hallmark of NAFLD, is associated with loss of insulin sensitivity. Ostreolysin (Oly) is a 15‐kDa fungal protein known to interact with cholesterol‐enriched raft‐like membrane domains. We aim to test whether a recombinant version of Oly (rOly) can induce functional changes in vitro in adipocytes or in vivo in mice fed a high‐fat diet (HFD).MethodsWhite preadipocyte 3T3‐L1 cells or mouse primary adipocytes treated with rOly. Male C57BL/6 mice were fed a control or HFD and treated with saline or with rOly (1 mg/kg BW) every other day for 4 weeks.ResultsWhite preadipocyte 3T3‐L1 cells or mouse primary adipocytes treated with rOly acquire a browning phenotype through activation of 5′ adenosine monophosphate‐activated protein kinase and downregulation of tumor necrosis factor α‐mediated activation of IκB kinase ε and TANK‐binding kinase 1. HFD‐fed mice treated with rOly showed a 10% reduction in BW and improved glucose tolerance, which paralleled improved expression of liver and adipose functionality, metabolism, and inflammation status, mimicking the in vitro findings.ConclusionThis study provides first evidence of rOly's prevention of HFD‐induced NAFLD by stimulating liver and adipose muscle tissue functionality and oxidative potential, improving glucose tolerance, and ameliorating the metabolic profile of diet‐induced obese mice.
Characterization of maize leaf pyruvate orthophosphate dikinase using high throughput sequencing
Authors: Zhang Yuling , Giuliani Rita , Zhang Youjun , Zhang Yang , Araujo Wagner Luiz , Wang Baichen , Liu Peng , Sun Qi , Cousins Asaph , Edwards Gerald , Fernie Alisdair , Brutnell Thomas P. , Li Pinghua 
Published: April 2018

AbstractIn C4photosynthesis, pyruvate orthophosphate dikinase (PPDK) catalyzes the regeneration of phosphoenolpyruvate in the carbon shuttle pathway. Although the biochemical function of PPDK in maize is well characterized, a genetic analysis of PPDK has not been reported. In this study, we use the maize transposable elementsMutatorandDsto generate multiple mutant alleles of PPDK. Loss‐of‐function mutants are seedling lethal, even when plants were grown under 2% CO2, and they show very low capacity for CO2assimilation, indicating C4photosynthesis is essential in maize. Using RNA‐seq and GC‐MS technologies, we examined the transcriptional and metabolic responses to a deficiency in PPDK activity. These results indicate loss of PPDK results in downregulation of gene expression of enzymes of the C4cycle, the Calvin cycle, and components of photochemistry. Furthermore, the loss of PPDK did not change Kranz anatomy, indicating that this metabolic defect in the C4cycle did not impinge on the morphological differentiation of C4characters. However, sugar metabolism and nitrogen utilization were altered in the mutants. An interaction between light intensity and genotype was also detected from transcriptome profiling, suggesting altered transcriptional and metabolic responses to environmental and endogenous signals in the PPDK mutants.
Association between psychotropic medications and presence of sleep bruxism: A systematic review
Authors: Melo G. , Dutra K. L. , Rodrigues Filho R. , Ortega A. O. L. , Porporatti A. L. , Dick B. , Flores‐Mir C. , De Luca Canto G. 
Published: April 2018

SummaryThe purpose of this study was to systematically review the literature for studies that investigated the association between use of psychotropic medications and presence of sleep bruxism (SB). Observational studies were selected in a two‐phase process. Searches were performed on six electronic databases, and a grey literature search was conducted on three databases. SB diagnosis was based on questionnaires or clinical examinations; no polysomnography examinations were performed. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross‐Sectional Studies. Overall quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation criteria. Five analytical cross‐sectional studies were included, evaluating antidepressants, anticonvulsants and psychostimulants. One study was judged as low risk of bias, three as moderate risk and one high risk. Antidepressants were evaluated in adult populations only; duloxetine (Odds Ratio [OR] = 2.16; 95% Confidence Interval [95% CI] = 1.12‐4.17), paroxetine (OR = 3.63; 95% CI = 2.15‐6.13) and venlafaxine (OR = 2.28; 95% CI = 1.34‐3.86) were positively associated with SB risk. No increased odds of SB were observed considering use of citalopram, escitalopram, fluoxetine, mirtazapine and sertraline. With regard to anticonvulsants, only barbiturates were associated with SB in children (OR = 14.70; 95% CI = 1.85‐116.90), while no increased odds were observed for benzodiazepine, carbamazepine and valproate. The only psychostimulant evaluated was methylphenidate, and an association with SB was observed in adolescents (OR = 1.67; 95% CI = 1.03‐2.68). Findings from this SR suggested that medications such as duloxetine, paroxetine, venlafaxine, barbiturates and methylphenidate might be associated with SB; however, overall quality of evidence was considered very low, and therefore, caution is recommended.
Hydration and nutritional status in patients on home‐dialysis—A single centre study
Authors: Li Janet S.C. , Chan John Y.H. , Tai Mandy M.Y. , Wong So M. , Pang S.M. , Lam Fanny Y.F. , Chu Carmen H.M. , Ching Chris S.Y. , Wong Joseph H.S. , Chak W.L. 
Published: April 2018

SUMMARYBackgroundOver‐hydration (OH) and malnutrition are prevalent among patients on dialysis therapy. The prevalence of OH and malnutrition as well as the risk factors associated with OH and malnutrition in our patients on home peritoneal dialysis (PD) and home haemodialysis (HD) are examined.Design and MethodsThis was a cross‐sectional study. The hydration and nutritional status of the study groups were assessed by a Body Composition Monitor. Patients who were stable on home dialysis therapy for over one year were invited to participate. Univariate and multivariate analyses were performed to identify associated factors and determine the predictors of OH and malnutrition, respectively.ResultsEighty‐eight patients (41 PD and 47 home HD) were recruited. A 32.95% of our patients on home dialysis therapy were in OH status. There was a significance difference in the prevalence of hydration status between patients on PD and home HD (p = 0.014), as overhydration was more common in patients on PD than home HD (46.34 vs. 21.28%). Dehydration was more common in patients on home HD than PD (29.79 vs. 9.76%). Male gender, decreasing haemoglobin level and presence of diabetes mellitus (DM) were risk factors of OH on multivariable analysis. There was no significance difference in the prevalence of malnutrition between patients on PD and home HD (p = 0.27). Increasing Fat Tissue Index (FTI), height and patients on PD therapy were at higher risk of malnutrition.ConclusionOH and malnutrition were prevalent patients on home dialysis therapy.
High perinatal mortality rates persist in Kirakira: The sustainable development goals for health remain out of reach in the provinces of Solomon Islands
Authors: Jones Peter D , Balasundaram Niroshan , D'Costa Lloyd , Kacker Kunaal , Kaludewa Amila , Fink James 
Published: April 2018

AimThis study aimed to calculate the perinatal mortality rate in Kirakira Hospital, a remote provincial hospital in Solomon Islands, over a 3‐year period, from 2014 to 2016.MethodsA retrospective audit of the labour ward admission books for the years 2014–2016 was conducted. Patient files of all perinatal deaths and caesarean sections were accessed and reviewed. Stillbirths and early neonatal deaths were classified, and results were compared with the national health statistics of Australia (2014).ResultsBetween 2014 and 2016, there were 1311 births and 40 perinatal deaths (mortality rate of 31 per 1000). This is approximately three times the Australian rate of 9.6 deaths per 1000. Of these deaths, 28 were stillbirths, and 12 were neonatal deaths. Detailed information was available for 88% (35/40) of the perinatal deaths. Only 15 caesarean sections (1.1% of deliveries) were performed, compared to a rate of 32.1% of caesarean sections in Australia (2014).ConclusionsKirakira continues to have a very high perinatal mortality rate that has not changed over the last 6 years. The rate is double that reported for Solomon Islands in current World Health Organization data. This discrepancy is likely due to an absence of clinical data outside of the National Referral Hospital in Honiara. This paper identifies clinical indicators that could be targeted to help lower the perinatal mortality rate in this remote and impoverished community.
Social Exclusion and Disengagement of Covert Attention from Social Signs: The Moderating Role of Fear of Negative Evaluation
Authors: Tanaka Hiroaki , Ikegami Tomoko 
Published: April 2018

AbstractPrevious research has demonstrated that social exclusion motivates individuals with low fear of negative evaluation (FNE) to pay attention to signs of social acceptance, but it does not motivate individuals with high FNE to do so. However, it remains unclear whether this finding reflects overt or covert attentional bias because the researchers employed a dot‐probe task. In order to resolve this ambiguity, the present study solely assessed disengagement of covert attention from social signs after exclusion manipulation in an experiment with university students (N = 60). As a result, exclusion delayed disengagement of covert attention from facial stimuli regardless of their types of expression for participants with low FNE, but such delay was not observed for participants with high FNE. The result indicated that social exclusion enhances attention to social information in individuals with low FNE, whereas it does not in individuals with high FNE. We discuss the possibility that a decline in inclusionary status affects overt and covert attentional processes differently.
Neo‐Victorian f(r)iction: Critical conversations and fictional narratives
Authors: Maier Sarah E. 
Published: April 2018

AbstractThis article explores how neo‐Victorian critics are drawn to investigate the f(r)iction between the past and to the present with a desire to understand the Victorian past, then to articulate its importance to the postmodern present. Articles in this special issue by Sarah E. Maier, Anna Jones, Marie‐Louise Kohlke, and Mark Llewellyn seek to widen the scope of these conversations, to find other neo‐Victorianisms across the globe and investigate narratives in manga, television, and true crime. The aim is to question how boundaries between high and low break down and consider what happens when intellectual rigour meets non‐traditional genres found within Neo‐Victorian narratives.
A classic twin study of lower urinary tract obstruction: Report of 3 cases and literature review
Authors: Frese Sandra , Weigert Alexander , Hoppe Bernd , Feldkötter Markus , Ludwig Michael , Weber Stefanie , Kiliś‐Pstrusińska Katarzyna , Zaniew Marcin , Reutter Heiko , Hilger Alina C. 
Published: April 2018

ObjectiveThe aim of the present study was to investigate genetic effects in the formation of congenital lower urinary tract obstruction (LUTO) comprising posterior urethral valves (PUV), urethral atresia, and urethras with variable degrees of stenosis.MethodsA classic twin study was performed by assessing LUTO twin pairs from the literature. Furthermore, data regarding 3 previously unreported twin pairs with PUV from University of Bonn, Essen and Wrocławs own in‐house databases were added. Both pair‐ and probandwise concordance rates were calculated and compared for monozygotic (MZ) and dizygotic (DZ) twin pairs.ResultsThe pairwise concordance rates for all LUTO were 53% (95% confidence interval [CI] 32%–73%) and 17% (95% CI 3%–56%) for MZ and DZ twin pairs, respectively (P = .180). The probandwise concordance rates were 69% (95% CI 51%–83%) and 29% (CI 95% 8%–64%) for MZ and DZ twin pairs respectively (P = .084). The MZ/DZ ratios of the pair‐ and probandwise concordance rates were 3.1 and 2.4, respectively.ConclusionThe present study did not show significant differences in comparisons of concordance rates of MZ and DZ twin pairs, probably due to the small number of twin pairs reported. However, the more than 2‐fold higher pair‐ and probandwise concordance rates for MZ versus DZ twin pairs are very suggestive of a contribution of genetic factors to the development of LUTO.
Sex differences in the drivers of reproductive skew in a cooperative breeder
Authors: Nelson‐Flower Martha J. , Flower Tom P. , Ridley Amanda R. 
Published: April 2018

AbstractMany cooperatively breeding societies are characterized by high reproductive skew, such that some socially dominant individuals breed, while socially subordinate individuals provide help. Inbreeding avoidance serves as a source of reproductive skew in many high‐skew societies, but few empirical studies have examined sources of skew operating alongside inbreeding avoidance or compared individual attempts to reproduce (reproductive competition) with individual reproductive success. Here, we use long‐term genetic and observational data to examine factors affecting reproductive skew in the high‐skew cooperatively breeding southern pied babbler (Turdoides bicolor). When subordinates can breed, skew remains high, suggesting factors additional to inbreeding avoidance drive skew. Subordinate females are more likely to compete to breed when older or when ecological constraints on dispersal are high, but heavy subordinate females are more likely to successfully breed. Subordinate males are more likely to compete when they are older, during high ecological constraints, or when they are related to the dominant male, but only the presence of within‐group unrelated subordinate females predicts subordinate male breeding success. Reproductive skew is not driven by reproductive effort, but by forces such as intrinsic physical limitations and intrasexual conflict (for females) or female mate choice, male mate‐guarding and potentially reproductive restraint (for males). Ecological conditions or “outside options” affect the occurrence of reproductive conflict, supporting predictions of recent synthetic skew models. Inbreeding avoidance together with competition for access to reproduction may generate high skew in animal societies, and disparate processes may be operating to maintain male vs. female reproductive skew in the same species.
Genome‐wide identification of long non‐coding RNAs suggests a potential association with effector gene transcription in Phytophthora sojae
Authors: Wang Yang , Ye Wenwu , Wang Yuanchao 
Published: April 2018

SummaryNumerous long non‐coding RNAs (lncRNAs) identified and characterized in mammals, plants and fungi have been found to play critical regulatory roles in biological processes. However, little is known about the role of lncRNAs in oomycete plant pathogens, which cause devastating damage to the economy and ecosystems. We used strand‐specific RNA sequencing (RNA‐seq) to generate a computational pipeline to identify lncRNAs in Phytophthora sojae, a model oomycete plant pathogen. In total, 940 lncRNAs with 1010 isoforms were identified from RNA‐seq data obtained from four representative stages of P. sojae. The lncRNAs had shorter transcript lengths, longer exon lengths, fewer numbers of exons, lower GC content and higher minimum free energy values compared with protein‐coding genes. lncRNAs in P. sojae exhibited low sequence conservation amongst oomycetes and P. sojae isolates. Transcriptional data indicated that P. sojae lncRNAs tended to be transcribed in a stage‐specific manner; representative lncRNAs were validated by semi‐quantitative reverse transcription‐polymerase chain reaction. Phytophthora sojae lncRNAs were concentrated in gene‐sparse regions, and lncRNAs were associated with secreted protein and effector coding genes. The neighbouring genes of lncRNAs encoded various effector family members, and RNA‐seq data revealed a correlation between the transcription level of lncRNAs and their neighbouring genes. Our results provide the first comprehensive identification of lncRNAs in oomycetes and suggest a potential association between lncRNAs and effector genes.
Down‐sizing of dung beetle assemblages over the last 53 000 years is consistent with a dominant effect of megafauna losses
Authors: Schweiger Andreas H. , Svenning Jens‐Christian 
Published: April 2018

The ongoing down‐sizing of the global mammal communities is assumed to have subsequent effects on mutualistic species communities. Dung beetles co‐evolved with large‐sized animals since millennia and depend on the megafauna feces of an appropriate size. Mammal community down‐sizing as a result of past and ongoing megafauna losses is therefore likely to result in a down‐sizing of dung beetle communities. However, empirical evidence for this co‐down‐sizing is lacking especially on larger spatial scales and over extended periods of time.Here, we show a significant down‐sizing of European dung beetle assemblages over the last ~53 000 years by relating Quaternary fossil records with trait information on body size of beetles. This significant down‐sizing of dung beetle communities was thereby not linear, but characterized by a weak decrease until the early Holocene but a strong acceleration in the recent pre‐history, from 6–7000 years BP onwards. This acceleration of down‐sizing coincides with the completion of the Quaternary megafauna extinction and the start of major shifts in human agricultural land‐use. In contrast, assemblage mean body size of non‐coprophagous scarabids as well as ground beetles – two groups of beetles with no or weak relations to megafauna – was observed to increase towards the present with an acceleration of body size increase coinciding with the onset of late‐glacial warming (14 200 years BP).In summary, the observed late‐Quaternary down‐sizing of European dung beetle communities is consistent with an effect of pre‐historic megafauna losses, and not with the coincident general warming. Ongoing down‐sizing of mammal communities is therefore likely to result in further down‐sizing of dung beetle assemblages, with potential effects on their important role for nutrient cycling and secondary seed dispersal in natural and extensive agro‐ecosystems. Future nature management initiatives could halt or even reverse this functional diversity loss via effective protection or restoration of megafauna communities.