bluuebunny/crossref_metadata_2025_split huggingface dataset:
Differential effects of follistatin on porcine oocyte competence and cumulus cell gene expression in vitro
Authors: Guo Z , Islam MS , Liu D , Liu G , Lv L , Yang Y , Fu B , Wang L , Liu Z , He H , Wu H 
Published: November 2017

ContentsSeveral oocyte‐derived genes/proteins are essential to early embryonic development. The expression and stability of these proteins are influenced by the autocrine/paracrine activity of factors released by oocytes and cumulus cells. This study investigated the paracrine and autocrine activity of follistatin (FS), which is secreted by oocytes and cumulus cells as part of porcine embryogenesis. Immunohistochemical (IHC) localization of follistatin was conducted on 100 randomly selected early‐ and late‐cleaving two‐cell embryos. Dissociated cumulus cells were treated with various doses of follistatin for determination of the follistatin gene (FST) mRNA expression levels by quantitative real‐time PCR analysis. Microinjection of siRNA induced a downregulation of FST mRNA during embryonic development, thereby decreasing the proportion embryos developing to the blastocyst stage (19.33%). Immunolocalization analysis showed enhanced staining for follistatin in early‐cleavage stage embryos. Quantitative real‐time PCR indicated a significantly lower FST transcript level in cumulus cells after application of the highest dose of follistatin (100 ng/ml). Exogenous follistatin treatment of in vitro maturation embryos resulted in statistically significant dose‐dependent changes during development. Application of the highest concentration (100 ng/ml) of follistatin decreased the maturation rate of the oocytes. On the other hand, the application of 10 ng/ml follistatin resulted in an increase in the number of embryos. The observed differential effect of exogenous follistatin might be due to maternal FST and autocrine/paracrine factors secreted by cumulus cells.
Cytological endometritis diagnosed at artificial insemination in repeat breeder dairy cows
Authors: Bogado Pascottini O , Hostens M , Opsomer G 
Published: November 2017

ContentsThis study aimed to (i) assess the prevalence of cytological endometritis (CYTO) diagnosed at artificial insemination (AI); (ii) evaluate the effect of CYTO on the pregnancy outcome of the same AI sample; and (iii) determine the risk factors associated with CYTO diagnosed at AI in repeat breeder (RB) dairy cows. We analysed the productive and reproductive performances of 146 RB Holstein‐Friesian cows. To obtain a CYTO sample at AI, we used the cytotape technique. Generalized mixed effect models were computed to find the risk factors associated with the pregnancy and CYTO outcome. Based on ≥1% PMN cut‐off point, the CYTO prevalence at AI in RB cows was 25.3%. The overall pregnancy at AI was 44.2%. The conception rate in CYTO‐positive (n = 37) RB cows was 29.7% versus 49.5% for CYTO‐negative (n = 109) cows. A RB cow diagnosed CYTO positive at AI had 0.47 [odds ratio (OR)] odds to become pregnant in comparison with a CYTO‐negative cow. Cows that produced more milk than their counterparts in this study had increased odds (OR = 1.01) to be CYTO positive at AI. A novel risk factor positively associated with CYTO diagnosed at AI in RB cows was the level of daily milk urea (OR = 1.11). To conclude, CYTO at the moment of AI had a significantly negative effect on the pregnancy outcome in RB dairy cows. However, as only one of fourth of RB cows is affected with CYTO at AI, it may not be considered a key element associated with the RB syndrome.
Occupational Mobility during South Africa's Industrial Take‐Off
Authors: Cilliers Jeanne , Fourie Johan 
Published: November 2017

AbstractIn the absence of historical income or education data, the change in occupations over time can be used as a measure of mobility. This paper investigates intergenerational occupational mobility using a novel genealogical dataset for settler South Africa, spanning its transition from an agricultural to an early industrialised society (1800‐1909). We identify fathers and sons for whom we have complete information on occupational attainment. We follow a two‐generation discrete approach to measure changes in both absolute and relative mobility over time. Consistent with qualitative evidence of a shift away from agriculture as the economy's dominant sector, we see the farming class shrinking and the skilled and professional classes growing. Controlling for changes in the structure of the labour market over time, we find increasing mobility, becoming significant after the discovery of minerals in 1868. We find this mobility particularly for semi‐skilled workers but virtually no improved mobility for sons of farmers. We also test hypotheses related to the mobility prospects for first‐born sons and sons of immigrants.
DNA‐based testing in lung transplant recipients with suspected non‐viral lower respiratory tract infection: A prospective observational study
Authors: Drick Nora , Seeliger Benjamin , Greer Mark , Bollmann Benjamin A. , Ziesing Stefan , Welte Tobias , Gottlieb Jens 
Published: November 2017

AbstractBackgroundNon‐viral lower respiratory tract infections (LRTI) are common among lung transplant (LTx) recipients with increased mortality. Early pathogen identification is crucial to guide therapy and avoid adverse events. Results from cultures may require up to 72 hours. Multiplex polymerase chain reaction assay (PCR) may allow faster pathogen identification, but its utility in LTx recipients with suspected non‐viral LRTI remains unclear.MethodsIn a prospective open‐label observational trial, LTx recipients presenting with suspected LRTI received bronchoscopy with bronchoalveolar lavage (BAL). Samples were simultaneously analyzed by multiplex PCR (Curetis P55 Pneumonia) and cultures for pathogen identification. Time to result notification for PCR and cultures and time to final diagnosis were recorded. Definition of non‐viral LRTI was isolation of a lung‐pathogenic non‐viral pathogen by either method.ResultsForty‐eight patients were included, with 32 (67%) having a lung‐pathogenic isolate by conventional cultures. In 17/32 pathogen identification was identical on PCR, in 12/32 (37%) PCR returned negative, and in 3/32 (10%) PCR and culture identified different pathogens. Sensitivity and specificity with 95% confidence intervals for pathogen isolation for PCR were 66% (47‐81) and 100% (79‐100), respectively. The positive predictive value for PCR was 100% (84‐100) and the negative predictive value was 59% (39‐78). PCR results were available after 21.2 hours (interquartile range [IQR] 19.3‐65.7) vs 23 hours (IQR 21.1‐67.4) from cultures (P < .0001). The time to final diagnosis of non‐viral LRTI was 22.9 hours (20.4‐37.5).ConclusionIn LTx recipients with suspected non‐viral LRTI, multiplex PCR had a lower sensitivity than cultures. Results were available 2 hours earlier.
Dose capping of plerixafor in patients weighing more than 100 kg at one vial led to successful mobilization outcomes and significant cost savings
Authors: Park Gabriel , Shayani Sepideh , Stiller Tracey , Wang Shirong , Yuan Shan 
Published: November 2017

BACKGROUNDPlerixafor is frequently used as an adjunct agent to improve mobilization of peripheral blood stem cells in many clinical settings. However, its high cost (>$8000 per single‐use 24‐mg vial) is a significant concern. The manufacturer‐recommended dose is 0.24 mg/kg. Therefore, patients weighing more than 100 kg would require a second vial, thus doubling the drug cost per dose. We implemented a policy of capping the dose of plerixafor at 24 mg, or one vial, for patients weighing more than 100 kg. This retrospective study compares the mobilization of patients more than 100 kg who received capped doses, with historical control patients who received full, uncapped doses.STUDY DESIGN AND METHODSConsecutive, eligible patients weighing more than 100 kg who received capped (n = 47) and full doses of plerixafor (n = 40) were identified. Plerixafor was given up‐front, as a rescue agent due to suboptimal mobilization, or during remobilization. Baseline characteristics and mobilization data were collected and compared.RESULTSPatients in the two groups showed comparable baseline characteristics. They collected similar total numbers of CD34+ cells/kg (median, 4.08 × 106 vs. 3.36 × 106 CD34+ cells/kg; p = 0.86) and achieved comparable collection success rates as defined by collecting more than 2.0 × 106 CD34+ cells/kg (98% vs. 90%, p = 0.21). However, patients who received capped doses required only half of the number of vials of plerixafor (median, 3 vials vs. 6 vials; p < 0.0001).CONCLUSIONDose capping plerixafor at 24 mg for patients more than 100 kg is a cost‐effective strategy, which achieved comparable mobilization outcomes and reduced the total number of vials of plerixafor used by half.
Factors affecting patient‐reported outcomes after red blood cell transfusion in medical patients
Authors: Chan Ka Lok Luke , Mak Wai Man Vivien , Tam Yat Hung , Lee Kwok Kuen Harold 
Published: November 2017

BACKGROUNDPhysical variables like mortality or cardiac events were used to evaluate the requirement of red blood cell (RBC) transfusion. However, patient‐reported outcomes (PROs) of blood transfusion recipients were seldom assessed. The health‐related quality of life (HRQoL) of patients before and after RBC transfusion was compared in this study.STUDY DESIGN AND METHODSThe study period was February to June 2016. Standardized generic and anemia symptom‐specific HRQoL instruments were administered to patients receiving RBC transfusion in the medical unit of a single center. The primary outcome was the change in HRQoL scores on Days 1 and 7 posttransfusion from baseline values on the day of transfusion (Day 0). Multiple linear regression analysis was performed to study the effect of transfusion strategy and other factors on PRO.RESULTSThe analysis included 99 general medical patients. The median (interquartile range) pretransfusion hemoglobin level was 72 (66‐78) g/L. Two or more units of RBCs were prescribed to 45 patients (45%) on Day 0. Functional Assessment of Cancer Therapy‐Anemia Subscale improved significantly on Days 1 and 7 by effect sizes of 0.41 and 0.38, respectively (p < 0.001). Regression analysis showed that lower baseline HRQoL scores were associated with better PRO on both Day 1 and Day 7 (p < 0.001). Transfusion trigger and number of RBC units transfused did not affect the change in HRQoL.CONCLUSIONWorse pretransfusion HRQoL is a predictor of improvement in PRO after blood transfusion. There is no evidence that a restrictive transfusion or single‐unit policy jeopardizes PRO.
Risk factors for tibial damage associated with the modified Maquet technique in 174 stifles
Authors: Lefebvre Michael D. , Broux Olivier R. , Barthélémy Nicolas P. , Hamon Martin , Moyse Evelyne V. , Bouvy Bernard M. , Balligand Marc H. 
Published: November 2017

AbstractObjectiveTo identify risk factors for tibial damage associated with the modified Maquet technique (MMT) in dogs with cranial cruciate ligament (CCL) disease.Study designRetrospective study.Sample populationOne hundred and seventy‐four stifles from 147 client‐owned dogs.MethodsMedical records of dogs diagnosed with CCL disease and treated with the current version of MMT were reviewed. Dogs were included if immediate postoperative radiographs were available. Cortical hinge fracture or fissure, tibial tuberosity fracture, and diaphyseal fractures of the tibia were recorded. Age, body weight (BW), thickness of the tibial cortical hinge, and angle of opening of the osteotomy were tested as potential risk factors for tibial damage by univariate logistic regression analysis.ResultsTibial damage included intraoperative tibial fissures in 37% of MMTs, intraoperative fractures of the cortical hinge in 3.4% of MMTs, postoperative tibial fractures in 14% of MMTs. Risk factors for intraoperative fissure included BW (P = .0153) and thickness of cortical hinge (P = .0006). The angle of opening of the osteotomy was identified as a risk factor for intraoperative cortical hinge fracture (P = .0034), angles below 11° being preventive. No risk factor was identified for postoperative fracture.ConclusionBased on these results, preventive measures against tibial damage associated with MMT should include: a thickness of cortical hinge based on the equation related to the BW; a length of osteotomy adjusted to the amount of TTA with an osteotomy angle below 10°; and slow advancement of the tibial tuberosity.
Implementation of a pediatric behavioral staffing algorithm in an acute hospital: a best practice implementation project
Authors: O’Connor Tamara 
Published: November 2017

EXECUTIVE SUMMARY

Background:
A progressive decline in acute psychiatric facility beds has led to a steadily increasing number of pediatric psychiatric patients hospitalized on acute care medical-surgical units. Clinical nurses in this environment feel ill-equipped to provide quality behavioral health care.

Aims/objectives:
This project aimed to improve continuity of care as well as staff and patient safety in pediatric acute and transitional care units. The specific objectives related to implementation of a resource allocation algorithm for staffing behavioral health admissions and consistent use of an interdisciplinary psychiatric huddle.

Methods:
This project used the Joanna Briggs Institute's Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit tool for promoting health practice change. A baseline medical record audit was conducted which was followed by charge nurse education on the resource allocation algorithm and huddle initiation. Three follow-up audits measured compliance with best practice criteria for assessing and managing care of behavioral pediatric patients.

Results:
Compliance with comprehensively assessing children with challenging behaviors who were hospitalized in acute care units achieved 100% for the first three months following algorithm implementation. Nurses reached 100% compliance with initiating psychiatric huddles. All audits for individualized care plans, which included family or carer involvement, were fully compliant.

Conclusions:
Use of a resource allocation algorithm for individualizing care of pediatric behavioral patients enhanced quality of care through a standardized process which enabled acute care nurses to better meet the safety needs of this patient population. Early signs of sustaining improvements were promising for hard-wiring workflows. Future plans include adoption of the algorithm and huddle by all in-patient areas in the children's hospital.
Digital technologies in occupational therapy and physiotherapy undergraduate and postgraduate education: a scoping review protocol
Authors: Olivier Benita , Verdonck Michele , Casteleijn Daleen 
Published: November 2017

Review question and objective:
How have digital technologies been used in occupational therapy and physiotherapy undergraduate and postgraduate education?
Specifically, the objective of this scoping review is to present an overview of research on the use of digital technologies in terms of type of digital technology used, pedagogy associated with the use of digital technology, subject/topic/area of application, experiences/perception of digital technology used, outcomes of the digital technology used and challenges to the use of digital technologies in occupational therapy and physiotherapy undergraduate and postgraduate education.
Dynamic Modelling of Updraft Gasifiers: Incidence of Feedstock Quality and Operational Variables in the Transient Model Structure
Authors: Narváez Cueva Ricardo , Blanchard R. , Guerrón G. , Chulde Diego , Dixon R. 
Published: November 2017

This paper describes the definition of the transient model structure for an updraft gasifier and the input variables related to the process and the feedstock quality with the most significant influence on the dynamic models and the transient behaviour.
For such purpose, a set of open-loop dynamics experiments were carried out in the gasifier. Moreover, the output variables performance was recorded together with the composition analysis of the municipal solid waste batch (MSW).
The output and operational variables record was used as base information for performing regressions of transient models with the purpose of determining the model type choice that achieves the largest occurrence frequency of fitting percentage figures above 50%. In addition, the dataset of regression parameters is analysed through feature selection in order to establish the influence of feedstock quality parameters and independent dynamic operational variables in dynamic changes.
The model structure selection determined that underdamped, second order with one zero transfer function (P2ZU) is the most accurate case for updraft gasifiers.
Regarding the influence of feedstock-related information, feature selection results show that ultimate composition is the group of quality parameters with the most significant influence on transient behaviour.
Results also show that recirculation flow rate is the operational variable whose effect in the output variables is the most likely to be predicted and potentially controlled. The results for this variable show that 64.3% of the performed regressions achieved a fitting percentage value above 50%.
Under-Actuated Humanoid Model With Elastomeric Springs
Authors: Fry Christian , Coram Stanley , Piovesan Davide 
Published: November 2017

This paper presents the mechanical modifications and simulation of a bipedal humanoid system actuated with linear springs to produce a standing equilibrium position.
The original humanoid system is comprised of two leg assemblies connected by a hip bracket. Eleven pairs of springs were attached to the system in locations designed to simulate the muscles and tendons in a human body.
The next evolution of the LUIGEE project is the inclusion of three servo motors per leg and a series of elastomeric springs. Although servo motors have been introduced, it is desired to maintain the passive, static aspect of the previous prototype. This paper reports on part modifications to accommodate servo motors and the introduction of polymeric springs that guarantee static stability. ABS plastic and photopolymer resin was used to produce the new model. Due to the size of the motors, some parts of the original robot were redesigned. The new design iteration was stimulated using SimWise 4D®, where the hysteretic effect of rubber was modelled with an equivalent viscous damping.
Implementation of the free maternity services policy and its implications for health system governance in Kenya
Authors: Pyone Thidar , Smith Helen , van den Broek Nynke 
Published: November 2017

IntroductionTo move towards universal health coverage, the government of Kenya introduced free maternity services in all public health facilities in June 2013. User fees are, however, important sources of income for health facilities and their removal has implications for the way in which health facilities are governed.ObjectiveTo explore how implementation of Kenya’s financing policy has affected the way in which the rules governing health facilities are made, changed, monitored and enforced.MethodsQualitative research was carried out using semistructured interviews with 39 key stakeholders from six counties in Kenya: 10 national level policy makers, 10 county level policy makers and 19 implementers at health facilities. Participants were purposively selected using maximum variation sampling. Data analysis was informed by the institutional analysis framework, in which governance is defined by the rules that distribute roles among key players and shape their actions, decisions and interactions.ResultsLack of clarity about the new policy (eg, it was unclear which services were free, leading to instances of service user exploitation), weak enforcement mechanisms (eg, delayed reimbursement to health facilities, which led to continued levying of service charges) and misaligned incentives (eg, the policy led to increased uptake of services thereby increasing the workload for health workers and health facilities losing control of their ability to generate and manage their own resources) led to weak policy implementation, further complicated by the concurrent devolution of the health system.ConclusionThe findings show the consequences of discrepancies between formal institutions and informal arrangements. In introducing new policies, policy makers should ensure that corresponding institutional (re)arrangements, enforcement mechanisms and incentives are aligned with the objectives of the implementers.
Evaluation of guidelines regarding surgical treatment of breast cancer using the AGREE Instrument: a systematic review
Authors: Lei Xin , Liu Fengtao , Luo Shuying , Sun Ya , Zhu Liling , Su Fengxi , Chen Kai , Li Shunrong 
Published: November 2017

ObjectivesMany clinical practice guidelines and consensus statements (CPGs/consensus statements) have been developed for the surgical treatments for breast cancer. This study aims to evaluate the quality of these CPGs/consensus statements.MethodsWe systematically searched the PubMed and EMBASE databases, as well as four guideline repositories, to identify CPGs and consensus statements regarding surgical treatments for breast cancer between January 2009 and December 2016. We used the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument to assess the quality of the CPGs and consensus statements included. The overall assessment scores from the AGREE instrument and radar maps were used to evaluate the overall quality. We also evaluated some factors that may affect the quality of CPGs and consensus statements using the Mann-Whitney U test or Kruskal-Wallis H test. All analyses were performed using SPSS V.19.0. This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsA total of 19 CPGs and four consensus statements were included. In general, the included CPGs/consensus statements (n=23) performed well in the ‘Scope and Purpose’ and ‘Clarity and Presentation’ domains, but performed poorly in the ‘Applicability’ domain. The American Society of Clinical Oncology (ASCO), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), New Zealand Guidelines Group (NZGG) and Belgium Health Care Knowledge Centre (KCE) guidelines had the highest overall quality, whereas the Saskatchewan Cancer Agency, Spanish Society of Medical Oncology (SEOM), Japanese Breast Cancer Society (JBCS) guidelines and the D.A.C.H and European School of Oncology (ESO) consensus statements had the lowest overall quality. The updating frequency of CPGs/consensus statements varied, with the quality of consensus statements generally lower than that of CPGs. A total of six, eight and five CPGs were developed in the North American, European and Asian/Pacific regions, respectively. However, geographic region was not associated with overall quality.ConclusionsThe ASCO, NICE, SIGN, NZGG and KCE guidelines had the best overall quality, and the quality of consensus statements was generally lower than that of CPGs. More efforts are needed to identify barriers and facilitators for CPGs/consensus statement implementation and to improve their applicability.