bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health System Consolidation and Diabetes Care Performance at Ambulatory Clinics
Authors: Crespin Daniel J. , Christianson Jon B. , McCullough Jeffrey S. , Finch Michael D. 
Published: February 2016

ObjectiveWe addressed two questions regarding health system consolidation through the acquisition of ambulatory clinics: (1) Was increasing health system size associated with improved diabetes care performance and (2) Did the diabetes care performance of acquired clinics improve postacquisition?Data Sources/Study SettingSix hundred sixty‐one ambulatory clinics in Minnesota and bordering states that reported performance data from 2007 to 2013.Study DesignWe employed fixed effects regression to determine if increased health system size and being acquired improved clinics' performance. Using our regression results, we estimated the average effect of consolidation on the performance of clinics that were acquired during our study.Data Collection/Extraction MethodsPublicly reported performance data obtained from Minnesota Community Measurement.Principal FindingsAcquired clinics experienced performance improvements starting in their third year postacquisition. By their fifth year postacquisition, acquired clinics had 3.6 percentage points (95 percent confidence interval: 2.0, 5.1) higher performance than if they had never been acquired. Increasing health system size was associated with slight performance improvements at the end of the study.ConclusionsHealth systems modestly improved the diabetes care performance of their acquired clinics; however, we found little evidence that systems experienced large, system‐wide performance gains by increasing their size.
Botulinum toxin injection and rehabilitation for neurosurgical patients with spasticity
Authors: See Michael Ka‐Wing , Taw Benedict Beng‐Teck , Chan Edward Man‐Tai , Chan Linda Yuk‐Ying , Lo Shuk‐Man , Kwong Terrence Wing‐Cheung , Leung Gilberto Ka‐Kit , Lui Wai‐Man 
Published: February 2016

AimSpasticity gives rise to impairment in motor functions and activities of daily living. Botulinum toxin (BTX) can be injected to temporarily paralyze the affected muscles, which provides a window of opportunity for rehabilitation. We present our 2.5‐year experience with BTX injection and a patient‐specific rehabilitation program provided by a multidisciplinary team, which consists of neurosurgeons, nurses, physiotherapists, occupational therapists and prosthetic orthotists.Patients and MethodsThis is a retrospective study of prospectively collected data in a local hospital including 22 patients suffering from spasticity. Outcome measures include goal attainment, caregiver burden and biomechanical assessment by Modified Ashworth Scale and Modified Tardieu Scale (MTS).ResultsOnabotulinumtoxinA injection together with rehabilitation facilitates the attainment of patient‐centred physical goals in daily activities. It reduces caregiver burden. Spasticity is reduced particularly for finger and wrist flexors as well as hip adductors. Responses of ankle plantarflexors are less satisfactory which may be due to inadequate dosages. Initial improvement in the R2 component of the MTS for ankle plantarflexors and hip adductors may be attributable to the application of ankle–foot orthosis and abduction pillow.ConclusionsMultidisciplinary management for spasticity is feasible within our healthcare setting and our promising findings indicate its wider adoption in this locality.
Purse‐string suture without pancreatic parenchymal stitches in pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy
Authors: Hsu Chih‐Wei , Lin Lien‐Fu , Law Ming‐Ko 
Published: February 2016

AimLaparoscopic pancreaticoduodenectomy is a controversial procedure because of the technical difficulty of the procedure. Complications are associated with reconstructive surgeries, in particular with pancreaticoenterostomy. In this study, we aimed to develop a method for pancreaticojejunostomy during laparoscopic pancreaticoduodenectomy.Patients and MethodsFive patients received laparoscopic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. The main pancreatic duct was identified after transection and cannulated with a 5‐Fr paediatric feeding tube. Two stay sutures of nonabsorbable 4–0 monofilament were applied in the both side of the pancreas. A hole was opened in the jejunum near the cross section of the pancreatic stump on the antimesenteric side. The surrounding layers of the jejunal hole were purse‐string sutured using a nonabsorbable 3–0 suture, and the surgeons ensured that the jejunal muscular layers enveloped the pancreatic stump.ResultsWe performed a purse‐string suture without pancreatic parenchymal stitches in a pancreaticojejunostomy during a laparoscopic pancreaticoduodenectomy in five patients. The patients began to drink water at 5–7 days postoperation. The patients began to eat a soft diet at 13–15 days postoperation. We also administered total parenteral nutrition after surgery. The average blood loss was 850 mL and the average operative time was 532 min. The postoperative hospital stays were 21, 25, 20, 25, and 19 days. Two patients exhibited delayed gastric emptying. No PFe was observed in short‐term follow‐up up to 6 months postoperation.ConclusionWe successfully performed purse‐string suturing without pancreatic parenchymal stitches during the pancreaticojejunostomy. The short‐term follow‐up exhibited no pancreatic fistulae. This anastomosis technique can be performed safely and easily.
Flow cytometry as the new ‘gold standard’ for detection of free tumour cells in abdominal lavage fluid in gastric cancer patients: A comparative study of molecular and conventional methods
Authors: Jagric Tomaz , Potrc Stojan , Mis Katarina , Mars Tomaz , Gradisnik Lidija , Gorenjak Maksimiljan , Goropevsek Ales 
Published: February 2016

AimThe ideal method for detection of free tumour cells in abdominal lavage fluid should be rapid, reliable and widely available. Flow cytometry potentially covers these properties, but there are only a few studies directly comparing flow cytometry for detecting gastric cancer cells to other methods. Therefore, we compared free tumour‐cell detection in abdominal lavage fluids using cytology with immunocytochemistry,RT‐qPCRand flow cytometry.MethodsPeritoneal lavage fluid samples were collected from 10 patients. Detection of free tumour cells was performed using cytological and immunocytochemical analysis, and usingRT‐qPCRand flow cytometry. Tumour cells were detected according toCEAandCK20mRNAexpression levels usingRT‐qPCR, and with the epithelial markersEpCAM/CD326andCEAusing flow cytometry.ResultsThe sensitivity and specificity of cytology were 40% and 100%, respectively, while theRT‐qPCRhad a sensitivity of 80% and specificity of 100%. Flow cytometry showed no false‐negative results and only one false‐positive result, giving a sensitivity and specificity of 100% and 80%, respectively. TheRT‐qPCRand flow cytometry could detect free tumour cells in each of the three false‐negative cases with cytology. In the samples with detected tumour cells, tumour cell clusters were observed with imaging flow cytometry, providing additional morphological confirmation.ConclusionThe combination of quantitative and qualitative data from flow cytometry and the images of tumour cells in borderline cases provide a rapid, reliable and reproducible method for detection of free tumour cells in abdominal lavage fluid, which is necessary for intraoperative selection of patients for intraperitoneal chemotherapy.
When a general morphology allows many habitat uses
Authors: TULLI María J. , CRUZ Félix B. , KOHLSDORF Tiana , ABDALA Virginia 
Published: February 2016

AbstractDuring the last decades the study of functional morphology received more attention incorporating more detailed data corresponding to the internal anatomy that together contribute for a better understanding of the functional basis in locomotion. Here we focus on 2 lizard families, Tropiduridae and Liolaemidae, and use information related to muscle‐tendinous and external morphology traits of hind legs. We investigate whether the value of the traits analyzed tend to exhibit a reduced phenotypic variation produced by stabilizing selection, and whether species showing specialization in their habitat use will also exhibit special morphological features related to it. As a result, we identified that evolution of hind limb traits is mainly explained by the Ornstein–Uhlenbeck model, suggesting stabilizing selection. Liolaemids and tropidurids show clear ecomorphological trends in the variables considered, with sand lizards presenting the most specialized morphological traits. Some ecomorphological trends differ between the 2 lineages, and traits of internal morphology tend to be more flexible than those of external morphology, restricting the ability to identify ecomorphs shared between these 2 lineages. Conservative traits of external morphology likely explain such restriction, as ecomorphs have been historically defined in other lizard clades based on variation of external morphology.
Intestinal tuberculosis and Crohn's disease: challenging differential diagnosis
Authors: Ma Jia Yi , Tong Jin Lu , Ran Zhi Hua 
Published: February 2016

AbstractAlong with epidemiological changes in tuberculosis (TB) and an increased incidence of Crohn's disease (CD), the differential diagnosis of intestinal TB (ITB) and CD is of vital importance and has become a clinical challenge because treatment based on misdiagnosis may lead to fatal outcomes. In this study, we reviewed the similarities and differences in clinical, endoscopic, radiological and histological features of these two diseases. Concomitant pulmonary TB, ascites, night sweats, involvement of fewer than four segments of the bowel, patulous ileocecal valve, transverse ulcers, scars or pseudopolyps strongly indicate ITB. Bloody stools, perianal signs, chronic diarrhea, extraintestinal manifestations, anorectal lesions, longitudinal ulcers and a cobblestone appearance are all suggestive of CD. Significant differences in the size, number, location and patterns of granulomas in ITB and CD with regard to their histopathologic features have been noted. Immune stain of cell surface markers is also helpful. Interferon‐γ release assay and polymerase chain reaction analysis have achieved satisfactory sensitivity and specificity in the diagnosis of ITB. Computed tomography enterographic findings of segmental small bowel or left colon involvement, mural stratification, the comb sign and fibrofatty proliferation are significantly more common in CD, whereas mesenteric lymph node changes (calcification or central necrosis) and focal ileocecal lesions are more frequently seen in ITB. A diagnosis should be carefully established before the initiation of the therapy. In suspicious cases, short‐term empirical anti‐TB therapy is quite efficient to further confirm the diagnosis.
Emerging Tools for Continuous Nutrient Monitoring Networks: Sensors Advancing Science and Water Resources Protection
Authors: Pellerin Brian A. , Stauffer Beth A. , Young Dwane A. , Sullivan Daniel J. , Bricker Suzanne B. , Walbridge Mark R. , Clyde Gerard A. , Shaw Denice M. 
Published: February 2016

AbstractSensors and enabling technologies are becoming increasingly important tools for water quality monitoring and associated water resource management decisions. In particular, nutrient sensors are of interest because of the well‐known adverse effects of nutrient enrichment on coastal hypoxia, harmful algal blooms, and impacts to human health. Accurate and timely information on nutrient concentrations and loads is integral to strategies designed to minimize risk to humans and manage the underlying drivers of water quality impairment. Using nitrate sensors as the primary example, we highlight the types of applications in freshwater and coastal environments that are likely to benefit from continuous, real‐time nutrient data. The concurrent emergence of new tools to integrate, manage, and share large datasets is critical to the successful use of nutrient sensors and has made it possible for the field of continuous monitoring to rapidly move forward. We highlight several near‐term opportunities for federal agencies, as well as the broader scientific and management community, that will help accelerate sensor development, build and leverage sites within a national network, and develop open data standards and data management protocols that are key to realizing the benefits of a large‐scale, integrated monitoring network. Investing in these opportunities will provide new information to guide management and policies designed to protect and restore our nation's water resources.
Extracting Snow Cover Time Series Data from Open Access Web Mapping Tile Services
Authors: Kadlec Jiří , Miller A. Woodruff , Ames Daniel P. 
Published: February 2016

AbstractThe probability of the presence of snow cover at a given location over time is a critical input to hydrologic simulation models in snowpack‐driven watersheds. While a number of open access web mapping tile services exist for viewing images of current and historical snow cover over large regions, no equally accessible tools exist for extracting numerical time series data of snow cover probability defined at particular point locations. This article presents the design, development, and testing of a new open source script and web application for snow cover probability time series extraction from map images. The script is deployed as a web app using the Tethys framework making it accessible to novice users through a user interface. A WaterML web‐API gives access to third‐party applications for automation and embedding in modeling tools. The full design of the script is presented such that it can serve as a model for similar or extended tools that may be developed by others. A set of use case experiments is presented demonstrating the full functionality of the script and its limitations, and an example application for ground validation of the Moderate Resolution Imaging Spectroradiometer snow cover dataset is discussed.
Management of Large Wood in Streams: An Overview and Proposed Framework for Hazard Evaluation
Authors: Wohl Ellen , Bledsoe Brian P. , Fausch Kurt D. , Kramer Natalie , Bestgen Kevin R. , Gooseff Michael N. 
Published: February 2016

AbstractInstream and floodplain wood can provide many benefits to river ecosystems, but can also create hazards for inhabitants, infrastructure, property, and recreational users in the river corridor. We propose a decision process for managing large wood, and particularly for assessing the relative benefits and hazards associated with individual wood pieces and with accumulations of wood. This process can be applied at varying levels of effort, from a relatively cursory visual assessment to more detailed numerical modeling. Decisions to retain, remove, or modify wood in a channel or on a floodplain are highly dependent on the specific context: the same piece of wood that might require removal in a highly urbanized setting may provide sufficient benefits to justify retention in a natural area or lower‐risk urban setting. The proposed decision process outlined here can be used by individuals with diverse technical backgrounds and in a range of urban to natural river reaches so that opportunities for wood retention or enhancement are increased.
Chronic Alcohol Consumption in Rats Leads to Desynchrony in Diurnal Rhythms and Molecular Clocks
Authors: Guo Rong , Simasko Steve M. , Jansen Heiko T. 
Published: February 2016

BackgroundCircadian rhythms are essential for adapting to the environment. Chronic alcohol consumption often leads to sleep and circadian disruptions, which may impair the life quality of individuals with alcohol use disorders and contribute to the morbidity associated with alcoholism.MethodsWe used a pair‐feeding liquid diet alcohol exposure protocol (6 weeks duration) in PER1::LUC transgenic rats to examine the effects of chronic alcohol exposure on: (i) diurnal rhythms of core body temperature and locomotor activity, (ii) plasma corticosterone (CORT) concentrations, and (iii) rhythms of ex vivo Period1 (Per1) expression in the suprachiasmatic nucleus (SCN), pituitary, and adrenal glands. We followed multiple circadian outputs not only to examine individual components, but also to assess the relative phase relationships among rhythms.ResultsWe found that chronic alcohol consumption: (i) reduced 24‐hour body temperature and locomotor activity counts in the dark period, (ii) advanced the acrophase of diurnal rhythms of body temperature and locomotor activity, (iii) abolished the phase difference between temperature and activity rhythms, (iv) blunted and advanced the diurnal CORT rhythm, and (v) advanced Per1 expression in the adrenal and pituitary glands but not in the SCN. We found that chronic alcohol altered the phase relationships among diurnal rhythms and between the central (SCN) and peripheral (adrenal and pituitary) molecular clocks.ConclusionsOur findings suggest that desynchrony among internal rhythms is an important and overlooked aspect of alcohol‐induced circadian disruptions. The misalignment of phases among rhythms may compromise normal physiological functions and put individuals with chronic alcohol use at greater risk for developing other physical and mental health issues. How this desynchrony occurs and the extent to which it participates in alcohol‐related pathologies requires further investigation.
The Polish Version of the Yale‐Brown Obsessive–Compulsive Scale, Modified to Reflect Obsessions and Compulsions Related to Heavy Drinking (YBOCS‐hd‐PL)
Authors: Nowakowska‐Domagała Katarzyna , Chodkiewicz Jan , Ziółkowski Marcin , Czarnecki Damian , Gąsior Krzysztof , Juczyński Artur , Biedrzycka Agata 
Published: February 2016

BackgroundThe aim of the research work was to present the process of adapting the Polish version of the YBOCS‐hd by Modell and colleagues (Alcohol Clin Exp Res 1992;16:266) to Polish conditions and to characterize the psychometric validation of the measure (e.g., validity, internal structure, and reliability). The scale is a self‐assessment method consisting of 10 statements designed for measuring the severity of obsessive and compulsive craving‐related thoughts and behaviors in alcohol‐dependent or alcohol‐abusing patients.MethodsThe study was carried out in a group of 550 patients diagnosed with alcohol dependence syndrome, 510 of whom (396 males and 114 females) were included in the final analysis. The patients were interviewed during the third week of therapy by the Polish version of the Yale‐Brown Compulsive Scale Modified to Reflect Obsessions and Compulsions Related to Heavy Drinking (YBOCS‐hd‐PL), the Penn Alcohol Craving Scale (PACS), Short Alcohol Dependence Data Questionnaire (SADD), and the “compulsive” subscale of SCL‐90.ResultsThe YBOCS‐hd‐PL is characterized by good psychometric properties. Factor analysis identified 2 factors corresponding to the structure of the original version. Its internal consistency, assessed on the basis of Cronbach's alpha, is satisfactory: 0.84 for YBOCS‐hd‐PL (overall), 0.75 for factor 1 (obsessive thoughts), and 0.79 for factor 2 (compulsive behaviors). The discriminant power of the questions ranged from 0.46 to 0.68 (p < 0.001). For the adapted YBOCS‐hd‐PL, significant correlations were found between its scores and the PACS and the “compulsive” subscale of the SCL‐90 scale. The obtained results indicate the Polish version of the YBOCS‐hd (YBOCS‐hd‐PL) proved to be a reliable and valid instrument.ConclusionsIn view of its very good psychometric properties, the Polish version of the YBOCS‐hd can be recommended as an instrument for assessment of alcohol craving and its obsessive and compulsive aspects in individuals with alcohol use disorders.
Gender‐Specific Effects of Mood on Alcohol‐Seeking Behaviors: Preliminary Findings Using Intravenous Alcohol Self‐Administration
Authors: Cyders Melissa A. , VanderVeen J. Davis , Plawecki Martin , Millward James B. , Hays James , Kareken David A. , O'Connor Sean 
Published: February 2016

BackgroundAlthough negative mood has long been implicated in differences in alcohol seeking by men and women, little research has used precise, well‐controlled laboratory experiments to examine how negative mood affects alcohol‐seeking behaviors.MethodsA total of 34 (19 women) community‐dwelling, alcohol‐using adults aged 21 to 32 (mean age = 24.86, SD = 3.40, 74.3% Caucasian; Alcohol Use Disorders Identification Test [AUDIT] = 10.1, SD = 3.4) completed 2 counterbalanced intravenous alcohol self‐administration sessions: one under negative mood and one under neutral mood. Fourteen individuals (9 women; mean age = 25.00, SD = 2.77) participated in an alcohol “liking” experiment (i.e., free access [FA] drinking) and 20 individuals (10 women; mean age = 24.77, SD = 3.73) participated in an alcohol “wanting” experiment, in which gaining access to alcohol required progressively effortful work. There was no significant difference between men and women on the AUDIT, t(32) = −0.38, p = 0.71.ResultsPriming with negative mood induction caused a significant decrease in self‐reported mood (mean change = −1.85, t(32) = −6.81, p < 0.001), as intended. In FA, negative mood was associated with a significantly increased peak breath alcohol concentration (BrAC; F = 9.41, p = 0.01), with a trend toward a greater effect in men than in women (F = 2.67, p = 0.13). Negative mood also had a significant effect on peak BrAC achieved in the progressive work paradigm (F = 5.28, p = 0.04), with a significantly stronger effect in men (F = 5.35, p = 0.03) than women; men also trended toward more consistent work for alcohol across both neutral and negative sessions.ConclusionsThese preliminary findings demonstrate a gender‐specific response on how mood affects alcohol seeking and suggest gender‐specific interventions to prevent mood‐based alcohol consumption.
Neonatal Ethanol Exposure Impairs Trace Fear Conditioning and Alters NMDA Receptor Subunit Expression in Adult Male and Female Rats
Authors: Goodfellow Molly J. , Abdulla Khalid A. , Lindquist Derick H. 
Published: February 2016

BackgroundEthanol (EtOH) exposure in neonate rats during a period comparable to the human third trimester, postnatal days (PD) 4 to 9, leads to persistent deficits in forebrain‐dependent cognitive function—modeling the dysfunction seen in individuals diagnosed with fetal alcohol spectrum disorders. EtOH‐exposed adult rats are impaired in auditory trace fear conditioning (TFC), a form of Pavlovian conditioning in which a neutral conditioned stimulus (CS; tone) is followed by an aversive unconditioned stimulus (US; footshock), with both stimuli separated in time by a stimulus‐free “trace” interval (TI). TFC acquisition depends on N‐methyl‐d‐aspartate NMDA receptor (NMDAR) activation in the dorsal hippocampus (DH), ventral hippocampus (VH), and medial prefrontal cortex (mPFC).MethodsMale and female rat pups were sham‐intubated (SI) or intragastrically intubated with EtOH (5E; 5 g/kg/d) over PD 4 to 9 and, as adults, submitted to TFC with a 15‐second tone CS and 30‐second TI. Whole‐cell tissue lysates from the DH, VH, and mPFC of TFC rats and DH synaptic/extrasynaptic membrane fractions from experimentally naïve animals were analyzed via Western blot for NMDAR subunit (GluN1, GluN2A, GluN2B) expression.ResultsFreezing behavior during CS‐alone test trials was significantly reduced in both male and female 5E rats, relative to same‐sex controls. Western blot results based on DH tissue samples revealed a greater proportion of GluN2A to GluN2B subunits in 5E rats, relative to SI rats, and significantly reduced synaptic GluN2B and PSD‐95 expression.ConclusionsEtOH‐induced changes in DH NMDAR subunit expression—particularly synaptic GluN2B, which is critical for TFC—are proposed to weaken long‐term memory consolidation and, during behavioral testing, diminish CS‐evoked freezing behavior.