bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rational clinical evaluation of suspected acute coronary syndromes: The value of more information
Authors: Hancock David G , Chuang Ming‐Yu (Anthony) , Bystrom Rebecca , Halabi Amera , Jones Rachel , Horsfall Matthew , Cullen Louise , Parsonage William A , Chew Derek P 
Published: June 2017

AbstractObjectiveMany meta‐analyses have provided synthesised likelihood ratio data to aid clinical decision‐making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome.MethodsClinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013. Bayes theorem was used to calculate patient‐specific post‐test probabilities using age‐ and gender‐specific pre‐test probabilities and likelihood ratios corresponding to the presence or absence of 18 clinical factors. Model performance was assessed as the presence of adverse cardiac outcomes among patients theoretically discharged at a post‐test probability less than 1%.ResultsBayes theorem‐based models containing high‐sensitivity troponin T (hs‐troponin) outperformed models excluding hs‐troponin, as well as models utilising TIMI and GRACE scores. In models containing hs‐troponin, a plateau in improving discharge safety was observed after the inclusion of four clinical factors. Models with fewer clinical factors better approximated the true event rate, tended to be safer and resulted in a smaller standard deviation in post‐test probability estimates.ConclusionsWe showed that there is a definable point where additional information becomes uninformative and may actually lead to less certainty. This evidence supports the concept that clinical decision‐making in the assessment of suspected acute coronary syndrome should be focused on obtaining the least amount of information that provides the highest benefit for informing the decisions of admission or discharge.
Synergistic chemo‐enzymatic hydrolysis of poly(ethylene terephthalate) from textile waste
Authors: Quartinello Felice , Vajnhandl Simona , Volmajer Valh Julija , Farmer Thomas J. , Vončina Bojana , Lobnik Alexandra , Herrero Acero Enrique , Pellis Alessandro , Guebitz Georg M. 
Published: June 2017

SummaryDue to the rising global environment protection awareness, recycling strategies that comply with the circular economy principles are needed. Polyesters are among the most used materials in the textile industry; therefore, achieving a complete poly(ethylene terephthalate) (PET) hydrolysis in an environmentally friendly way is a current challenge. In this work, a chemo‐enzymatic treatment was developed to recover the PET building blocks, namely terephthalic acid (TA) and ethylene glycol. To monitor the monomer and oligomer content in solid samples, a Fourier‐transformed Raman method was successfully developed. A shift of the free carboxylic groups (1632 cm−1) of TA into the deprotonated state (1604 and 1398 cm−1) was observed and bands at 1728 and 1398 cm−1 were used to assess purity of TA after the chemo‐enzymatic PET hydrolysis. The chemical treatment, performed under neutral conditions (T = 250 °C, P = 40 bar), led to conversion of PET into 85% TA and small oligomers. The latter were hydrolysed in a second step using the Humicola insolens cutinase (HiC) yielding 97% pure TA, therefore comparable with the commercial synthesis‐grade TA (98%).
Systematic review with meta‐analysis: the impact of a depressive state on disease course in adult inflammatory bowel disease
Authors: Alexakis C. , Kumar S. , Saxena S. , Pollok R. 
Published: June 2017

SummaryBackgroundDespite a higher prevalence of psychosocial morbidity in Inflammatory Bowel Disease (IBD), the association between depressive state and disease course in IBD is poorly understood.AimTo investigate the impact of depressive state on disease course in IBD.MethodsWe conducted a systematic review in MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews and PsychINFO for prospective studies evaluating the impact of baseline depressive state on subsequent disease course in adult IBD.ResultsEleven studies matched our entry criteria, representing 3194 patients with IBD. Three reported on patients with ulcerative colitis (UC), four included patients with Crohn's disease (CD) exclusively, and four studies included both UC and CD. Five studies reported an association between depressive state and disease course. None of the UC‐specific studies found any association. In three of four CD‐specific studies, a relationship between depressive state and worsening disease course was found. In four of five studies including patients in remission at baseline, no association between depressive state and disease course was found. Pooled analysis of IBD studies with patients in clinical remission at baseline identified no association between depressive state and disease course (HR 1.04, 95%CI: 0.97‐1.12).ConclusionThere is limited evidence to support an association between depressive state and subsequent deterioration in disease course in IBD, but what data that exist are more supportive of an association with CD than UC. Baseline disease activity may be an important factor in this relationship. Further studies are needed to understand the relationship between mental health and outcomes in IBD.
The Political Economy of Care: Flight Attendant Unions and the Struggle over Airline Deregulation in the 1980s
Authors: Murphy Ryan Patrick 
Published: June 2017

AbstractThis paper traces flight attendant union activism in the 1980s to demonstrate how the ideology of the family weighed on the practice of care. Previous scholarship, especially the work of Arlie Russell Hochschild, has demonstrated that emotional labor is a defining feature of the flight attendant profession and of other service work. Because airline managers had framed women's jobs as providing care and not as work, flight attendants had always made far less money than their male peers in the airline industry. In the early 1970s, and in conjunction with the women's, gay, and lesbian liberation movements, flight attendant unions transformed the relationship between care and work, as they won large raises that allowed flight attendants to be breadwinners for their families. With flight attendants' economic advances, caregiving was defined in political economic terms, a practice that required a robust wage and affordable benefits. After the deregulation of the airline industry, however, airline managers strove to redefine the meaning of care. Working in tandem with the ascendant “pro‐family” and pro‐business activist movements of the early 1980s that aimed to cut taxes, roll back welfare programs, and eliminate government regulation, the airlines offered “family values” as a means to make up for what neoliberal reforms were taking away. This paper analyzes the ensuing confrontation, arguing that the category of care was a fault line in the struggle over the rise of neoliberalism.
Failure of Ethical Leadership: Implications for Stakeholder Theory and “Anti‐Stakeholders”
Authors: Hill Ronald Paul 
Published: June 2017

AbstractLeaders in a variety of organizations are beset by challenges that test their commitments to ethical behavior in interactions with stakeholders who make up their working environments. Situations that present themselves include complex management of expectations, people, and resources, which require novel solutions that also test the boundaries between right and wrong. Such conditions arose after the 9/11 terrorist attacks on the World Trade Center Twin Towers. President Bush asked the Central Intelligence Agency to round up persons who represented a continuing threat of harm to U.S. interests. What followed was a series of decisions and actions by a number of internal and external constituencies based on inaccurate reporting of treatment of and information gleaned from detainees. Lessons for understanding and avoiding resulting leadership ethical dilemmas and a novel stakeholder perspective are provided in the close.
Prediction of lithium response in first‐episode mania using the LITHium Intelligent Agent (LITHIA): Pilot data and proof‐of‐concept
Authors: Fleck David E , Ernest Nicholas , Adler Caleb M , Cohen Kelly , Eliassen James C , Norris Matthew , Komoroski Richard A , Chu Wen‐Jang , Welge Jeffrey A , Blom Thomas J , DelBello Melissa P , Strakowski Stephen M 
Published: June 2017

ObjectivesIndividualized treatment for bipolar disorder based on neuroimaging treatment targets remains elusive. To address this shortcoming, we developed a linguistic machine learning system based on a cascading genetic fuzzy tree (GFT) design called the LITHium Intelligent Agent (LITHIA). Using multiple objectively defined functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy (1H‐MRS) inputs, we tested whether LITHIA could accurately predict the lithium response in participants with first‐episode bipolar mania.MethodsWe identified 20 subjects with first‐episode bipolar mania who received an adequate trial of lithium over 8 weeks and both fMRI and 1H‐MRS scans at baseline pre‐treatment. We trained LITHIA using 18 1H‐MRS and 90 fMRI inputs over four training runs to classify treatment response and predict symptom reductions. Each training run contained a randomly selected 80% of the total sample and was followed by a 20% validation run. Over a different randomly selected distribution of the sample, we then compared LITHIA to eight common classification methods.ResultsLITHIA demonstrated nearly perfect classification accuracy and was able to predict post‐treatment symptom reductions at 8 weeks with at least 88% accuracy in training and 80% accuracy in validation. Moreover, LITHIA exceeded the predictive capacity of the eight comparator methods and showed little tendency towards overfitting.ConclusionsThe results provided proof‐of‐concept that a novel GFT is capable of providing control to a multidimensional bioinformatics problem—namely, prediction of the lithium response—in a pilot data set. Future work on this, and similar machine learning systems, could help assign psychiatric treatments more efficiently, thereby optimizing outcomes and limiting unnecessary treatment.
Current challenges and future prospects in oral anticoagulant therapy
Authors: Czuprynska Julia , Patel Jignesh P. , Arya Roopen 
Published: June 2017

SummaryThe choice for oral anticoagulant (OAC) therapy was previously limited to the vitamin K antagonists (VKAs). The advent of the direct oral anticoagulants (DOACs) brought with it the expectation that oral anticoagulation would become simpler (with the elimination of routine monitoring and introduction of a fixed‐dose anticoagulant), and that the use of VKAs would be slowly phased out. Although DOACs have made anticoagulation more convenient and accessible, we are now faced with what can be described as a tyranny of choice, together with many unanswered questions relating to DOAC use. These include optimal DOAC selection and dosing, use in complex ‘real‐world’ patients, the role for monitoring and issues surrounding adherence. Warfarin remains the anticoagulant of choice in certain scenarios (e.g. metallic heart valves). The future holds much excitement: clinical studies are underway to expand the indications for DOACs and experience continues to grow outside the trials setting.
Nicotine effects on exercise performance and physiological responses in nicotine‐naïve individuals: a systematic review
Authors: Johnston Robert , Doma Kenji , Crowe Melissa 
Published: June 2017

SummaryThe purpose of this systematic review was to evaluate the effects of smokeless forms of nicotine on physiological responses and exercise performance. Methodology and reporting were based on the PRISMA statement. The intervention was defined as any product containing nicotine that did not require smoking. Searches were conducted across two electronic databases with supplementary approaches utilized. Studies were selected following set inclusion and exclusion criteria and checked by two independent authors. A modified PEDro scale was utilized to rate study quality with studies averaging 9·3/13. Six studies assessed exercise performance with endurance‐based parameters reported as significantly improved with nicotine in one study, while anaerobic parameters were unaffected or decreased compared to placebo except in one study which reported enhanced leg extensor torque but no effect on countermovement jump or Wingate anaerobic capacity. Sixteen of 28 studies investigating physiological responses reported that nicotine significantly increased heart rate compared to placebo or control. Blood pressure and blood flow were also reported as significantly increased in multiple studies. While there is strong evidence of nicotine‐induced changes in physiological function that would benefit physical performance, beneficial effects have only been reported on leg extensor torque and endurance performance by one study each. Subsequently, there is need for more research with strong methodological quality to definitively evaluate nicotine's potential as an ergogenic aid.
Finding a Language for Faith: Liturgy and Worship
Authors: Lange Dirk G. 
Published: June 2017

AbstractThe sacramental and liturgical texts in The Annotated Luther series (volumes 1 and 3) reflect Luther's ongoing concern for the faith life of the people. They also give us an insight into Luther's own struggle to find words (and, of course, practices) that reflect the fundamental insight of the Reformation: justification by faith alone. Luther refused to abandon ritual or a strict liturgical order even though it can so easily become, in the minds and hearts of believers, a work they must do. The freedom of the gospel does not dispense us from a liturgical order or from participation; in fact, for Luther, that freedom compels us to worship! This tension can be found within these writings as Luther searches for new words and redefines and/or reorients other words to express a spirituality of justification.
Abnormal γ‐aminobutyric acid neurotransmission in a Kcnq2 model of early onset epilepsy
Authors: Uchida Taku , Lossin Christoph , Ihara Yukiko , Deshimaru Masanobu , Yanagawa Yuchio , Koyama Susumu , Hirose Shinichi 
Published: June 2017

SummaryObjectiveMutations of the KCNQ2 gene, which encodes the Kv7.2 subunit of voltage‐gated M‐type potassium channels, have been associated with epilepsy in the neonatal period. This developmental stage is unique in that the neurotransmitter gamma aminobutyric acid (GABA), which is inhibitory in adults, triggers excitatory action due to a reversed chloride gradient.MethodsTo examine whether KCNQ2‐related neuronal hyperexcitability involves neonatally excitatory GABA, we examined 1‐week‐old knockin mice expressing the Kv7.2 variant p.Tyr284Cys (Y284C).ResultsBrain slice electrophysiology revealed elevated CA1 hippocampal GABAergic interneuron activity with respect to presynaptic firing and postsynaptic current frequency. Blockade with the GABAA receptor antagonist bicuculline decreased ictal‐like bursting in brain slices with lowered divalent ion concentration, which is consistent with GABA mediating an excitatory function that contributes to the hyperexcitability observed in mutant animals.SignificanceWe conclude that excitatory GABA contributes to the phenotype in these animals, which raises the question of whether this special type of neurotransmission has broader importance in neonatal epilepsy than is currently recognized.
Social Contagion and Cultural Epidemics: Phenomenological and “Experience‐Near” Explorations
Authors: Grøn Lone , Meinert Lotte 
Published: June 2017

AbstractWe open the special issue by asking: how are groups of people affected by similar conditions, even when these are not biologically contagious? This is linked to broader theoretical and empirical questions of how we are influenced by others and by the specific times and places in which we live. We describe the history and etymology of the concepts of epidemics and contagion and argue that we need to reclaim some of the pre‐Hippocratic meanings of these concepts. Importantly, we suggest a postponement, or epoche, of the negative moral judgment of these terms with a view to exploring what actually happens when noncommunicable diseases and conditions spread. We introduce a variety of existing approaches and argue that they have taken us only part of the way in trying to understand social contagion and cultural epidemics. The articles in this issue explore a variety of noncommunicable conditions that have gained global prominence as epidemic problems—diabetes, obesity, trauma, and autism—through perspectives and concepts from phenomenological and experience‐near traditions. This includes emic ideas of social contagion and contamination, intersubjective units of analysis, causal indeterminacy, as well as diversity and transformation in social contagion.
Dreamscapes of Intimacy and Isolation: Shadows of Contagion and Immunity
Authors: Hollan Douglas 
Published: June 2017

AbstractIn this article, I use the study of selfscape dreams to discuss contagion‐like processes not as unique or extraordinary phenomena per se, but rather as a particular kind of social influence more broadly conceived. In particular, I argue that dream consciousness gives us clues about how social influence (and contagion) actually works: partially, incrementally, in a “condensed” way, through a variety of sensory and perceptual modalities, contingent on and delimited by the emotional memories of those involved, but with the potential of exceeding those contingencies and limitations by the ability of all of the participants to imaginatively elaborate upon what is experienced and communicated. I compare and contrast how and why two men from two very different parts of the world dream of their deceased parents. I use the dreams to illustrate how people come to inhabit, experience, and become influenced by their social and cultural worlds in the particular way they do and also to demonstrate how dream experience may be implicated in everyday behavior.
Maintaining post‐grazing sward height of Panicum maximum (cv. Mombaça) at 50 cm led to higher animal performance compared with post‐grazing height of 30 cm
Authors: Euclides V. P. B. , Carpejani G. C. , Montagner D. B. , Nascimento Junior D. , Barbosa R. A. , Difante G. S. 
Published: June 2017

AbstractIn swards of tall, tufted, tropical grasses like Mombaça guinea grass (Panicum maximum (Jacq.)), post‐grazing heights promote changes in sward structure, which influence animal performance. This study evaluated changes in sward structure in response to grazing management at two post‐grazing heights (30 and 50 cm), associated with 90 cm pre‐grazing height. Each treatment was allocated to experimental unit (1.5 ha) in three replicated blocks. Pastures were evaluated pre‐ and post‐grazing to estimate herbage mass, percentages of leaf (LP), stem (SP) and dead material (DP), and nutritive value (VN). Stocking rate was adjusted twice a week “using the put‐and‐take approach,” and animals were weighed every 28 days. Forage accumulation rate was greater for pasture managed at 30 cm (64.8 vs. 55.1 kg ha−1 day−1) than 50 cm. A greater number of days were required after grazing 30‐cm residual pasture to achieve the pre‐grazing target height, resulting in 25% decrease in number of grazing cycles compared with pastures managed at 50 cm. Regardless of post‐grazing height targets, SP and DP decreased, whereas LP and NV increased from soil level to top of canopy. Stocking rate was greater in pastures managed to 30 cm than in those managed to 50 cm residual height (4.7 vs. 3.4 AU ha−1). However, average daily gain was greater for 50 cm than for 30 cm post‐grazing height (795 vs. 590 g steer−1 day−1), resulting in a greater animal production per area (917 vs. 794 kg/ha of live weight). Thus, Mombaça guinea grass subject to intermittent grazing should be managed at 50 cm residual height.
Quasi una gens: Saxony and the Frankish world, c. 772–888
Authors: Rembold Ingrid 
Published: June 2017

AbstractThe Saxons were conquered by Charlemagne in 804, after 33 years of intermittent campaigning; they were converted to Christianity and incorporated into the Carolingian political order. Yet despite this history of conquest and incorporation, historians have largely viewed Carolingian Saxony as distinct from the Frankish world. To a large extent, this may be seen as a result of the politicization of Saxon history in the early 20th century. Early Nazi propaganda drew upon the Saxon wars as an example of German heroism and resistance, with particular attention paid to the history of conflict and warfare; unsurprisingly, there was little interest in such circles in delineating subsequent cooperation and coexistence. The postwar period, by contrast, saw a resurgence of local history, which, while serving as a corrective to earlier nationalistic approaches, did not seek to situate the history of individual Saxon Christian centres, whether monasteries or bishoprics, in their wider context. Only recently has an interest in Saxon regional history resurfaced, but even still, the connection of the region to the Frankish world remains relatively unexplored with a few notable exceptions. Recent work on the Carolingian empire has stressed its regionalism and variety, arguing for less top‐down control and more “grassroots” politics. In such a context, Carolingian Saxony need not stand as an outlier: rather, it should be analyzed both alongside, and as part of, the wider Carolingian world.
What role could community pharmacists in Malaysia play in diabetes self-management education and support? The views of individuals with type 2 diabetes
Authors: Lee E Lyn , Wong Pei Se , Tan Ming Yeong , Sheridan Janie 
Published: June 2017

Abstract

Objectives
This study explored the experiences and views of individuals with type 2 diabetes mellitus (T2D) on their diabetes self-management and potential roles for community pharmacists in diabetes self-management education and support (DSME/S) in Malaysia.

Methods
A qualitative study, using semi-structured, face-to-face interviews, was conducted with patients with T2D attending a primary care health clinic in Kuala Lumpur, Malaysia. The interviews were audio-recorded, transcribed verbatim and analysed inductively.

Key findings
Fourteen participants with T2D were interviewed. Data were coded into five main themes: experience and perception of diabetes self-management, constraints of the current healthcare system, perception of the community pharmacist and community pharmacies, perceived roles for community pharmacists in diabetes care, and challenges in utilising community pharmacies to provide DSME/S. There were misconceptions about diabetes management that may be attributed to a lack of knowledge. Although participants described potential roles for community pharmacists in education, medication review and continuity of care, these roles were mostly non-clinically oriented. Participants were not confident about community pharmacists making recommendations and changes to the prescribed treatment regimens. While participants recognised the advantages of convenience of a community pharmacy-based diabetes care service, they raised concerns over the retail nature and the community pharmacy environment for providing such services.

Conclusion
This study highlighted the need to improve the care provision for people with T2D. Participants with T2D identified potential, but limited roles for community pharmacists in diabetes care. Participants expressed concerns that need to be addressed if effective diabetes care is to be provided from community pharmacies in Malaysia.