bluuebunny/crossref_metadata_2025_split huggingface dataset:
University women's and men's mindsets surrounding postcesarean birth: Findings and implications for practice and policy
Authors: Soliday Elizabeth , Grant Gillian , James Jillian , Noell Bailey , Samaduroff Joel 
Published: July 2017

AbstractBackgroundNearly twice as many women report preferring vaginal birth after cesarean (VBAC) than actually undergo it. It is unknown whether the preference pattern would hold in childbearing‐aged individuals who had not yet been directly influenced by care experiences. We therefore examined postcesarean birth preferences in nulliparous university women and men to provide additional evidence to help advance related policy and practice.MethodsAn online study of 558 university women and 164 men who read a hypothetical postcesarean birth scenario was conducted. Students selected the option they would prefer for themselves or a partner in a similar situation; these data were analyzed descriptively and for gender differences. Students’ written rationales were analyzed qualitatively.ResultsOf women, 38.2% reported preference for VBAC compared with 47.6% of men (P < .05). Thematic analysis revealed that women and men based their preferences on safety, quality of experience, and other concerns similar to those reported among pregnant women making the decision. Assumptions and misinformation were also noted.ConclusionGiven the current primary cesarean rate of ~20%, the current childbearing generation will be facing cesarean and postcesarean birth decisions in appreciable numbers. The relatively high VBAC preference rate reported by our participants, particularly men, is useful in advocating for expanded access and practice. From a constructivist perspective, evidence of young adults’ mindsets and misconceptions surrounding postcesarean birth is valuable for developing effective educational interventions.
Correlation between human ether‐a‐go‐go‐related gene channel inhibition and action potential prolongation
Authors: Saxena P , Hortigon‐Vinagre M P , Beyl S , Baburin I , Andranovits S , Iqbal S M , Costa A , IJzerman A P , Kügler P , Timin E , Smith G L , Hering S 
Published: July 2017

Background and PurposeHuman ether‐a‐go‐go‐related gene (hERG; Kv11.1) channel inhibition is a widely accepted predictor of cardiac arrhythmia. hERG channel inhibition alone is often insufficient to predict pro‐arrhythmic drug effects. This study used a library of dofetilide derivatives to investigate the relationship between standard measures of hERG current block in an expression system and changes in action potential duration (APD) in human‐induced pluripotent stem cell‐derived cardiomyocytes (hiPSC‐CMs). The interference from accompanying block of Cav1.2 and Nav1.5 channels was investigated along with an in silico AP model.Experimental ApproachDrug‐induced changes in APD were assessed in hiPSC‐CMs using voltage‐sensitive dyes. The IC50 values for dofetilide and 13 derivatives on hERG current were estimated in an HEK293 expression system. The relative potency of each drug on APD was estimated by calculating the dose (D150) required to prolong the APD at 90% (APD90) repolarization by 50%.Key ResultsThe D150 in hiPSC‐CMs was linearly correlated with IC50 of hERG current. In silico simulations supported this finding. Three derivatives inhibited hERG without prolonging APD, and these compounds also inhibited Cav1.2 and/or Nav1.5 in a channel state‐dependent manner. Adding Cav1.2 and Nav1.2 block to the in silico model recapitulated the direction but not the extent of the APD change.Conclusions and ImplicationsPotency of hERG current inhibition correlates linearly with an index of APD in hiPSC‐CMs. The compounds that do not correlate have additional effects including concomitant block of Cav1.2 and/or Nav1.5 channels. In silico simulations of hiPSC‐CMs APs confirm the principle of the multiple ion channel effects.
Segmentation of consumer markets in the US: What do intercity price differences tell us?
Authors: Choi Chi‐Young , Murphy Anthony , Wu Jyh‐Lin 
Published: July 2017

AbstractWe quantify the magnitude of market segmentation in US consumer market and explore the underlying factors behind this segmentation, using a quarterly panel of retail prices for 45 products in 48 US cities from 1985 to 2009. The extent of market segmentation is estimated using city‐pair price differences within the framework of both linear autoregressive (AR) and nonlinear threshold autoregressive (TAR) models. We find that the magnitude of market segmentation varies from one product to another, but even more across city pairs in each product. Contrary to a widespread perception, market segmentation within the US is not necessarily larger for non‐tradable services compared to tradable goods. We identify potential drivers of market segmentation by relating the cross‐city and cross‐product variations of market segmentation to location‐specific and product‐specific characteristics—distance, relative city sizes, differences in wage and rent, type of product and proximity to marketplace. Distance, which captures more than transport costs, turns out to be the most salient factor even after controlling for a range of other potential factors. The effect of distance, however, varies substantially across products, with perishable products and locally produced products showing larger distance effect on market segmentation. We find that the magnitude of market segmentation has been somewhat stable during the sample period, but intercity price differences have become more sensitive to distance over time in many products under study.
Cost‐effectiveness of caries‐preventive fluoride varnish applications in clinic settings among patients of low, moderate and high risk
Authors: Schwendicke Falk , Splieth Christian H. , Thomson William Murray , Reda Seif , Stolpe Michael , Foster Page Lyndie 
Published: July 2017

AbstractObjectivesThe total body of evidence finds fluoride varnish effective to prevent caries. However, most trials were conducted in high‐risk populations, with more recent trials on low‐risk groups finding a lower efficacy. We aimed to assess the cost‐effectiveness of fluoride varnish application in clinic setting in populations with different caries risk.MethodsA mixed public‐private‐payer perspective in the context of German health care was performed using a lifetime Markov model. Effectiveness data were derived from an update of the most recent systematic Cochrane review and synthesized in three different risk groups according to control group caries increment via random‐effects meta‐analysis. Varnish was assumed to be applied twice yearly between age 6 and 18 years. Teeth with carious defects would be treated restoratively and could experience further follow‐up treatments. Costs were deduced from German fee item catalogues. Monte Carlo microsimulations were used for to analyse lifetime treatment costs and caries increment (Euro/Decayed, Missing, Filled Teeth (DMFT)).ResultsIn low‐risk groups, fluoride varnish was nearly twice as costly and minimally more effective (293 Euro, 8.1 DMFT) than no varnish (163 Euro, 8.5 DMFT). The incremental cost‐effectiveness ratio (ICER) was 343 Euro spent per avoided DMFT. The ICER was lower in medium‐risk (ICER 93 Euro/DMFT) and high‐risk groups (8 Euro/DMFT).ConclusionsApplication of fluoride varnish in the clinic setting is unlikely to be cost‐effective in low‐risk populations. There is the need to either target high‐risk groups or to provide fluoride varnish at lower costs, possibly in nonclinic settings.
Interleukin-9 over-expression and T helper 9 polarization in systemic sclerosis patients
Authors: Guggino G , Lo Pizzo M , Di Liberto D , Rizzo A , Cipriani P , Ruscitti P , Candore G , Gambino C M , Sireci G , Dieli F , Giacomelli R , Triolo G , Ciccia F 
Published: July 2017

Summary
T helper 9 (Th9) cells and interleukin (IL)-9 are involved in the pathogenesis of several autoimmune diseases. The exact role of IL-9 and Th9 cells in patients with systemic sclerosis (SSc) have not yet been studied adequately. IL-9, IL-9R, transcription factor PU.1 (PU.1), IL-4, thymic stromal lymphopoietin (TSLP) and transforming growth factor (TGF)-β expression were assessed in skin and kidney biopsies of SSc patients and healthy controls (HC) by immunohistochemistry (IHC). The cellular source of IL-9 was also analysed by confocal microscopy analysis. Peripheral IL-9-producing cells were also studied by flow cytometry. The functional relevance of IL-9 increased expression in SSc was also investigated. Our results demonstrated a strong expression of IL-9, IL-9R, IL-4, TSLP and TGF-β in skin tissues of patients with both limited and diffuse SSc. IL-9 expression was observed mainly in the context of skin infiltrating mononuclear cells and keratinizing squamous epithelium. IL-9 over-expression was also observed in renal biopsies of patients with SSc. IL-9 producing cells in the skin were identified as Th9 cells. Similarly, Th9 cells were expanded and were the major source of IL-9 among SSc peripheral blood mononuclear cells (PBMC), their percentage being correlated directly with the modified Rodnan skin score. Infiltrating mononuclear cells, mast cells and neutrophils expressed IL-9R. In in-vitro studies stimulation with rIL-9 significantly induced NET (neutrophil extracellular traps) release by dying cells (NETosis) in neutrophils, expansion of mast cells and increase of anti-systemic scleroderma 70 (Scl70) production by B cells. Our findings suggest that Th9 cells and IL-9 could be implicated in the pathogenesis of SSc.
Factors associated with aortic root dilatation after surgically repaired ventricular septal defect
Authors: Saito Chihiro , Fukushima Noritoshi , Fukushima Keiko , Matsumura Goki , Ashihara Kyomi , Hagiwara Nobuhisa 
Published: July 2017

BackgroundAortic root dilatation (ARD) in congenital heart disease is related to aortic aneurysm, rupture, and dissection. This study aimed to investigate the factors associated with ARD in patients with surgically repaired ventricular septal defect (VSD).MethodsThis cross‐sectional study included 152 patients with surgically repaired VSD. Two definitions of ARD were used: (1) observed Valsalva diameter to body surface area (BSA) ratio >2.1 cm/m2 and (2) absolute value of Valsalva diameter ≥4.0 cm. Odds ratios (ORs) and 95% confidence intervals (CIs) of ARD presence were calculated using multivariate logistic regressions.ResultsThe prevalence of ARD ranged between 8.6% and 32.9%. Using the definition of observed aortic root diameter/BSA >2.1 cm/m2, patients with nonsubarterial VSD type were more likely to have ARD (OR 5.65, 95% CI; 1.83–17.44, P=.003) than those with subarterial type, and patients with preoperative right‐ or noncoronary cusp prolapse (R/NCCP) were more likely to have ARD (OR 3.68, 95% CI; 1.20–11.23, P=.022) than patients without preoperative R/NCCP after adjustment for sex, age at repair (ie, shunt duration), VSD size, and postoperative follow‐up period. Using the definition of absolute Valsalva diameter ≥4 cm, nonsubarterial VSD type and presence of R/NCCP were also significantly associated with ARD after adjustment for the same covariates.ConclusionsAnatomical and morphological features (nonsubarterial type and presence of preoperative R/NCCP) are independently correlated with ARD in patients with VSD regardless of the different definitions of ARD. Patients with surgically repaired VSD may need careful monitoring for potential ARD development.
Contractile reserve and cardiopulmonary exercise parameters in patients with dilated cardiomyopathy, the two dimensions of exercise testing
Authors: Moneghetti Kegan J. , Kobayashi Yukari , Christle Jeffrey W. , Ariyama Miyuki , Vrtovec Bojan , Kouznetsova Tatiana , Wilson Andrew , Ashley Euan , Wheeler Matthew T. , Myers Johnathan , Haddad Francois 
Published: July 2017

BackgroundLeft ventricular (LV) contractile reserve assessed using imaging and cardiopulmonary exercise testing (CPX) has been shown to predict outcome in patients with dilated cardiomyopathy (DCM). Few clinical studies have, however, analyzed the relationship between them.MethodsA cohort of 75 ambulatory patients with DCM underwent stress treadmill echocardiography with CPX. LV contractile reserve was calculated as absolute change (ΔLVEF=LVEFpeak−LVEFrest) and percent change (%LVEF=[(LVEFpeak−LVEFrest)/LVEFpeak)]×100) in LVEF, circumferential and longitudinal strain (LS). Exercise capacity was measured as peak oxygen uptake (peak VO2) and ventilatory efficiency as the slope of minute ventilation to CO2 production (VE/VCO2 slope). Values of contractile reserve were compared to matched controls. We also explored which metric of ventricular response (absolute or percent change) was less dependent on baseline LV function.ResultsPatients with DCM had a mean age, rest and peak LVEF of 44±10 years, 42±10% and 50±12%, respectively. Among parameters of contractile reserve, peak cardiac output was the strongest parameter associated with peak VO2 (r=.63, P<.001). Along with age, sex, and BMI, it explained more than 70% of the variance in peak VO2. In contrast, LVEF and LS were only weakly related to peak VO2. With regard to ventilatory efficiency, the strongest parameter that emerged was right atrial volume index (r=.36, P<.001). Percent change in LVEF was more independent of baseline function than absolute change.ConclusionEchocardiographic contractile reserve and CPX provide complementary information. Percent change in contractile reserve was most independent of baseline function, therefore may be preferred when analyzing the ventricular response to exercise.
Evaluation of the congenital supravalvular aortic stenosis by different imaging modalities
Authors: Guner Ahmet , Havan Nuri , Gunduz Sabahattin , Akgun Taylan , Guvendi Busra , Kahveci Gokhan 
Published: July 2017

A 36‐year‐old female was admitted to hospital exhibiting chest pain, dyspnea, and a heart murmur on the right upper sternal border, radiating to both carotid arteries. The blood pressure of the patient's right arm exceeded the pressure in the left by 25 mm Hg (Coanda effect). In spite of laboratory results that did not fall outside the expected range, the left ventricle was revealed to be hypertrophic following electrocardiography. Transthoracic echocardiography revealed a severe supravalvular aortic stenosis (SVAS) with a peak Doppler velocity of 6.04 cm/s and an estimated mean pressure gradient of 89 mm Hg, with moderate aortic and mitral regurgitation. Contrast‐enhanced computed tomography (CCT) indicated a partial hourglass‐shaped narrowing of the ascending aorta. Lesions associated with supravalvular stenosis of the pulmonary artery, patent ductus arteriosus, and aortic coarctation were ruled out by the CCT. Congenital SVAS is a rare heart condition, and three anatomically distinct forms have been described. The most common type is the “hourglass,” which produces a marked thickening and disorganization of the aortic tissue, producing a constricting annular ridge at the superior margin of the sinuses of Valsalva.
Influence of decision aids on oral anticoagulant prescribing among physicians: a randomised trial
Authors: Baicus Cristian , Delcea Caterina , Dima Alina , Oprisan Emilia , Jurcut Ciprian , Dan Gheorghe Andrei 
Published: July 2017

AbstractBackgroundOral anticoagulants (OAC) are underused in treatment of atrial fibrillation (AF), with differences in patient and physician preferences. For risk communication, the graphic showing risks on treatment contains all the information, therefore, the graphic showing risks without treatment may not be necessary. Here, our objective was to assess whether decision aids require information of risks without treatment and specifically whether presentation of 5‐year stroke risk in patients with AF increases use of OACs compared with presentation of 1‐year risk and whether decisions on treatment are different when physicians decide their own treatment vs. that of the patient.DesignRandomised controlled trial with 23 factorial design, performed at 12 university hospitals, one internal medicine course and one national medical conference.ResultsOf 968 physicians who participated, 83·3% prescribed anticoagulation therapy. Treatment decisions were not influenced by the number of graphics or by the time frame of risk estimation, with risk differences of 0·5% (95% confidence interval, −4·0% to 5·4%) and 3·4% (−1·3% to 8·1%). However, physician‐to‐patient prescription rates were 5·4% (0·2–10·6%) more frequent after seeing the 5‐year risk graphic. Physician‐to‐self intentions to prescribe occurred less frequently, with risk difference of 15·4% (10·8–20%). Physicians considered the baseline risk and the absolute risk reduction only when prescribing to patients but not to themselves.ConclusionsRisks could be communicated using decision aids with only one graphic. Showing the risk of stroke at 5 years could increase the prescription of OACs to patients with AF. Faced with the same risk of stroke, physicians prescribed less to themselves than to patients.
Strategic delegation in asymmetric tax competition
Authors: Ogawa Hikaru , Susa Taiki 
Published: July 2017

AbstractThis study examines asymmetric tax competition under representative democracy systems. The findings show that the degree of asymmetry between countries affects the result of elections in each country, where the citizens select a policy‐maker to set a tax rate for the country. In particular, under certain conditions, a decisive voter in the election can select a citizen whose share of the country's capital is higher than the decisive voter's own share.
Feasibility study suggests no impact from protected engagement time on adverse events in mental health wards for older adults
Authors: Smith Toby , Clark Allan , Dodd Emily , Khoo Mary‐Ellen , Heneker Sarah , Cross Jane , Cheston Rik , Gray Richard , Fox Chris , Nolan Fiona 
Published: July 2017

AbstractHospital adverse events, such as falls, violence and aggression, security, self‐harm, and suicide, are difficult to manage in older people with dementia. The purpose of the present study was to determine whether protected engagement time (PET) resulted in lower adverse events and incidents compared to comparable non‐PET wards for people admitted to inpatient older people's mental health wards. Ten inpatient wards for older people were included. Five followed a PET‐management pathway, while five continued usual care. All adverse events and incidents were recorded in routine hospital records over 72 weeks. Data were gathered from these records and analysed as rate per person per week to assess differences in frequency and type of adverse events between wards. A total of 4130 adverse events were recorded. In the PET wards, a mean of 0.38 adverse events occurred per person per week compared to 0.40 in non‐PET wards. No statistically‐significant differences were found between PET and non‐PET wards for adverse events (P = 0.93), or for adverse events of any particular type (P ≥ 0.15). Therefore, there is no evidence to suggest that PET has any impact on adverse events in older people's mental health wards. Further investigation with a larger cohort is warranted, using a definitive, phase 3, clinical trial.
Communicating about death and dying: Developing training for staff working in services for people with intellectual disabilities
Authors: Tuffrey‐Wijne Irene , Rose Tracey , Grant Robert , Wijne Astrid 
Published: July 2017

BackgroundMany people with intellectual disabilities are affected by death, yet conversations about death are often avoided by staff working with them. This study aimed to assess staff training needs and to develop, trial and evaluate a training course on communicating about death and dying.Method(i) Semi‐structured interviews with 20 staff in residential/supported living services to establish training needs; (ii) three‐one‐day courses were attended by 114 staff and evaluated through questionnaires. The course consisted of World Café sessions, presentations and feedback by people with intellectual disabilities, and an expert teaching session.ResultsStaff fear, cultural influences and inexperience with death‐related conversations were major communication barriers. Evaluation of the course was overwhelmingly positive.ConclusionsIntellectual disabilities services must have clear staff training strategies around death, dying and communication. More work is needed to assess the resource implications and impact on practice of different training methods and other support strategies.
Blood pressure control and mortality in US‐ and foreign‐born blacks in New York City
Authors: Gyamfi Joyce , Butler Mark , Williams Stephen K. , Agyemang Charles , Gyamfi Lloyd , Seixas Azizi , Zinsou Grace Melinda , Bangalore Sripal , Shah Nirav R. , Ogedegbe Gbenga 
Published: July 2017

This retrospective cohort study compared blood pressure (BP) control (BP <140/90 mm Hg) and all‐cause mortality between US‐ and foreign‐born blacks. We used data from a clinical data warehouse of 41 868 patients with hypertension who received care in a New York City public healthcare system between 2004 and 2009, defining BP control as the last recorded BP measurement and mean BP control. Poisson regression demonstrated that Caribbean‐born blacks had lower BP control for the last BP measurement compared with US‐ and West African–born blacks, respectively (49% vs 54% and 57%; P<.001). This pattern was similar for mean BP control. Caribbean‐ and West African–born blacks showed reduced hazard ratios of mortality (0.46 [95% CI, 0.42–0.50] and 0.28 [95% CI, 0.18–0.41], respectively) compared with US‐born blacks, even after adjustment for BP. BP control rates and mortality were heterogeneous in this sample. Caribbean‐born blacks showed worse control than US‐born blacks. However, US‐born blacks experienced increased hazard of mortality. This suggests the need to account for the variations within blacks in hypertension management.
Practitioner Review: Therapist variability, patient‐reported therapeutic alliance, and clinical outcomes in adolescents undergoing mental health treatment – a systematic review and meta‐analysis
Authors: Murphy Regina , Hutton Paul 
Published: July 2017

BackgroundPrevious meta‐analyses have only found small correlations (r = .10 tor = .19) between therapeutic alliance and clinical outcomes in samples of adolescents receiving psychological therapy. Although study‐level variables have been found to moderate this, little is known about the impact of therapist variability. The present meta‐analysis aimed to address this gap by using patient‐therapist ratio as a moderator variable.MethodsContrary to previous reviews of adolescent alliance, individual effect sizes were extracted using a preregistered conceptual hierarchy. Controlling for treatment‐level confounds, a random effects meta‐analysis assessed the moderating effect of patient‐therapist ratio on the alliance‐outcome relationship in predefined single‐predictor and multipredictor meta‐regressions.ResultsThe alliance‐outcome relationship was found to be larger than previously thought (k = 28,N = 2,911,r = .29, 95% Confidence Interval 0.21, 0.37;p < .0001,I2 = 80%). When study samples exceeding the adolescent 12–19 age range were removed, the correlation rose (k = 15,N = 1,797,r = .34, 95% Confidence Interval 0.23, 0.45;p < .0001,I2 = 83%). In contrast to research with adults, patient‐therapist ratio did not moderate this relationship in either single‐predictor (p = .26) or multi‐predictor (p = .22) models.ConclusionsThe alliance‐outcome relationship for adolescents was larger than previously thought, and comparable to estimates in adult samples. The failure of patient‐therapist ratio to moderate its strength, however, challenges the hypothesis that variability in therapist characteristics is an important determinant of the alliance‐outcome effect in this age group.