bluuebunny/crossref_metadata_2025_split huggingface dataset:
Operationalization of the new Pain and Disability Drivers Management model: A modified Delphi survey of multidisciplinary pain management experts
Authors: Tousignant‐Laflamme Yannick , Cook Chad E. , Mathieu Annie , Naye Florian , Wellens Frédéric , Wideman Timothy , Martel Marc‐Olivier , Lam Olivier Tri‐Trinh 
Published: July 2019

AbstractBackgroundWe recently proposed the Pain and Disability Drivers Management (PDDM) model, which was designed to outline comprehensive factors driving pain and disability in low back pain (LBP). Although we have hypothesized and proposed 41 elements, which make up the model's five domains, we have yet to assess the external validity of the PDDM's elements by expert consensus.Research objectivesThis study aimed to reach consensus among experts regarding the different elements that should be included in each domain of the PDDM model.RelevanceThe PDDM may assist clinicians and researchers in the delivery of targeted care and ultimately enhance treatment outcomes in LBP.MethodsUsing a modified Delphi survey, a two‐round online questionnaire was administered to a group of experts in musculoskeletal pain management. Participants were asked to rate the relevance of each element proposed within the model. Participants were also invited to add and rate new elements. Consensus was defined by a greater than or equal to 75% level of agreement.ResultsA total of 47 (round 1) and 33 (round 2) participants completed the survey. Following the first round, 38 of 41 of the former model elements reached consensus, and 10 new elements were proposed and later rated in the second round. Following this second round, consensus was reached for all elements (10 new + 3 from first round), generating a final model composed of 51 elements.ConclusionThis expert consensus–derived list of clinical elements related to the management of LBP represents a first step in the validation of the PDDM model.
Defend or raise? Optimising flood risk reduction strategies
Authors: Lendering Kasper T. , Jonkman Sebastiaan N. , van Ledden Mathijs , Vrijling Johannes K. 
Published: July 2019

AbstractFlood risk reduction can be provided by interventions such as raising land or constructing flood defences. This paper introduces an approach to optimise the selection of risk reduction strategies. It expands existing economic optimization approaches for flood defences, by introducing (largely) analytical formulations to include the effects of approaches to mitigate flood consequences. The method considers the size of the protected area and associated damages, the costs and dimensioning of interventions and the likelihood of flooding. It is applied in several practical cases. Within the context of this economic model, we conclude that a system of flood defences is more economical than a landfill for larger areas. Fills are preferred for small areas and/or for low costs. A combination of strategies is preferred when the value protected by the flood defence is low compared to the value protected by the fill, or when the high value development is relatively small in size. The sensitivity of outcomes to the choice of the main input parameters is presented, as well as implications of the results and selection of strategies in developing and developed countries. Overall, this approach supports decision makers in developing effective strategies to manage and reduce flood risk.
Gut microbial profile in biliary atresia: a case‐control study
Authors: Wang Junfeng , Qian Tian , Jiang Jingying , Yang Yifan , Shen Zhen , Huang Yanlei , Chen Gong , Zheng Shan , Dong Rui 
Published: July 2019

AbstractBackground and AimBiliary atresia (BA) is a progressive fibro‐inflammatory cholangiopathy with an unclear etiology. Various liver disorders are associated with an altered microbiome. However, gut microbiome in BA remains unknown. Here, we performed a case‐control study to investigate the gut microbiota in BA.MethodsA cross‐sectional analysis was first conducted for 34 BA patients and 34 healthy controls. Then we investigated the shift in gut microbiota 2 weeks after the Kasai procedure in 16 BA patients. Gut microbiome was initially analyzed using 16S ribosome RNA gene sequencing and further validated by metagenomic sequencing. Fecal bile acids were determined using ultra‐high performance liquid chromatography.ResultsCompared with healthy controls, BA showed lower diversity and significant structural segregation in the microbiome. At phylum level, Proteobacteria numbers increased, whereas those of Bacteroidetes decreased in BA. At genus level, several potential pathogens such as Streptococcus and Klebsiella thrived in BA, while numbers for Bifidobacterium and several butyrate‐producing bacteria declined. The microbiome was also disturbed after the Kasai procedure. Operational taxonomic units responding to BA showed significant correlation with liver function. Furthermore, the abundance ratio of Streptococcus/Bacteroides showed great promise in distinguishing BA from healthy controls. Intestinal bile acids were dramatically decreased in BA, and Clostridium XIVa positively correlated with the ratio of primary/secondary bile acids.ConclusionsGut microbial dysbiosis, may be caused by decreased bile acids, was associated with liver function and had a good diagnostic potential for BA. Therefore, further exploration of gut microbiota may provide important insights into their potential diagnostic and therapeutic benefits.
Phaeohyphomycosis caused by Phialophora americana with CARD9 mutation and 20‐year literature review in China
Authors: Huang Chen , Zhang Yi , Song Yinggai , Wan Zhe , Wang Xiaowen , Li Ruoyu 
Published: July 2019

SummaryBackgroundPhaeohyphomycosis is a chronic cutaneous, subcutaneous or systemic mycotic infection caused by various dematiaceous fungi. The diverse clinical manifestations and poor prognosis of phaeohyphomycosis necessitate studies on it to better recognise the disease and improve its management.ObjectivesTo investigate the epidemiology, aetiology, diagnosis, treatment and prognosis of phaeohyphomycosis in China over the past 20 years, and to study the first case of phaeohyphomycosis caused by Phialophora americana and the genetic and immunological mechanisms.Patients/MethodsClinical and laboratory findings of the case were studied, and the patient's DNA was sequenced for CARD9, followed by immunological studies using patient's PBMCs. Cases of phaeohyphomycosis in China from 1998 to 2018 in both the Chinese and English literature were collected and analysed, including 45 articles and 46 patients.ResultsWe confirmed the patient holding a homozygous frameshift mutation of CARD9, which led to impairment of pro‐inflammatory cytokine production, and lower Th17‐ and Th22‐associated responses upon fungus‐specific stimulation. From the literature review, we revealed that the clinical presentations of phaeohyphomycosis were diverse. Diagnoses were established mainly on the basis of histopathology and fungal culture. Oral itraconazole, voriconazole, and posaconazole are the first choices for treatment, and a combination with surgical excision is also recommended.ConclusionsOur study establishes that obtaining detailed histories is vital for understanding the immune state and that patients with recurrent or chronic phaeohyphomycosis in the absence of known immunodeficiencies should be tested for CARD9 mutations. We hope our findings will aid clinicians in the diagnoses and treatment of such infections.
Concept analysis of nurse retention
Authors: Efendi Ferry , Kurniati Anna , Bushy Angeline , Gunawan Joko 
Published: July 2019

AbstractNurse retention is widely acknowledged as a crucial international workforce issue, yet the concept remains ambiguous. This study focuses on a concept analysis in an effort to clarify the attributes of nurse retention, including its antecedents and consequences. The Walker and Avant approach was applied to analyze the concept of nurse retention. Four key attributes of nurse retention were identified in the analysis, specifically motivation, intention, and individual decision; strategy and intervention; geographic context; and attachment to work. Antecedents of nurse retention included the healthcare system at the macro level, the health care facility, health personnel, and living conditions. Retention has consequences for individual nurses, the healthcare organization, and the overall health system. Our concept analysis provides clarification to better understand nurse retention along with its implications for the healthcare workforce. The analysis further emphasizes the importance of retention as a comprehensive priority issue for human resources when recruiting and maintaining the nursing workforce internationally.
Conceptualizing throughput legitimacy: Procedural mechanisms of accountability, transparency, inclusiveness and openness in EU governance
Authors: Schmidt Vivien , Wood Matthew 
Published: July 2019

AbstractThis symposium demonstrates the potential for throughput legitimacy as a concept for shedding empirical light on the strengths and weaknesses of multi‐level governance, as well as challenging the concept theoretically. This article introduces the symposium by conceptualizing throughput legitimacy as an ‘umbrella concept’, encompassing a constellation of normative criteria not necessarily empirically interrelated. It argues that in order to interrogate multi‐level governance processes in all their complexity, it makes sense for us to develop normative standards that are not naïve about the empirical realities of how power is exercised within multi‐level governance, or how it may interact with legitimacy. We argue that while throughput legitimacy has its normative limits, it can be substantively useful for these purposes. While being no replacement for input and output legitimacy, throughput legitimacy offers distinctive normative criteria—accountability, transparency, inclusiveness and openness—and points towards substantive institutional reforms.
Lung separation in children: Options and impact on gas exchange and lung compliance
Authors: Hale Jason E. , Meador Marcie R. , Mossad Emad B. 
Published: July 2019

AbstractBackgroundOne‐lung ventilation is a challenging airway technique in the pediatric population. Multiple airway devices can be employed, but there is no consensus as to the most reliable and physiologically advantageous method. This report is a review of the methods of one‐lung ventilation in children in our practice, as well as an analysis of the impact of airway device type, patient age, and duration of lung separation on respiratory mechanics and gas exchange.MethodsThe records of all pediatric patients undergoing procedures requiring one‐lung ventilation in a single center over an 18‐month period were reviewed. Demographics, time required to achieve lung separation (anesthesia ready‐time), and duration of one‐lung ventilation were collected. Data from arterial blood gas analysis and ventilator parameters were collected at three time points: 15 minutes prior to one‐lung ventilation (pre–OLV), 15 minutes after initiation of one‐lung ventilation (during OLV), and 15 minutes after one‐lung ventilation was ended (post–OLV). Standard equations for calculating compliance, the ratio of arterial partial pressure of oxygen to the fraction of inspired oxygen, and the alveolar‐arterial oxygen gradient were used.ResultsForty‐six patients were identified with a mean age of 9.3 (inner quartile range 3‐15) years. All patients had significant changes in pulmonary function when comparing pre–OLV with during OLV and when comparing during OLV with post–OLV. There were no significant changes from pre– to post–OLV. On further analysis, there were more pronounced changes in compliance and gas exchange in older patients (P = 0.003; 95% CI: −0.62 to −0.14). There was also a significant decrease in post–OLV compliance with a longer duration of OLV (P = 0.018; 95% CI: −0.02 to <−0.01). Airway device type did not have significant impact on the parameters examined.ConclusionOur report demonstrates significant changes in lung function during one‐lung ventilation. One particular device does not seem to be superior. Though pre–OLV measures of pulmonary function correlate closely with post–OLV, older age and a prolonged duration of one‐lung ventilation did impact compliance.
Use of public health service increased risk kidneys in pediatric renal transplant recipients
Authors: Meyers Melissa R. , Shults Justine , Laskin Benjamin , Porrett Paige , Levine Matthew , Abt Peter , Amaral Sandra , Goldberg David S. 
Published: July 2019

AbstractWith the opioid epidemic and expansion of “IR” classification, 25% of deceased donors are categorized PHS‐IR. Studies have assessed utilization of PHS‐IR organs among adults, but little is known about pediatric recipients. This retrospective cohort study from 2004‐2016 (IR period) aimed to: (a) assess IR kidney utilization patterns between adults and children; (b) identify recipient factors associated with transplant from IR donors among pediatric kidney recipients; and (c) determine geography's role in IR kidney utilization for children. The proportion of pediatric recipients receiving IR kidneys was significantly lower than adults (P < 0.001), even when stratified by donor mechanism of death (non‐overdose/overdose) and era. In mixed effects models accounting for clustering within centers and regions, older recipient age, later era (post‐PHS‐IR expansion), and blood type were associated with significantly higher odds of receiving an IR kidney (17 years era 5: OR 5.16 [CI 2.05‐13.1] P < 0.001; 18‐21 years era 5: OR 2.72 [CI 1.05‐7.06] P = 0.04; blood type O: OR 1.32 [CI 1.06‐1.64] P = 0.013). The median odds ratio for center within region was 1.77 indicating that when comparing two patients in a region, the odds of receiving an IR kidney were 77% higher for a patient from a center with higher likelihood of receiving an IR kidney. Utilization of PHS‐IR kidneys is significantly lower among pediatric recipients versus adult counterparts. More work is needed to understand the reasons for these differences in children in order to continue their access to this life‐prolonging therapy.
Human Factors and Cybersecurity in Online Game Addiction: An Analysis of the Relationship Between High School Students' Online Game Addiction and the State of Providing Personal Cybersecurity and Representing Cyber Human Values in Online Games
Authors: Yildiz Durak Hatice 
Published: July 2019

ObjectiveThe number of users of online games is increasing day by day due to their constantly developing features. Users who have access to online games at all times are in a constant interaction with other users. In this regard, it can be suggested the interaction carries human values and does not contain information security threats. As a matter of fact, the virtual world presented in online gaming environments has evolved into an alternative survival area for individuals. On the other hand, the massive time spent in online environments leads to game addiction. This article seeks to determine the relationship between online game addiction (OGA) and the state of providing personal cybersecurity and representing cyber human values of high school students who actively play online games.MethodsIn accordance with this purpose, 212 high school students playing online games and using various applications have been surveyed.Results and ConclusionAs a result of this study in which relational screening method was employed, a significant relationship was found between OGA and behaviors that focus on human values of truth and tolerance. In this study, which is aimed to expand existing knowledge, variables identified in this study and providing predictability of OGA can be used to prevent and alleviate gaming addiction in high school students.
Usutu virus infection in Dutch blood donors
Authors: Zaaijer Hans L. , Slot Ed , Molier Michel , Reusken Chantal B.E.M. , Koppelman Marco H.G.M. 
Published: July 2019

BACKGROUNDThe screening of Dutch blood donations for West Nile virus (WNV) may be imminent, as WNV emerges in nearby countries and more donors travel to WNV‐affected regions. Since 2016 the related, mosquito‐borne Usutu virus (USUV) causes seasonal mortality in Dutch birds. To what extent will human USUV infections affect Dutch WNV donor screening?STUDY DESIGN AND METHODSFrom April through September 2018, plasma samples from blood donations in blackbird‐rich regions were stored. When increased bird mortality was reported in August, samples from July, August, and September were tested for USUV‐RNA in pools of eight, using a home‐brew combined WNV/USUV‐PCR assay. Reactive pools were deconstructed. Original plasma units and samples of previous and follow‐up donations of reactive donors were tested for USUV‐ and WNV‐RNA, and for antibody responses.RESULTSThe number of USUV RNA‐positive, WNV RNA‐negative donations was 0 of 2688 donations in July, 6 of 4416 in August (1:736), and 1 of 4936 in September. The seven infected donors tested negative for USUV‐RNA in preceding and follow‐up donations. For 6 donors, seroconversion for USUV‐antibodies was demonstrated. All index donations tested positive in a commonly used PCR‐assay for WNV donor screening. Three exposed recipients did not show signs of infection. Screening a random subset of 1092 donations from September for USUV‐IgG antibodies showed that 22 donors tested reactive; for three donors retrospective testing identified an USUV PCR‐positive pre‐seroconversion donation.CONCLUSIONSeasonal USUV infection in Dutch blood donors is common. Cross‐reactivity in molecular assays for WNV‐screening occurs, but can be resolved using USUV‐ and WNV‐specific PCR‐primers and sequencing of viral RNA.
Urocortin 3 signalling in the auditory brainstem aids recovery of hearing after reversible noise‐induced threshold shift
Authors: Fischl Matthew J. , Ueberfuhr Margarete A. , Drexl Markus , Pagella Sara , Sinclair James L. , Alexandrova Olga , Deussing Jan M. , Kopp‐Scheinpflug Conny 
Published: July 2019

Key points
Ongoing, moderate noise exposure does not instantly damage the auditory system but may cause lasting deficits, such as elevated thresholds and accelerated ageing of the auditory system.
The neuromodulatory peptide urocortin‐3 (UCN3) is involved in the body's recovery from a stress response, and is also expressed in the cochlea and the auditory brainstem.
Lack of UCN3 facilitates age‐induced hearing loss and causes permanently elevated auditory thresholds following a single 2 h noise exposure at moderate intensities.
Outer hair cell function in mice lacking UCN3 is unaffected, so that the observed auditory deficits are most likely due to inner hair cell function or central mechanisms.
Highly specific, rather than ubiquitous, expression of UCN3 in the brain renders it a promising candidate for designing drugs to ameliorate stress‐related auditory deficits, including recovery from acoustic trauma.
AbstractEnvironmental acoustic noise is omnipresent in our modern society, with sound levels that are considered non‐damaging still causing long‐lasting or permanent changes in the auditory system. The small neuromodulatory peptide urocortin‐3 (UCN3) is the endogenous ligand for corticotropin‐releasing factor receptor type 2 and together they are known to play an important role in stress recovery. UCN3 expression has been observed in the auditory brainstem, but its role remains unclear. Here we describe the detailed distribution of UCN3 expression in the murine auditory brainstem and provide evidence that UCN3 is expressed in the synaptic region of inner hair cells in the cochlea. We also show that mice with deficient UCN3 signalling experience premature ageing of the auditory system starting at an age of 4.7 months with significantly elevated thresholds of auditory brainstem responses (ABRs) compared to age‐matched wild‐type mice. Following a single, 2 h exposure to moderate (84 or 94 dB SPL) noise, UCN3‐deficient mice exhibited significantly larger shifts in ABR thresholds combined with maladaptive recovery. In wild‐type mice, the same noise exposure did not cause lasting changes to auditory thresholds. The presence of UCN3‐expressing neurons throughout the auditory brainstem and the predisposition to hearing loss caused by preventing its normal expression suggests UCN3 as an important neuromodulatory peptide in the auditory system's response to loud sounds.
Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis
Authors: Florez Ivan D , Sierra Javier M , Niño-Serna Laura F 
Published: July 2019

ObjectiveTo determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions.Eligibility criteria for selecting studiesRandomised controlled trials in children with ADG, comparing GT with placebo.ResultsOf 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea.ConclusionThe effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty).PROSPERO registration numberCRD42018087902.
Identifying the factors for improving quality of oral fluorescein angiography
Authors: Amador-Patarroyo Manuel J , Lin Tiezhu , Meshi Amit , Dans Kunny C , Chen Kevin , Borooah Shyamanga , Molano-Gonzalez Nicolás , Díaz-Rojas Jorge A , Freeman William R 
Published: July 2019

AimTo evaluate the quality of oral fluorescein angiography (FA) in relation to food intake.MethodsThis is an observational, case-crossover study. We collected information from patients undergoing routine oral FA for retinal disease at the Shiley Eye Institute. Eighty patients (160 eyes) were analysed. Fasting and non-fasting images of the same patient were recorded, compared and analysed for different image quality parameters and clinical relevance by experienced retina specialists.ResultsWhen analysing the images, intergrader agreement was moderate to good with a Kappa averaging 0.60 (0.5–0.85). When patients were fasting pre-imaging, better angiography quality scores were achieved when compared with images taken when patients were non-fasting (mean 0.84 vs 0.72, p<0.001). Multivariate analysis showed that non-fasting patients with higher body mass index had the worst scores. Other clinical parameters, such as staining of drusen, staining of disciform scars or central and peripapillary atrophy, were also significantly better during the pre-fasting exam (p<0.001). Oral FA was approximately 22% faster (time to fluorescein dye appearance) under fasting conditions than non-fasting (mean±SD, minutes, 18.7±6.9 vs 25.14±8.1, p<0.001).ConclusionFasting oral FA provided significantly better quality images as well as faster optimal imaging times when compared with non-fasting oral FA. By improving its overall quality, oral FA could be a useful adjunctive examination to optical coherence tomography (OCT) and OCT angiography in patients who require FA studies but who have difficult access or refuse an invasive procedure.