bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients' perceptions of their doctors' notes and after‐visit summaries: A mixed methods study of patients at safety‐net clinics
Authors: Belyeu Brittaney M. , Klein Jared W. , Reisch Lisa M. , Peacock Sue , Oster Natalia V. , Elmore Joann G. , Jackson Sara L. 
Published: November 2017

AbstractBackgroundPatients are increasingly offered electronic access to their doctors' notes, and many consistently receive paper After‐Visit Summaries. Specific feedback from patients about notes and summaries are lacking, particularly within safety‐net settings.DesignA mixed methods studySetting and ParticipantsPatients with poorly controlled diabetes attending two urban safety‐net primary care clinics in Washington State.MethodsPatients read their own most recent clinic note and After‐Visit Summary, then completed a brief survey followed by a focus group discussion (3 groups in a large general medicine teaching clinic and 1 in an HIV/AIDS clinic) about their perceptions of the clinic note and After‐Visit Summary.ResultsTwenty‐seven patients participated; 70% were male, 41% were Black, 48% were unemployed or disabled, 56% reported fair/poor health, and 37% had accessed the electronic patient portal. A majority of patients felt their note content was useful (89%); a minority reported that their notes were not accurate (19%), had too much medical jargon (29%), or were too long (26%). Themes identified from the discussions included reliance on the provider to explain confusing content; a desire for more rather than less detail; and perceived inaccuracies, particularly in heavily templated notes. In each focus group, one or more portal users were enthusiastically willing to teach other patients.ConclusionsThe majority of focus group participants at this safety‐net site had not accessed the electronic patient portal, but those who had were willing to promote the portal benefits and assist others. Patients identified specific opportunities to improve clinic notes and After‐Visit Summaries.
A review of shampoo surfactant technology: consumer benefits, raw materials and recent developments
Authors: Cornwell P. A. 
Published: November 2017

AbstractSurfactants form the core of all shampoo formulations, and contribute to a wide range of different benefits, including cleansing, foaming, rheology control, skin mildness and the deposition of benefit agents to the hair and scalp. The purpose of this review was to assist the design of effective, modern, shampoo surfactant technologies. The mechanisms through which surfactants help deliver their effects are presented, along with the appraisal techniques through which surfactant options can be tested and screened for product development. The steps that should be taken to select the most appropriate blend of surfactants are described, and useful information on the most widely used surfactants is provided. The review concludes with an examination of recent developments in ‘greener’ surfactants, ‘sulphate‐free’ technologies and structured liquid phases for novel sensory properties and for suspending benefit agents.
The use of Nannochloropsis sp. as a source of omega‐3 fatty acids in dry pasta: chemical, technological and sensory evaluation
Authors: Rodríguez De Marco Estefanía , Steffolani María Eugenia , Martínez Marcela , León Alberto E. 
Published: November 2017

SummaryNannochloropsis is a microalga characterised by having high amounts of eicosapentaenoic acid (EPA), a fatty acid known for its health benefits. The aim of this study was to elaborate dry pasta with a significant contribution of EPA using Nannochloropsis sp., without affecting the quality product and with good consumer acceptance. Technological quality was analysed in terms of cooking properties and texture profile. Cooked pasta was characterised through proximal composition, phenolic compound, fatty acid content and sensorial analysis. It was possible to replace up to 30% of wheat flour with microalgae without affecting the technological quality of pasta and with a significant contribution of EPA to the daily diet (0.237 g per 100 g pasta). The incorporation of 10% and 20% Nannochloropsis in pasta formulation allowed to decrease the n6:n3 ratio from 25:1 to 5:1 and 2:1, respectively. Therefore, the microalgae are an interesting ingredient to increase EPA consumption in products like pasta, while the sensory evaluation confirms the possibility towards a commercial approach.
A preliminary investigation into differences in hops’ aroma attributes
Authors: Barry Susan , Muggah Elizabeth M. , McSweeney Matthew B. , Walker Shane 
Published: November 2017

SummaryConsumers are welcoming the use of locally sourced ingredients in their beer, and hops are now beginning to be grown in new regions. One new region is the province of Nova Scotia, Canada. Four different hop varieties (Cascade, Mt. Hood, Golding and Nugget) were sourced from Nova Scotia, and matching varieties (Cascade, Mt. Hood and Nugget) were sourced from Oregon, USA, and England, UK. The main objective of this study was to identify whether differences in the hop aroma exist based on their geographic origin. Projective mapping trials (n = 2) were conducted for the aroma of all eight hops varieties. The first trial utilised crushed whole‐leaf hops, while the second consisted of a dry‐hopped conventional Canadian lager. Results indicated that there are differences in the hop aromas of both whole‐leaf hops and dry‐hopped lager.
Antecedents and associations of sickness presenteeism and sickness absenteeism in nurses: A systematic review
Authors: Brborović Hana , Daka Qëndresë , Dakaj Kushtrim , Brborović Ognjen 
Published: November 2017

AbstractAimsThis study comprehensively analysed and systemized the elements associated with nursing sickness presenteeism (SP) and sickness absenteeism (SA).BackgroundBoth behaviours represent a real challenge to nursing departments because they can increase costs, cause health care adverse events, and impact the quality of health care.DesignThe systematic review of cohort studies was designed to be consistent with the PRISMA guidelines.Data sourcesPubMed, ProQuest, and Emerald were systematically searched for peer‐reviewed articles published from the 1950s to December 2016.Review methodsCohort studies were included (12 SA and 1 SP) in the review if they examined the association between one or more exposures and SP and/or SA in nurses. The methodological quality of the included studies was assessed using the Newcastle‐Ottawa Scale.ResultsTwenty‐three antecedents were associated with SA and grouped as work and organizational, mental and physical health, and demographic; 3 antecedents were associated with SP (job demands, burnout, and exhaustion). Exhaustion (fatigue) and job demands were associated with SA and SP. Depersonalization was an outcome of SP over time.ConclusionThe ability to predict presenteeism and absenteeism in nursing is useful to constrain costs and ensure that quality care is delivered.
High neutrophil‐to‐lymphocyte ratio predicts worse overall survival in patients with advanced/metastatic urothelial bladder cancer
Authors: Tan Yu Guang , Eu Ernest Wen Cong , Huang Hong Hong , Lau Weber Kam On 
Published: November 2017

ObjectivesTo study the role of the neutrophil‐to‐lymphocyte ratio in predicting survival outcomes for patients with advanced bladder cancer.MethodsWe retrospectively reviewed 150 patients diagnosed with advanced or metastatic bladder cancer between January 2004 and June 2014. The neutrophil‐to‐lymphocyte ratio was computed on diagnosis and after the first cycle of chemotherapy. A neutrophil‐to‐lymphocyte ratio cut‐off of 3.0 was determined, with a concordance index of 0.89. Kaplan–Meier curves, log–rank tests, Cox proportional hazards and logistic regression models were used to predict the association of the neutrophil‐to‐lymphocyte ratio with survival outcomes.ResultsJust five patients were alive at the end of the study; the rest died from metastatic bladder cancer. On multivariate analysis, higher Eastern Cooperative Oncology Group status, lymphadenopathy, visceral metastases and neutrophil‐to‐lymphocyte ratio ≥3.0 were associated with poorer overall survival (hazard ratio 1.67, P = 0.03; hazard ratio 1.97, P = <0.01; hazard ratio 2.02, P = <0.01; hazard ratio 5.06, P = <0.01), whereas chemotherapy conferred better overall survival (hazard ratio 0.546, P = 0.01). Furthermore, the role of chemotherapy prolonged survival longer in patients with a neutrophil‐to‐lymphocyte ratio <3.0 (median overall survival 13.0 vs 22.0 months, hazard ratio 0.273, P = 0.008) compared with a neutrophil‐to‐lymphocyte ratio ≥3.0 (median overall survival 4.0 vs 7.0 months, hazard ratio 0.452, P = 0.020). More importantly, when dichotomized to the four different pre‐ and post‐chemotherapy groups, patients with a pre‐ and post‐chemotherapy neutrophil‐to‐lymphocyte ratio <3.0 had the best additional median overall survival of 19.0 months compared with patients with a pre‐ and post‐chemotherapy neutrophil‐to‐lymphocyte ratio ≥3.0 (3.0 months).ConclusionsElevated neutrophil‐to‐lymphocyte ratio is independently associated with poorer chemotherapeutic response and overall survival in patients with advanced or metastatic bladder cancer. The neutrophil‐to‐lymphocyte ratio can be an inexpensive novel factor in prognosticating disease progression and providing better patient counseling.
Technical Analysis Profitability Without Data Snooping Bias: Evidence from Chinese Stock Market
Authors: Jiang Fuwei , Tong Guoshi , Song Guokai 
Published: November 2017

AbstractWe perform a comprehensive analysis on the profitability of a large number of technical analysis based trading rules in Chinese stock market. To counter data snooping bias, we employ a stepwise superior predictive ability test to identify genuinely profitable trading rules among more than 28,000 technical signals. Using 19 years of daily data on Chinese aggregate stock market return, we find substantial evidence on the profitability of technical trading rules measured by either the market timing ability or Sharpe ratio gain. Our results on the profitability of technical rules hold during different subperiods and remain valid under the presence of transaction costs.
Antipsychotics and the Risk of Aspiration Pneumonia in Individuals Hospitalized for Nonpsychiatric Conditions: A Cohort Study
Authors: Herzig Shoshana J. , LaSalvia Mary T. , Naidus Elliot , Rothberg Michael B. , Zhou Wenxiao , Gurwitz Jerry H. , Marcantonio Edward R. 
Published: November 2017

Background/ObjectivesOff‐label use of antipsychotics is common in hospitals, most often for delirium management. Antipsychotics have been associated with aspiration pneumonia in community and nursing home settings, but the association in hospitalized individuals is unexplored. We aimed to investigate the association between antipsychotic exposure and aspiration pneumonia during hospitalization.DesignRetrospective cohort study.SettingLarge academic medical center.ParticipantsAll adult hospitalizations between January 2007 and July 2013. We excluded outside hospital transfers, hospitalizations shorter than 48 hours, and psychiatric hospitalizations.MeasurementsAntipsychotic use defined as any pharmacy charge for an antipsychotic medication. Aspiration pneumonia was defined according to a discharge diagnosis code for aspiration pneumonia not present on admission and validated using chart review. A generalized estimating equation was used to control for 43 potential confounders.ResultsOur cohort included 146,552 hospitalizations (median age 56; 39% male). Antipsychotics were used in 10,377 (7.1%) hospitalizations (80% atypical, 35% typical, 15% both). Aspiration pneumonia occurred in 557 (0.4%) hospitalizations. The incidence of aspiration pneumonia was 0.3% in unexposed individuals and 1.2% in those with antipsychotic exposure (odds ratio (OR) = 3.9, 95% confidence interval (CI) = 3.2–4.8). After adjustment, antipsychotic exposure was significantly associated with aspiration pneumonia (adjusted OR = (aOR) = 1.5, 95% CI = 1.2–1.9). Similar results were demonstrated in a propensity‐matched analysis and in an analysis restricted to those with delirium or dementia. The magnitude of the association was similar for typical (aOR = 1.4, 95% CI = 0.94–2.2) and atypical (aOR = 1.5, 95% CI = 1.1–2.0) antipsychotics.ConclusionAntipsychotics were associated with greater odds of aspiration pneumonia after extensive adjustment for participant characteristics. This risk should be considered when prescribing antipsychotics in the hospital.
Fracturing, fluid flow and shear zone development: Relationships between chemical and mechanical processes in Proterozoic mafic dykes from southwestern Montana, USA
Authors: Condit Cailey B. , Mahan Kevin H. 
Published: November 2017

AbstractFluids can play an important role in the localization of deformation in the deep crust, yet the specific mechanisms active during the complex interactions between metasomatism, metamorphism and deformation remain elusive. Precambrian metagabbronorite dykes in southwest Montana contain fractures filled with Hbl±Grt and discrete cm‐scale shear zones with well‐preserved strain gradients. This system offers an ideal opportunity to constrain the chemical and mechanical processes that facilitated strain localization. An early M1 assemblage of Grt1+Cpx1+Pl1+Qz developed at conditions of 0.51–0.85 GPa and 500–700°C and is preserved largely as a static replacement of relict igneous phases (Opx, Pgt, Pl) in coronitic textures. An M2 assemblage characterized by Grt2+Pl2±Cpx2+Hbl+Scp+Qz developed at 0.86–1.00 GPa and 660–730°C coincided with fluid flow and deformation associated with shear zone development. Microstructural observations in marginal protomylonite/mylonite and laminated ultramylonite suggest a shear zone evolution that involved (1) nucleation from pre‐existing fractures that were sites for major fluid infiltration, (2) initial widening coincident with grain‐size reduction by microfracturing, dislocation creep, and synkinematic metamorphic reaction by solution transfer, and (3) a switch in the dominant deformation mechanisms active in the ultramylonite from grain‐size insensitive mechanisms to grain‐size sensitive granular flow accommodated by fluid‐assisted diffusion. Throughout this evolution, the effective bulk compositions of the rock volumes responding to metamorphism changed through a combination of mechanical and metasomatic processes.
Effectiveness of fetal cardiac screening for congenital heart disease using a combination of the four‐chamber view and three‐vessel view during the second trimester scan
Authors: Itsukaichi Mina , Serikawa Takehiro , Yoshihara Kosuke , Suzuki Hiroshi , Haino Kazufumi , Yamaguchi Masayuki , Enomoto Takayuki ,   Niigata Fetal Cardiac Screening Study Group, Takakuwa Koichi 
Published: November 2017

AbstractAimWe aimed to assess the accuracy and effectiveness of fetal cardiac screening for congenital heart disease (CHD) during the second trimester by general obstetricians in a non‐selected population.MethodsIn this multicenter, prospective cohort study of fetal cardiac screening, four‐chamber and three‐vessel views were recorded by obstetricians at 18–21 gestational weeks (GW). A total of 3005 fetuses that were scheduled for delivery at our institution were included.ResultsThirty‐seven newborns were born with CHD (1.2%). On excluding 23 cases of ventricular septal defects, the prenatal detection rate of CHD was 42.8%. Although six cases (75.0%) of severe structural abnormality were diagnosed prenatally, the prenatal detection rate of valvular abnormalities was 0%.ConclusionOne‐point ultrasound screening of the fetal heart using a combination of four‐chamber and three‐vessel views at 18–21 GW by general obstetricians in a non‐selected population may be useful for detecting severe structural abnormalities but not valvular abnormalities. However, this limitation may be improved by conducting another fetal cardiac screening at approximately 30 GW along with the routine use of color Doppler.
Metformin as a prophylactic treatment of gestational diabetes in pregnant patients with pregestational insulin resistance: A randomized study
Authors: Valdés Enrique , Sepúlveda‐Martínez Alvaro , Candia Paula , Abusada Nancy , Orellana Rodrigo , Manukian Bárbara , Cuellar Eduardo 
Published: November 2017

AbstractAimWe aimed to assess the use of metformin (MTF) in the prevention of gestational diabetes mellitus (GDM) in patients with pregestational insulin resistance (PIR).MethodsA double blind, multicenter, randomized trial was carried out in patients with a history of PIR and pregestational MTF treatment. Groups were allocated either to MTF 1700 mg/day or placebo. Patients were recruited between 12+0 and 15+6 gestational weeks, and treatment was extended until week 36. A multiple logistic regression analysis was applied to determine the relation between the use of metformin and the development of GDM.ResultsOne hundred and forty one patients were randomized (68 patients in the MTF group and 73 in the placebo group). A total of 30 patients withdrew from the study during follow‐up. Administration of MTF was not associated with a decrease in the incidence of GDM as compared to placebo (37.5% vs 25.4%, respectively; P = 0.2). Moreover, MTF administration was associated with a significant increase in drug intolerance as compared to placebo (14.3% vs 1.8%, respectively; P = 0.02).ConclusionThe use of MTF is not effective in prevention of GDM in populations with PIR. The use of MTF shows a significantly higher frequency of drug intolerance than placebo.
Effects of vitamin D supplementation on insulin sensitivity and androgen levels in vitamin‐D‐deficient polycystic ovary syndrome patients
Authors: Karadağ Cihan , Yoldemir Tevfik , Yavuz Dilek Gogas 
Published: November 2017

AbstractAimThe aim of this study was to identify the effects of vitamin D supplementation on insulin sensitivity and androgen levels in vitamin‐D‐deficient polycystic ovary syndrome (PCOS) patients.MethodsSixty‐seven vitamin‐D‐deficient (25‐hydroxyvitamin D [25(OH)D] levels below 20 ng/mL) PCOS patients and 54 vitamin‐D‐deficient non‐PCOS volunteer subjects matched for age and body mass index were enrolled to this prospective study. All participants were given 50 000 IU/week cholecalciferol orally for 8 weeks and 1500 IU/day for 4 weeks. Insulin sensitivity was calculated with the Matsuda insulin sensitivity index (ISI) based on an oral glucose tolerance test. Matsuda ISI, gonadal hormones (estrogen, testosterone, androstenedione), and 25(OH)D levels were studied before and at the end of the 12th week of vitamin D load.ResultsAfter vitamin D supplementation, serum androstenedione levels had decreased significantly (P = 0.007) and Matsuda ISI values had increased significantly (P = 0.001) in the PCOS group but no significant changes were seen in those parameters in controls. We observed positive correlations between 25(OH)D levels and Matsuda ISI (r = 0.307; P < 0.01), and negative correlations between 25(OH)D levels and total testosterone (r = −0.306; P < 0.01) and androstenedione (r = −0.275; P < 0.01) levels in the PCOS group.ConclusionVitamin D supplementation increased insulin sensitivity and decreased androgen levels in vitamin‐D‐deficient women with PCOS but did not have any effect in vitamin‐D‐deficient non‐PCOS women. These results may indicate the possible role of vitamin D in the complex pathogenesis of PCOS.
Cesarean section rates and local resources for perinatal care in Japan: A nationwide ecological study using the national database of health insurance claims
Authors: Maeda Eri , Ishihara Osamu , Tomio Jun , Sato Aya , Terada Yukihiro , Kobayashi Yasuki , Murata Katsuyuki 
Published: November 2017

AbstractAimHigh cesarean section (CS) rates in middle and high‐income countries are partly attributable to provider factors, such as staffing patterns and fear of litigation. However, the relationship between CS rates and healthcare resources in the community is poorly understood. Official data on CS rates has been particularly limited in Japan. In this study, we examined nationwide CS statistics and evaluated the association with local resources for perinatal care.MethodsWe used accumulated data for CS registered in the Japan National Database of health insurance claims in 2013 and calculated crude and age‐standardized CS rates at national and prefectural levels. We analyzed the ecological associations with supply of obstetricians and institution and scale of obstetric facilities using multiple regression models.ResultsThere were 190 361 cesarean deliveries in 2013, giving an overall CS rate of 18.5% (elective CS rates 11.0%), which varied by prefecture from 14.0% to 25.6%. In multiple regression analyses, the areal number of obstetricians (standardized regression coefficient [β] = −0.58), the proportion of births at small‐scale institutions (β = 0.36) and the number of beds at neonatal intensive care units per birth (β = −0.20) were significantly associated with the age‐standardized elective CS rate after adjusting for socioeconomic factors (R2 for the model = 0.40).ConclusionsHigher elective CS rates might be associated with limited or unconsolidated medical resources. Policymakers should be aware of regional differences and the possible effects of perinatal care resources on CS rates.
Rate of intrapartum cesarean section and related factors in older nulliparous women at term
Authors: Muto Haruka , Ishii Keisuke , Nakano Takahiro , Hayashi Shusaku , Okamoto Yoko , Mitsuda Nobuaki 
Published: November 2017

AbstractAimThe aim of this study was to determine the effect of maternal age on emergency cesarean section (CS) during labor, and to identify the independent risk factors for emergency CS.MethodsThis was a retrospective cohort study using data from 2009 to 2014 from a tertiary perinatal care center in Japan. Inclusion criteria were maternal age ≥ 35 years, nulliparous singleton pregnancy at term and a cephalic presentation without indication of elective CS at onset of labor. The primary outcome was rate of emergency CS, while independent risk factors were elucidated using multivariate logistic regression analysis.ResultsOf 953 women, 199 (20.9%) delivered by emergency CS. Rates of emergency CS were 18.3% (129/706) in women aged 35–39 years and 28.3% (70/247) in those aged ≥ 40 years (P < 0.01). Adjusted odds ratios (95% confidence intervals) of independent risk factors were 1.50 (1.03–2.18) for maternal age ≥ 40 years, 1.51 (1.06–2.17) for body mass index ≥ 25 kg/m2, 2.22 (1.24–3.98) for hypertensive disorder during pregnancy, 3.43 (1.31–8.95) for large‐for‐date fetus and 4.64 (3.23–6.69) for induction of labor.ConclusionsThe rate of intrapartum emergency CS in older nulliparous women at term was approximately 21%. Induction of labor should be recognized as a significant factor for emergency CS.
Is emission intensity or output U‐shaped in the strictness of environmental policy?
Authors: Dijkstra Bouwe R. , Gil‐Moltó Maria J. 
Published: November 2017

AbstractWe show that, in a range of market conditions, an ever stricter environmental policy does not always lead to ever cleaner production methods and ever lower production of polluting goods. We consider an integrated technology, where firms can reduce their emission intensities in a continuous fashion. Analogous to the previous literature we find that firms' emission intensities can be U‐shaped in the strictness of policy, but we show that this applies only under low profitability conditions. Under high profitability conditions, output levels are U‐shaped in the strictness of the policy. The latter result is new in the literature. In the case where the U‐shape arises in emission intensities, the minimum is reached where the marginal abatement cost curves intersect.