bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of implementing cervical cancer screening program using smartphone imaging as a training aid for nurses in rural India
Authors: Sharma Drishti , Rohilla Latika , Bagga Rashmi , Srinivasan Radhika , Jindal Har Ashish , Sharma Nikita , Kankaria Ankita , Jamir Limalemla , Suri Vanita , Singh Rakesh Kumar , Duggal Mona 
Published: May 2018

AbstractBackgroundThe Indian national program stresses implementation of cervical cancer screening by health workers/nurses using VIA (Visual Inspection under Acetic acid). We demonstrate its feasibility and reliability in rural setting, assessing the role of smartphone‐imaging for continuous training of nurses.DesignA cross‐sectional design to assess the reliability of the nurse‐led VIA test. To assess feasibility, VIA positive patients were observed till confirmative diagnosis was made.SampleHospital‐based purposive sampling was used to recruit participants.MeasuresA structured questionnaire for recording participants' details, VIA findings and follow‐up information; and an observational checklist to record implementation parameters during each clinic. An expert assessed the nurse's judgment using smartphone‐images of cervix.ResultsDuring October 2016–June 2017, 2758 patients attended the weekly clinic; 238 (8.6%) met the criteria, of those 180 (75.6%) tested after consent. Nurse reported 25 (13.8%) VIA‐positive cases, but only 19 accessed the referral service. Kappa statistic: 0.45 (CI: 0.26‐0.63) suggested moderate nurse‐expert agreement. Image retrieval and quality affected expert's evaluation. Implementation challenges include low awareness among the population and referral link‐up.ConclusionAppropriately trained nurses can reliably conduct screening. Real‐time expert feedback might improve reporting. Rigorous awareness activities and on‐site treatment can reduce drop‐outs. The medical institute's involvement and administrative will were instrumental.
Social administration revisited: Traditions of observational fieldwork and their value
Authors: Exley Sonia 
Published: May 2018

AbstractThis article revisits traditions of observational fieldwork inside welfare institutions which formed a core part of past social administration teaching and research in the United Kingdom. Drawing on archive materials, a historical exploration of journal contents and some supplementary interview data, it is argued that such approaches—though carried out in a less theoretically pluralist, more vocationally‐oriented time for the subject of social policy and administration—were at the same time valuable in facilitating critical perspectives on how welfare bureaucracies work. Their popularity is potentially rising once again in social policy teaching. Where cultivated alongside an appreciation of theory and where carefully integrated into university social policy departments' wider pedagogical and curricular strategies, they may be of benefit today to students and more senior scholars alike.
The Golden Ticket Project for peer recognition
Authors: Gribben Valerie , Bogetz Alyssa , Bachrach Laura , Blankenburg Rebecca 
Published: May 2018

SummaryBackgroundA supportive working environment can be protective against burnout in residency training. To help foster a positive culture, we developed the ‘Golden Ticket Project’ (GTP) and evaluated it as a tool for peer appreciation.MethodsIn October 2013–July 2014, all paediatric residents (n = 83) at a paediatric residency programme were invited to participate in the GTP. Through an electronic form, residents could award a co‐resident with a ‘Golden Ticket’ for any behaviour that they were grateful for. Two authors manually coded and analysed the tickets using content analysis to identify recurring themes. We also distributed an anonymous survey to all residents to assess their attitudes toward the GTP.ResultsThe majority (61%) of residents either gave or received ‘Golden Tickets’ (51/83). Reasons for receiving tickets fell into five categories: (i) teamwork; (ii) positive attitude; (iii) patient care; (iv) resident–resident support; and (v) supervisory skills. Across all three classes, teamwork was recognised most frequently, noted in 43% of all tickets. The recognition of other behaviours varied by class. Fifty‐five percent (46/83) of residents completed the programme evaluation survey. Seventy‐six percent (35/46) of respondents wanted the programme to continue; of those, 49% (17/35) ‘agreed’ or ‘strongly agreed’ that they were ‘more aware of acts of kindness in the residency program because of the GTP’.A supportive working environment can be protective against burnout in residency trainingDiscussionThe GTP is a feasible and valued peer‐support initiative for residents. The GTP characterised behaviours and attitudes that residents were grateful for in their peers. These behaviours could inform the development of wellness interventions for residents that focus on building supportive working environments.
The interplay between microbes and the immune response in inflammatory bowel disease
Authors: Goethel Ashleigh , Croitoru Kenneth , Philpott Dana J. 
Published: May 2018

AbstractThe aetiology and pathogenesis of inflammatory bowel disease (IBD) remains unclear but involves a complex interplay between genetic risk, environmental exposures, the immune system and the gut microbiota. Nearly two decades ago, the first susceptibility gene for Crohn's disease, NOD2, was identified within the IBD 1 locus. Since then, over 230 genetic risk loci have been associated with IBD and yet NOD2 remains the strongest association to date. As an intracellular innate immune sensor of bacteria, investigations into host–microbe interactions, involving both innate and adaptive immune responses, have become of particular interest in understanding the pathogenesis of IBD. Advancements in sequencing technology have lead to the groundbreaking characterization of the gut microbiota and its role in health and disease. While an altered microbiome has been described for IBD, whether it is a cause or an effect of the intestinal inflammation has yet to be determined. Moreover, the bidirectional relationship between the gut microbiota and the mucosal immune system adds to the multifaceted complexity of intestinal homeostasis. A better understanding of how host genetics, including NOD2, influence immune–microbe interactions and alter susceptibility to IBD is necessary in order to develop therapeutic and preventative treatments.
image
Toxicant inhalation among singleton waterpipe tobacco users in natural settings
Authors: Jawad Mohammed , Eissenberg Thomas , Salman Rola , Soule Eric , Alzoubi Karem H , Khabour Omar F , Karaoghlanian Nareg , Baalbaki Rima , El Hage Rachel , Saliba Najat A , Shihadeh Alan 
Published: May 2018

Background
Studies that assess waterpipe tobacco smoking behaviour and toxicant exposure generally use controlled laboratory environments with small samples that may not fully capture real-world variability in human behaviour and waterpipe products. This study aimed to conduct real-time sampling of waterpipe tobacco use in natural environments using an in situ device.

Methods
We used the REALTIME sampling instrument: a validated, portable, self-powered device designed to sample automatically a fixed percentage of the aerosol flowing through the waterpipe mouthpiece during every puff. We recruited participants at café and home settings in Jordan and measured puffing behaviour in addition to inhalation exposure of total particulate matter (TPM), carbon monoxide (CO), nicotine, polycyclic aromatic hydrocarbons and volatile aldehydes. We correlated total inhaled volume with five selected toxicants and calculated the regression line of this relationship.

Results
Averaged across 79 singleton sessions (52% male, mean age 27.0, 95% home sessions), sessions lasted 46.9 min and participants drew 290 puffs and inhaled 214 L per session. Mean quantities of inhaled toxicants per session were 1910 mg TPM, 259 mg CO, 5.0 mg nicotine, 117 ng benzo[a]pyrene and 198 ng formaldehyde. We found positive correlations between total inhaled volume and TPM (r=0.472; p<0.001), CO (r=0.751; p<0.001), nicotine (r=0.301, p=0.035) and formaldehyde (r=0.526; p<0.001), but a non-significant correlation for benzo[a]pyrene (r=0.289; p=0.056).

Conclusions
In the natural environment, waterpipe tobacco users inhale large quantities of toxicants that induce tobacco-related disease, including cancer. Toxicant content per waterpipe session is at least equal, but for many toxicants several magnitudes of order higher, than that of a cigarette. Health warnings based on early controlled laboratory studies were well founded; if anything our findings suggest a greater exposure risk.
Yellow nutsedge (Cyperus esculentus L.) control in corn with various rates of halosulfuron
Authors: Soltani Nader , Shropshire Christy , Sikkema Peter H. 
Published: May 2018

There are a limited number of herbicide options that provide commercially acceptable control of yellow nutsedge in corn. A study consisting of nine field experiments was conducted during 2013–2016 in growers’ fields in Ontario to evaluate the efficacy of glyphosate plus various rates of halosulfuron applied after emergence (postemergence, POST) for the control of yellow nutsedge in glyphosate-resistant corn. Glyphosate (900 g a.e. ha−1) plus halosulfuron applied POST at the registered rate of 34–68 g a.i. ha−1 caused minimal injury in glyphosate-resistant corn. The predicted halosulfuron rates needed to control yellow nutsedge 50%, 80%, and 90% were 3, 24, and >140 g a.i. ha−1 at 4 weeks after herbicide application (WAA) and 2, 13, and 73 g a.i. ha−1 at 8 WAA, respectively. The predicted halosulfuron rates required to reduce yellow nutsedge density 50%, 80%, and 90% were 13, 42, and 109 g a.i. ha−1, respectively. In addition, the predicted halosulfuron rates required to reduce yellow nutsedge dry weight 50%, 80%, and 90% were 6, 23, and 54 g a.i. ha−1, respectively. Contrasts comparing halosulfuron (35 g a.i. ha−1) with other herbicides showed that glyphosate plus halosulfuron provided as much as 35% greater control of yellow nutsedge than glyphosate plus bentazon (1080 g a.i. ha−1) and as much as 22% greater control of yellow nutsedge than glyphosate plus tembotrione/thiencarbazone (45 g a.i. ha−1).
A 3–14 GHz, Self-Body Biased Common-Gate UWB LNA for Wireless Applications in 90 nm CMOS
Authors: Singh Vikram , Arya Sandeep Kumar , Kumar Manoj 
Published: May 2018

Inspired from continuous growth in the field of low power and low noise wireless communication devices, a low noise amplifier (LNA) using self-body biased common-gate (CG) configuration is presented in this paper. The proposed LNA is designed for 3–14[Formula: see text]GHz ultra-wideband (UWB) frequency range using 90[Formula: see text]nm CMOS process. Common-gate configuration with self-body biasing has been used at the input stage to provide wideband input matching with low noise figure (NF) for the complete UWB frequency. An impedance matching network consisting of parallel to series RLC network has been used between common-gate and cascaded common source (CS) stages. Two stages of the CS configuration have been used for bandwidth enhancement and to increase the power gain (S[Formula: see text]) with acceptable NF. Buffer stage at the output has been used to achieve output reflection coefficient (S[Formula: see text]) less than [Formula: see text]10.8[Formula: see text]dB. The proposed LNA achieves an average S[Formula: see text] of 15.9[Formula: see text][Formula: see text][Formula: see text]0.7[Formula: see text]dB with a maximum of 16.7[Formula: see text]dB at 3.0[Formula: see text]GHz and NF of 1.68–2.7[Formula: see text]dB for 3.1–10.6[Formula: see text]GHz UWB frequency range. It provides input reflection coefficient (S[Formula: see text]) less than [Formula: see text]10.2[Formula: see text]dB, reverse isolation (S[Formula: see text]) less than [Formula: see text]75.8[Formula: see text]dB and a NF of 1.68–4.0[Formula: see text]dB throughout the proposed UWB frequency range. The proposed LNA provides input 1[Formula: see text]dB compression point (P1dB) of [Formula: see text]13[Formula: see text]dBm and input third-order intercept point (IIP3) of [Formula: see text]8[Formula: see text]dBm at 6[Formula: see text]GHz. It consumes 20.1[Formula: see text]mW of power from a 1.2[Formula: see text]V power supply.
Interaction of Left Ventricular Size and Sex on Outcome of Cardiac Resynchronization Therapy Among Patients With a Narrow QRS Duration in the EchoCRT Trial
Authors: Varma Niraj , Sogaard Peter , Bax Jeroen J. , Abraham William T. , Borer Jeffrey S. , Dickstein Kenneth , Singh Jagmeet P. , Gras Daniel , Holzmeister Johannes , Brugada Josep , Ruschitzka Frank 
Published: May 2018

Background

Longer
QRS
duration (
QRS
d) improves, but increased left ventricular (
LV
) end‐diastolic volume (
LVEDV
) reduces, efficacy of cardiac resynchronization therapy (
CRT
).
QRS
d/
LVEDV
ratios differ between sexes. We hypothesized that in the Echo
CRT
(Echocardiography Guided Cardiac Resynchronization Therapy) trial enrolling patients with heart failure with
QRS
d <130 ms, those with larger
LVEDV
would deteriorate but those with the highest
QRS
d/
LVEDV
would
improve
with
CRT
.

Methods and Results

Primary outcome in patients (n=787, 72% men, 93% New York Heart Association class
III
,
QRS
d <130 ms, LV ejection fraction ≤35%,
LV
dilation and dyssynchrony) randomized to
CRT
‐
ON
or CRT‐
OFF
and followed up for 19 months was compared according to
LVEDV
(height indexed) or
QRS
d/
LVEDV
ratio, in multivariable analysis. Structural remodeling was assessed echocardiographically 6 months after implantation. Patients with baseline LVEDV higher than or equal to median worsened with
CRT
(death/heart failure hospitalization:
CRT
‐
ON
versus
CRT
‐
OFF
, 35.2% versus 24.5% [hazard ratio, 1.64; 95% confidence interval, 1.11–2.42;
P
=0.012]), but those with LVEDV lower than median remained unaffected. Patients with the highest
QRS
d/
LVEDV
ratio improved with
CRT
(death/heart failure hospitalization in top quartile: 20.9% in CRT‐
ON
[n=91] versus 28.3% in CRT‐OFF [n=106] [hazard ratio, 0.64; 95% confidence interval, 0.34–1.24;
P
=0.188], versus the remaining quartiles: 31.7% in
CRT‐ON
[n=300] versus 24.8% in
CRT‐OFF
[n=290] [hazard ratio, 1.47; 95% confidence interval, 1.07–2.02;
P
=0.016], test for interaction
P
=0.046).
QRS
d and dyssynchrony were similar between groups. The 3‐way test for interaction indicated no sex‐specific effects. However, numerically, men with LVEDV higher than or equal to median accounted for worse outcomes of
CRT
‐
ON
. Women, with the highest
QRS
d/
LVEDV
ratio exhibited significant reverse remodeling.

Conclusion

CRT
has opposite effects among patients with heart failure with
QRS
d <130 ms according to
LV
size: worsening outcomes in patients with larger LV, but inducing beneficial effects in those with smaller
LV
.

Clinical Trial Registration

URL:
https://www.clinicaltrials.gov/
. Unique identifier:
NCT
00683696.
“Prayers from Him Who Is Unable to Make Offerings”: The Cult of Bēlet-ṣēri at Late Babylonian Uruk
Authors: Krul Julia 
Published: May 2018

AbstractAfter 484BC, several deities were (re)introduced into the pantheon of Uruk—most importantly the city’s new patron deity, the sky god Anu, but also the netherworld goddess Bēlet-ṣēri (“Lady of the Steppe”). In this article, I investigate the possible reasons behind the introduction of Bēlet-ṣēri’s cult at Uruk and the role ascribed to her by local worshipers. Using literary compositions, ritual texts, and legal documents, I trace the historical development of Bēlet-ṣēri’s divine characteristics, reconstruct her daily worship at Uruk, and examine the socioeconomic status of Urukean individuals bearing a “Bēlet-ṣēri-name.” I conclude that Bēlet-ṣēri was especially popular among non-elite citizens, probably because she could intercede with the queen of the netherworld, Ereškigal, for the lives of her followers and their families.
Introduction: The EU as International Mediator – Theoretical and Empirical Perspectives
Authors: Bergmann Julian , Haastrup Toni , Niemann Arne , Whitman Richard 
Published: May 2018

AbstractIn this introductory article of the special issue, we examine European Union (EU) mediation practice and identify different conceptual and empirical perspectives from which it can be analyzed. We present different understandings of mediation in research and practice a definition and conceptual clarification ofEUmediation practice, and offer a definition that covers mediation efforts and mediation support activities. Then, the institutional architecture forEUmediation activities is presented. Next, the focus of this special issue is examined and research questions that have not yet been sufficiently addressed in existing research ofEUforeign policy and mediation are discussed. Based on these questions, we offer several fruitful avenues for studyingEUmediation: examining the drivers ofEUmediation,EUmediation roles and strategies, andEUmediation effectiveness. Finally, we provide an overview of the contributions to this special issue is presented.
Resting-state functional brain networks in first-episode psychosis: A 12-month follow-up study
Authors: Ganella Eleni P , Seguin Caio , Pantelis Christos , Whittle Sarah , Baune Bernhard T , Olver James , Amminger G Paul , McGorry Patrick D , Cropley Vanessa , Zalesky Andrew , Bartholomeusz Cali F 
Published: May 2018

Introduction: Schizophrenia is increasingly conceived as a disorder of brain network connectivity and organization. However, reports of network abnormalities during the early illness stage of psychosis are mixed. This study adopted a data-driven whole-brain approach to investigate functional connectivity and network architecture in a first-episode psychosis cohort relative to healthy controls and whether functional network properties changed abnormally over a 12-month period in first-episode psychosis. Methods: Resting-state functional connectivity was performed at two time points. At baseline, 29 first-episode psychosis individuals and 30 healthy controls were assessed, and at 12 months, 14 first-episode psychosis individuals and 20 healthy controls completed follow-up. Whole-brain resting-state functional connectivity networks were mapped for each individual and analyzed using graph theory to investigate whether network abnormalities associated with first-episode psychosis were evident and whether functional network properties changed abnormally over 12 months relative to controls. Results: This study found no evidence of abnormal resting-state functional connectivity or topology in first-episode psychosis individuals relative to healthy controls at baseline or at 12-months follow-up. Furthermore, longitudinal changes in network properties over a 12-month period did not significantly differ between first-episode psychosis individuals and healthy control. Network measures did not significantly correlate with symptomatology, duration of illness or antipsychotic medication. Conclusions: This is the first study to show unaffected resting-state functional connectivity and topology in the early psychosis stage of illness. In light of previous literature, this suggests that a subgroup of first-episode psychosis individuals who have a neurotypical resting-state functional connectivity and topology may exist. Our preliminary longitudinal analyses indicate that there also does not appear to be deterioration in these network properties over a 12-month period. Future research in a larger sample is necessary to confirm our longitudinal findings.
Contact tracing for chronic hepatitis B in primary care? A ‘snapshot’ audit in Grampian, Northeast Scotland
Authors: Phillips Bethan , Corrigan Helen , Okpo Emmanuel 
Published: May 2018

Introduction Contact tracing for chronic hepatitis B infection is an important activity for preventing the spread of hepatitis B infection. In the UK, the ‘Green Book’ recommends that all sexual and household contacts of individuals with chronic hepatitis B should be tested and vaccinated if required. This audit aimed to evaluate contact tracing in primary care. Barriers to effective follow-up of contacts of patients with chronic hepatitis B were explored and recommendations made. Methods and results Mixed method, including a survey of general practitioners and review of hepatitis B surveillance data from 1 June 2015 to 31 December 2015 held by NHS Grampian Health Protection Team. The audit was carried out in August 2016. Contact tracing was mainly by patient referral. Only 20% (4/20) of identified close contacts were tested. No contact eligible for vaccination was vaccinated, and 57% (8/14) of general practitioners who completed the audit questionnaire suggested that general practitioners do not have a role in contact tracing. Barriers identified were: lack of time, lack of resources and contacts being registered with a different practice. Conclusions This audit suggests that contact tracing for chronic hepatitis B in primary care is largely incomplete. Moving contact tracing from general practice to health protection teams in Boards may be a pragmatic way of improving follow-up activities.
Integration and Utilization of Peer Leaders for Diabetes Self-Management Support: Results From Project SEED (Support, Education, and Evaluation in Diabetes)
Authors: Piatt Gretchen A. , Rodgers Elizabeth A. , Xue Lingshu , Zgibor Janice C. 
Published: May 2018

Purpose The purpose of the study was to evaluate the effectiveness of a peer leader-led (PL) diabetes self-management support (DSMS) group in achieving and maintaining improvements in A1C, self-monitoring of blood glucose (SMBG), and diabetes distress in individuals with diabetes. Diabetes self-management support is critical; however, effective, sustainable support models are scarce. Methods The study was a cluster randomized controlled trial of 221 people with diabetes from 6 primary care practices. Practices and eligible participants (mean age: 63.0 years, 63.8% female, 96.8% white, 28.5% at or below poverty level, 32.5% using insulin, A1C ≥7%: 54.2%) were randomized to diabetes self-management education (DSME) + PL DSMS (n = 119) or to enhanced usual care (EUC) (DSME + traditional DSMS with no PL; n = 102). Data were collected at baseline, after DSME (6 weeks), after DSMS (6 months), and after telephonic DSMS (12 months). Results Decreases in A1C occurred between baseline and post-DSME in both groups. Both groups sustained improvements during DSMS, but A1C levels increased during telephonic DSMS. Improvements in self-monitoring of blood glucose were observed in both groups following DSME and were sustained throughout. At study end, the intervention group was 4.3 times less likely to have diabetes regimen–related distress compared to EUC. Conclusions PL DSMS is as effective as traditional DSMS in helping participants to maintain glycemic control and self-monitoring of blood glucose (SMBG) and more effective at improving distress. With increasing diabetes prevalence and shortage of diabetes educators, it is important to integrate and use low-cost interventions in high-risk communities that build on available resources.