bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to point-of-care ultrasound use in rural emergency departments
Authors: Micks Taft , Sue Kyle , Rogers Peter 
Published: July 2016

AbstractOver the past few decades, point-of-care ultrasound (PoCUS) has come to play a major role in the practice of emergency medicine. Despite its numerous benefits, there has been a slow uptake of PoCUS use in rural emergency departments. Surveys conducted across Canada and the United States have identified a lack of equipment, training, funding, quality assurance, and an inability to maintain skills as major barriers to PoCUS use. Potential solutions include expanding residency training in ultrasound skills, extending funding for PoCUS training to rural physicians in practice, moving PoCUS training courses to rural sites, and creating telesonography training for rural physicians. With these barriers identified and solutions proposed, corrective measures must be taken so that the benefits of PoCUS are extended to patients in rural Canada where, arguably, it has the greatest potential for benefit when access to advanced imaging is not readily available.
Risk Factors for Carbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae (CP-CRE) Acquisition Among Contacts of Newly Diagnosed CP-CRE Patients
Authors: Schwartz-Neiderman Anat , Braun Tali , Fallach Noga , Schwartz David , Carmeli Yehuda , Schechner Vered 
Published: July 2016

OBJECTIVECarbapenemase-producing carbapenem-resistantEnterobacteriaceae(CP-CRE) are extremely drug-resistant pathogens. Screening of contacts of newly identified CP-CRE patients is an important step to limit further transmission. We aimed to determine the risk factors for CP-CRE acquisition among patients exposed to a CP-CRE index patient.METHODSA matched case-control study was performed in a tertiary care hospital in Israel. The study population was comprised of patients who underwent rectal screening for CP-CRE following close contact with a newly identified CP-CRE index patient. Cases were defined as positive tests for CP-CRE. For each case patient, 2 matched controls were randomly selected from the pool of contacts who tested negative for CP-CRE following exposure to the same index case. Bivariate and multivariate analyses were conducted using conditional logistic regression.RESULTSIn total, 53 positive contacts were identified in 40 unique investigations (896 tests performed on 735 contacts) between October 6, 2008, and June 7, 2012.blaKPCwas the only carbapenemase identified. In multivariate analysis, risk factors for CP-CRE acquisition among contacts were (1) contact with an index patient for ≥3 days (odds ratio [OR], 9.8; 95% confidence interval [CI], 2.0–48.9), (2) mechanical ventilation (OR, 4.1; 95% CI, 1.4–11.9), and (3) carriage or infection with another multidrug-resistant organism (MDRO; OR, 2.6; 95% CI, 1.0–7.1). Among patients who received antibiotics, cephalosporins were associated with a lower risk of acquisition.CONCLUSIONSPatient characteristics (ventilation and carriage of another MDRO) as well as duration of contact are risk factors for CP-CRE acquisition among contacts. The role of cephalosporins requires further study.Infect Control Hosp Epidemiol2016;1–7
A scaling law for the shear-production range of second-order structure functions
Authors: Pan Y. , Chamecki M. 
Published: July 2016

Dimensional analysis suggests that the dissipation length scale ($\ell _{{\it\epsilon}}=u_{\star }^{3}/{\it\epsilon}$) is the appropriate scale for the shear-production range of the second-order streamwise structure function in neutrally stratified turbulent shear flows near solid boundaries, including smooth- and rough-wall boundary layers and shear layers above canopies (e.g. crops, forests and cities). These flows have two major characteristics in common: (i) a single velocity scale, i.e. the friction velocity ($u_{\star }$) and (ii) the presence of large eddies that scale with an external length scale much larger than the local integral length scale. No assumptions are made about the local integral scale, which is shown to be proportional to$\ell _{{\it\epsilon}}$for the scaling analysis to be consistent with Kolmogorov’s result for the inertial subrange. Here${\it\epsilon}$is the rate of dissipation of turbulent kinetic energy (TKE) that represents the rate of energy cascade in the inertial subrange. The scaling yields a log-law dependence of the second-order streamwise structure function on ($r/\ell _{{\it\epsilon}}$), where$r$is the streamwise spatial separation. This scaling law is confirmed by large-eddy simulation (LES) results in the roughness sublayer above a model canopy, where the imbalance between local production and dissipation of TKE is much greater than in the inertial layer of wall turbulence and the local integral scale is affected by two external length scales. Parameters estimated for the log-law dependence on ($r/\ell _{{\it\epsilon}}$) are in reasonable agreement with those reported for the inertial layer of wall turbulence. This leads to two important conclusions. Firstly, the validity of the$\ell _{{\it\epsilon}}$-scaling is extended to shear flows with a much greater imbalance between production and dissipation, indicating possible universality of the shear-production range in flows near solid boundaries. Secondly, from a modelling perspective,$\ell _{{\it\epsilon}}$is the appropriate scale to characterize turbulence in shear flows with multiple externally imposed length scales.
Minimal short-term effect of dietary 2'-fucosyllactose on bacterial colonisation, intestinal function and necrotising enterocolitis in preterm pigs
Authors: Cilieborg Malene S. , Bering Stine B. , Østergaard Mette V. , Jensen Michael L. , Krych Łukasz , Newburg David S. , Sangild Per T. 
Published: July 2016

AbstractHuman milk decreases the risk of necrotising enterocolitis (NEC), a severe gastrointestinal disease that occurs in 5–10 % of preterm infants. The prebiotic and immune-modulatory effects of milk oligosaccharides may contribute to this protection. Preterm pigs were used to test whether infant formula enriched with α1,2-fucosyllactose (2'-FL, the most abundant oligosaccharide in human milk) would benefit gut microbial colonisation and NEC resistance after preterm birth. Caesarean-delivered preterm pigs were fed formula (Controls, n 17) or formula with 5 g/l 2'-FL (2'-FL, n 16) for 5 d; eight 2'-FL pigs (50 %) and twelve Controls (71 %) developed NEC, with no difference in lesion scores (P=0·35); 2'-FL pigs tended to have less anaerobic bacteria in caecal contents (P=0·22), but no difference in gut microbiota between groups were observed by fluorescence in situ hybridisation and 454 pyrosequencing. Abundant α1,2-fucose was detected in the intestine with no difference between groups, and intestinal structure (villus height, permeability) and digestive function (hexose absorption, brush border enzyme activities) were not affected by 2'-FL. Formula enrichment with 2'-FL does not affect gut microbiology, digestive function or NEC sensitivity in pigs within the first few days after preterm birth. Milk 2'-FL may not be critical in the immediate postnatal period of preterm neonates when gut colonisation and intestinal immunity are still immature.
The use of multiple imputation method for the validation of 24-h food recalls by part-time observation of dietary intake in school
Authors: Kupek Emil , de Assis Maria Alice A. 
Published: July 2016

AbstractExternal validation of food recall over 24 h in schoolchildren is often restricted to eating events in schools and is based on direct observation as the reference method. The aim of this study was to estimate the dietary intake out of school, and consequently the bias in such research design based on only part-time validated food recall, using multiple imputation (MI) conditioned on the information on child age, sex, BMI, family income, parental education and the school attended. The previous-day, web-based questionnaire WebCAAFE, structured as six meals/snacks and thirty-two foods/beverage, was answered by a sample of 7–11-year-old Brazilian schoolchildren (n602) from five public schools. Food/beverage intake recalled by children was compared with the records provided by trained observers during school meals. Sensitivity analysis was performed with artificial data emulating those recalled by children on WebCAAFE in order to evaluate the impact of both differential and non-differential bias. Estimated bias was within ±30 % interval for 84·4 % of the thirty-two foods/beverages evaluated in WebCAAFE, and half of the latter reached statistical significance (P<0·05). Rarely (<3 %) consumed dietary items were often under-reported (fish/seafood, vegetable soup, cheese bread, French fries), whereas some of those most frequently reported (meat, bread/biscuits, fruits) showed large overestimation. Compared with the analysis restricted to fully validated data, MI reduced differential bias in sensitivity analysis but the bias still remained large in most cases. MI provided a suitable statistical framework for part-time validation design of dietary intake over six daily eating events.
To proceed or not to proceed: ENT surgery in paediatric patients with acute upper respiratory tract infection
Authors: Shemesh S , Tamir S , Goldfarb A , Ezri T , Roth Y 
Published: July 2016

AbstractBackground:Upper respiratory tract infection is the most common non-preventable cause of surgery cancellation. Consequently, surgeons and anaesthesiologists involved in elective ENT surgical procedures frequently face a dilemma of whether to proceed or to postpone surgery in affected children.Methods:A literature review was conducted and a practical assessment algorithm proposed.Conclusion:The risk–benefit assessment should take into consideration the impact of postponing the surgery intended to bring relief to the child and the risks of proceeding with general anaesthesia in an inflamed airway. The suggested algorithm for assessment may be a useful tool to support the decision of whether to proceed or to postpone surgery.
Connectivity of the anterior insula differentiates participants with first-episode schizophrenia spectrum disorders from controls: a machine-learning study
Authors: Mikolas P. , Melicher T. , Skoch A. , Matejka M. , Slovakova A. , Bakstein E. , Hajek T. , Spaniel F. 
Published: July 2016

BackgroundEarly diagnosis of schizophrenia could improve the outcomes and limit the negative effects of untreated illness. Although participants with schizophrenia show aberrant functional connectivity in brain networks, these between-group differences have a limited diagnostic utility. Novel methods of magnetic resonance imaging (MRI) analyses, such as machine learning (ML), may help bring neuroimaging from the bench to the bedside. Here, we used ML to differentiate participants with a first episode of schizophrenia-spectrum disorder (FES) from healthy controls based on resting-state functional connectivity (rsFC).MethodWe acquired resting-state functional MRI data from 63 patients with FES who were individually matched by age and sex to 63 healthy controls. We applied linear kernel support vector machines (SVM) to rsFC within the default mode network, the salience network and the central executive network.ResultsThe SVM applied to the rsFC within the salience network distinguished the FES from the control participants with an accuracy of 73.0% (p = 0.001), specificity of 71.4% and sensitivity of 74.6%. The classification accuracy was not significantly affected by medication dose, or by the presence of psychotic symptoms. The functional connectivity within the default mode or the central executive networks did not yield classification accuracies above chance level.ConclusionsSeed-based functional connectivity maps can be utilized for diagnostic classification, even early in the course of schizophrenia. The classification was probably based on trait rather than state markers, as symptoms or medications were not significantly associated with classification accuracy. Our results support the role of the anterior insula/salience network in the pathophysiology of FES.
Multifaceted impairments in impulsivity and brain structural abnormalities in opioid dependence and abstinence
Authors: Tolomeo S. , Gray S. , Matthews K. , Steele J. D. , Baldacchino A. 
Published: July 2016

BackgroundChronic opioid exposure, as a treatment for a variety of disorders or as drug of misuse, is common worldwide, but behavioural and brain abnormalities remain under-investigated. Only a small percentage of patients who receive methadone maintenance treatment (MMT) for previous heroin misuse eventually achieve abstinence and studies on such patients are rare.MethodThe Cambridge Neuropsychological Test Automated Battery and T1weighted magnetic resonance imaging (MRI) were used to study a cohort of 122 male individuals: a clinically stable opioid-dependent patient group receiving MMT (n= 48), an abstinent previously MMT maintained group (ABS) (n= 24) and healthy controls (n= 50).ResultsStable MMT participants deliberated longer and placed higher bets earlier in the Cambridge Gambling Task (CGT) and showed impaired strategic planning compared with healthy controls. In contrast, ABS participants showed impairment in choosing the least likely outcome, delay aversion and risk adjustment on the CGT, and exhibited non-planning impulsivity compared with controls. MMT patients had widespread grey matter reductions in the orbitomedial prefrontal cortex, caudate, putamen and globus pallidus. In contrast, ABS participants showed midbrain–thalamic grey matter reductions. A higher methadone dose at the time of scanning was associated with a smaller globus pallidus in the MMT group.ConclusionsOur findings support an interpretation of heightened impulsivity in patients receiving MMT. Widespread structural brain abnormalities in the MMT group and reduced brain structural abnormality with abstinence suggest benefit of cessation of methadone intake. We suggest that a longitudinal study is required to determine whether abstinence improves abnormalities, or patients who achieve abstinence have reduced abnormalities before methadone cessation.
Some Notes on the Death Duties from an Actuarial Point of View
Authors: Denmead John Charles 
Published: July 2016

When some time ago I was flattered with an invitation to read a paper before the Faculty of Actuaries, it was suggested that I should deal with the question of the amount to be deducted, in valuing reversions, for duties which, will be payable out of the funds, in reversion.This is a somewhat difficult question to deal with directly, and I fear it will be thought that in the following pages the raison d'être of my paper has been forgotten. I may say, however, that while not overlooking the ostensible object in view, I have felt that the best way of giving effect to it is to write a short account of the various death duties which will have to be considered in making such valuations. The only alternative method of dealing with the subject which occurred to me, was to give a series of examples, but this would involve such a large number of instances to meet even a small fraction of the possible cases that may arise, in practice, that I had to abandon all idea of treating the subject in this way. I must fall back upon general principles and not rely on concrete instances, although examples of the general principles are given in a few cases.
A Method of Using Mechanical Sorting and Tabulating for the Preparation and Issue of Bonus Intimations
Authors: Davie James , Scrimgeour D. A. B. 
Published: July 2016

The problem of reduction of the work involved in life assurance valuation has long engaged the attention of the actuarial profession. The Z method, Karup's method, and the various short valuation methods have resulted in reduction of the groupings necessary for valuation. There still remains, however, summation of the sums assured, bonuses, premiums, net premiums, Z's etc. etc. of the individual cases forming these groups, and to expedite this work we may have recourse to mechanical methods of sorting and tabulating.These methods have been employed for many years by Life Assurance Offices in the United States and by the large Industrial Offices in this country, but it is only within the past few years that ordinary Life Offices here have begun to adopt them. The number of ordinary Life Offices in this country making use of mechanical methods of sorting and tabulating is still, however, small.
The Compilation of Price Index Numbers and Yield Statistics Relative to Stock Exchange Securities
Authors: Murray A. C. 
Published: July 2016

SynopsisReference is made in the introductory remarks to the appointment of Investment Research Committees by the Faculty and Institute of Actuaries to undertake, in the first instance, the compilation of a comprehensive service of Index Numbers relating to British Stock Exchange Securities which will be suitable for Insurance Companies, Trust Companies, and so on. The Committees have been at work for some time, and it is hoped that publication of the results will be commenced at an early date. The Paper discusses the purposes of such indexes and the most suitable form of index numbers for the purposes decided upon. The difficulties arise from two sources ; the variety of uses for which the index must cater, and the requirement that the results must be comparable between any two dates in the series.At every point in compilation the objects of the results must be carefully kept in view. These objects are divided under three headings : (a) uses directly connected with current investment activities ; (b) investigation of the effect of economic financial and political events on the level of security prices ; and (c) assistance in measuring approximately changes in the value of a portfolio of investments. It is suggested that securities should be divided into homogeneous classes, and a separate index calculated for each class. The wide groups “Fixed Interest” and “Variable Dividend” are not suitable for the purposes involved. The weighting system should approximate to the distribution likely to be found in an Insurance or Trust Company's investments.Within each class companies' holdings will tend to approximate more nearly to equal amounts of money in each security than to any other distribution for which a system of varied weights would cater. Simple weights are accordingly advocated.Various methods of averaging are discussed and reasons given for preferring the geometric average of price ratios to other methods. The dangers of adopting the arithmetic average—where the resulting figures are always dependent on the base prices—are illustrated in Table I. The geometric results are independent of base. Even using the geometric average great care must be exercised in applying the results to valuation purposes in groups where individual price movements show wide divergencies. The “error” involved by the geometric method, however, is always in the same direction. Capital appreciation is never overstated and depreciation never understated.The foregoing remarks refer to price indexes. To obtain maximum utility from the results yield statistics also are required. The very different nature of the problem of yields is stated and an arithmetic average of individual yields in each group is advocated. While the price index should be related to 100 at the starting-point it is obviously preferable to publish actual yield averages.
The Selection of Lives (Revised Edition 1930)
Authors: Orr Lewis P. 
Published: July 2016

SynopsisThe Paper is a revised edition of that contributed to the Faculty in 1919. In the interval there have been developments in medico-actuarial science, and it seemed desirable that they should be recorded.The use and abuse of statistics are dealt with, and reference is made to Primary Selection by Branch Officials and to Medical Selection.The Section of Family History Impairments opens with a reference to Heredity, Mendelism and Eugenics. The influence of Tuberculosis is discussed, and suggestions made for the assessing of the lives concerned. In view of the circumstance that there exists among many a confident belief in the hereditary nature of Cancer, there are given reasons for holding the opinion that when the Cancer problem is solved it is probable that the influence, if any, of heredity will be found to be distinctly small, and possibly negligible. A number of other diseases are dealt with briefly.The Section of Personal History Impairments opens with Heart Abnormalities. Blood Pressure is gone into at some length. It is pointed out that hitherto there has been no recognised Standard Table of Blood Pressure in use among British Offices, and there is now put forward one compiled from the record of 1444 first-class lives. It is regarded as a Tentative Table, and is given in the hope that it will stimulate the production of another founded on a broader basis. The method of ascertaining the Blood Pressure is explained in an Appendix. Various other impairments are referred to; and probably of the articles revised the most important are those relating to Glycosuria and Gastroduodenal Ulcers.Weight in relation to Height and Age is gone into, and reasons given for retaining the Table of 1919 in preference to the later Table of Seven Offices.Female Lives, Non-medical Examination Business, Children's Assurances, etc., are the subjects of other paragraphs.The Paper concludes with a reference to the public benefit of Life Assurance Research.
The Effect of a Falling Rate of Interest on the Values of Certain Actuarial Functions
Authors: Stoodley Charles L. 
Published: July 2016

SynopsisThe paper first discusses in a general way the methods hitherto devised for giving effect in actuarial calculations to a falling rate of interest, which methods it is suggested are cumbersome and inelastic and so of little practical value. A method is put forward which it is claimed facilitates the study of the many important and interesting problems involved in the assumption of a declining rate of interest.Where it is the rate of interest in the tth year, the assumption is made thatwhere a, c and k are constants to be determined.By making certain substitutions the following equation for the value of it is derived :–It is demonstrated that under certain conditions this equation produces a decreasing series, and that by giving the constants suitable values a wide range of interest curves of the same general character may be obtained.The formula is developed in combination with actuarial functions, and it is shown that where f′(x) represents the value of a function at a decreasing rate of interest determined by the above formulawhere is calculated at rate k and at rate l.The method is applied to the evaluation of annuities, reversions and other actuarial functions under four sets of interest conditions and the results are analysed and compared with values on a 4 per cent. basis.The cognate question of an increasing rate is also touched upon.