bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Dentists Read a Technique Article: A Grounded Theory Investigation
Authors: Chambers David W. , Lyon Lucinda J. 
Published: November 2016

AbstractPurposeTo conduct an empirical investigation using qualitative techniques of the way dentists engage in the process of reading a technique‐oriented journal article and what they pay attention to in the process.Materials and MethodsGrounded theory was used to identify how dentists read an article describing the fabrication of an interim prosthesis in the esthetic zone. Twenty‐one experienced practitioners were videotaped, and their verbatim reflections were coded. The sequence of attending to various features of the paper was noted.ResultsNinety‐five percent of readers voiced specific, multiple attempts to identify or refine the main purpose of the article as they processed the material. All readers engaged in various activities to navigate through the article, including skipping and backtracking, and none “read” the article straight through. All readers also made repeated observations about the relevance of the technique to their personal practice situation. Eighty percent used some form of “distancing,” whereby the content and value of the article were accepted, but the reader reserved the privilege of not being bound by the results because of technical, sponsorship, or methodological issues that “might be present.” The quality of photographs was accepted as a proxy for the quality of technical work performed.ConclusionsDentists actively customized the reading of a journal article that described a technical procedure. They imposed a non‐linear structure for absorbing information and a standard of personal relevance, and, while accepting the results, created reasons for not necessarily having to accept them as applicable. The approach clinicians use in reading a procedural article may be different from the structure writers use in preparing a paper.
Two Virtuous Actions Cannot both be Completed
Authors: Ing Michael D. K. 
Published: November 2016

AbstractThis essay highlights an alternative tradition of understanding value conflicts in early Confucian thought. In contrast to a prominent position among interpreters that argues for the resolvability or harmonization of conflicting values, I argue that some early Confucians conceptualized value conflicts as irresolvable. In other words, when meaningful aspects of a situation come into tension with each other and values are threatened to be either left unfulfilled or harmed, early Confucians put forth a variety of views. Some believed that all values could be tended to as long as one had the moral imagination of a sage, whereas others saw the world as a place where irreconcilable conflicts between values could occur for even the most profound people. Within this diversity, I take up a view about irresolvable value conflicts where the confrontation with a deep value conflict leaves behind a moral remainder that can mar even the character of a sage.
Ethnography and Jewish Ethics
Authors: Raucher Michal S. 
Published: November 2016

AbstractThis essay offers a Jewish approach to ethnography in religious ethics. Following the work of other ethnographers working in religious ethics, I explore how an ethnographic account of reproductive ethics among Haredi (ultra‐Orthodox) Jewish women in Jerusalem enhances and improves Jewish ethical discourse. I argue that ethnography should become an integral part of Jewish ethics for three reasons. First, with a contextual approach to guidance and application of law and norms, an ethnographic approach to Jewish ethics parallels the way ethical decisions are made on a daily basis in Jewish communities. Second, ethnography bolsters the voices of those involved in ethical discourse. Third, ethnography facilitates the bridge between local ethical questions and global ethical discourse.
The Buddhist Roots of Watsuji Tetsurô's Ethics of Emptiness
Authors: Sevilla Anton Luis 
Published: November 2016

AbstractWatsuji Tetsurô (1889–1960) is famous for having constructed a systematic socio‐political ethics on the basis of the idea of emptiness. This essay examines his 1938 essay “The Concept of ‘Dharma’ and the Dialectics of Emptiness in Buddhist Philosophy” and the posthumously published The History of Buddhist Ethical Thought (based on lectures given in the 1920s), in order to clarify the Buddhist roots of his ethics. It aims to answer two main questions which are fundamentally linked: “Which way does Watsuji's legacy turn: toward totalitarianism or toward a balanced theory of selflessness?” and “Is Watsuji's systematic ethics Buddhist?” In order to answer these questions, this essay discusses Watsuji's view of dharma, dependent arising, and morality in Hīnayāna Buddhism. It then proceeds to Watsuji's fine‐tuning of the concept of emptiness in Mādhyamika and Yogācāra Buddhism. Finally, this essay shows how Watsuji's modernist Buddhist theory connects to his own systematic ethical theory. These two theories share a focus on non‐duality, negation, and emptiness. But they differ in their accounts of the relations between the individual and the community, between the “is” and the “ought,” and between hermeneutics and transcendence. These findings give us hints as to Watsuji's origins, pitfalls, and possibilities.
Invasive Melanoma in a Patient with Congenital Ichthyosiform Erythroderma
Authors: Jaju Prajakta , Novoa Roberto A. , Swetter Susan M. , Sarin Kavita Y. 
Published: November 2016

AbstractWe describe the case of a 26‐year‐old woman with a history of congenital ichthyosiform erythroderma (CIE) who initially presented with a stage IIA amelanotic melanoma on her forearm that was surgically excised. We also review the literature on CIE‐associated skin cancers and discuss the possible contribution of ichthyosis to the risk of cutaneous malignancies. Our findings emphasize the importance of close lifelong skin cancer screening in individuals with CIE and highlight the unique malignancy risk of these individuals.
Water Policy in a Time of Climate Change: Coping with Complexity
Authors: Skinner Rob M. 
Published: November 2016

AbstractThe unpredictable impacts of climate change, combined with significant social and economic changes, mean that policy analysis is becoming inordinately more complex. Coping with this increasing complexity while engaging with a full range of stakeholders and the community requires a new approach to leadership and governance. Water planners (and others involved in the planning processes) need new skills in active listening and constructive cultural behavior, and all agencies need to recognize that thinking and acting only in the interests of their own silo of responsibilities will inevitably produce suboptimal outcomes. Leadership focused on constructive behavior that recognizes and rewards generosity of spirit across disciplines and between organizations is the foundation of this new approach.
Biologically Active Secondary Metabolites from the Fungi
Authors: Bills Gerald F. , Gloer James B. 
Published: November 2016

ABSTRACT
Many Fungi have a well-developed secondary metabolism. The diversity of fungal species and the diversification of biosynthetic gene clusters underscores a nearly limitless potential for metabolic variation and an untapped resource for drug discovery and synthetic biology. Much of the ecological success of the filamentous fungi in colonizing the planet is owed to their ability to deploy their secondary metabolites in concert with their penetrative and absorptive mode of life. Fungal secondary metabolites exhibit biological activities that have been developed into life-saving medicines and agrochemicals. Toxic metabolites, known as mycotoxins, contaminate human and livestock food and indoor environments. Secondary metabolites are determinants of fungal diseases of humans, animals, and plants. Secondary metabolites exhibit a staggering variation in chemical structures and biological activities, yet their biosynthetic pathways share a number of key characteristics. The genes encoding cooperative steps of a biosynthetic pathway tend to be located contiguously on the chromosome in coregulated gene clusters. Advances in genome sequencing, computational tools, and analytical chemistry are enabling the rapid connection of gene clusters with their metabolic products. At least three fungal drug precursors, penicillin K and V, mycophenolic acid, and pleuromutilin, have been produced by synthetic reconstruction and expression of respective gene clusters in heterologous hosts. This review summarizes general aspects of fungal secondary metabolism and recent developments in our understanding of how and why fungi make secondary metabolites, how these molecules are produced, and how their biosynthetic genes are distributed across the Fungi. The breadth of fungal secondary metabolite diversity is highlighted by recent information on the biosynthesis of important fungus-derived metabolites that have contributed to human health and agriculture and that have negatively impacted crops, food distribution, and human environments.
Complement Receptors in Myeloid Cell Adhesion and Phagocytosis
Authors: Dustin Michael L. 
Published: November 2016

ABSTRACTMyeloid cells make extensive use of the complement system in the context of recruitment, phagocytosis, and other effector functions. There are several types of complement receptors on myeloid cells, including G protein-coupled receptors for localizing the source of complement activation, and three sets of type I transmembrane proteins that link complement to phagocytosis: complement receptor 1, having an extracellular domain with tandem complement regulatory repeats; complement receptors 3 and 4, which are integrin family receptors comprising heterodimers of type I transmembrane subunits; and VSIG4, a member of the Ig superfamily. This review will focus on the role of the different classes of complement receptors and how their activities are integrated in the setting of immune tolerance and inflammatory responses.
ImmunoglobuliNin theTreatment ofEncephalitis (IgNiTE): protocol for a multicentre randomised controlled trial
Authors: Iro M A , Sadarangani M , Absoud M , Chong W K , Clark C A , Easton A , Gray V , Kneen R , Lim M , Pike M , Solomon T , Vincent A , Willis L , Yu L-M , Pollard A J 
Published: November 2016

IntroductionInfectious and immune-mediated encephalitides are important but under-recognised causes of morbidity and mortality in childhood, with a 7% death rate and up to 50% morbidity after prolonged follow-up. There is a theoretical basis for ameliorating the immune response with intravenous immunoglobulin (IVIG), which is supported by empirical evidence of a beneficial response following its use in the treatment of viral and autoimmune encephalitis. In immune-mediated encephalitis, IVIG is often used after a delay (by weeks in some cases), while diagnosis is confirmed. Wider use of IVIG in infectious encephalitis and earlier use in immune-mediated encephalitis could improve outcomes for these conditions. We describe the protocol for the first ever randomised control trial of IVIG treatment for children with all-cause encephalitis.Methods and analysis308 children (6 months to 16 years) with a diagnosis of acute/subacute encephalitis will be recruited in ∼30 UK hospitals and randomised to receive 2 doses (1 g/kg/dose) of either IVIG or matching placebo, in addition to standard treatment. Recruitment will be over a 42-month period and follow-up of each participant will be for 12 months post randomisation. The primary outcome is ‘good recovery’ (score of 2 or lower on the Glasgow Outcome Score Extended—paediatric version), at 12 months after randomisation. Additional secondary neurological measures will be collected at 4–6 weeks after discharge from acute care and at 6 and 12 months after randomisation. Safety, radiological, other autoimmune and tertiary outcomes will also be assessed.Ethics and disseminationThis trial has been approved by the UK National Research Ethics committee (South Central—Oxford A; REC 14/SC/1416). Current protocol: V4.0 (10/03/2016). The findings will be presented at national and international meetings and conferences and published in peer-reviewed journals.Trial registration numbersNCT02308982, EudraCT201400299735 andISRCTN15791925; Pre-results.
Which cuff should I use? Indirect blood pressure measurement for the diagnosis of hypertension in patients with obesity: a diagnostic accuracy review
Authors: Irving Greg , Holden John , Stevens Richard , McManus Richard J 
Published: November 2016

ObjectiveTo determine the diagnostic accuracy of different methods of blood pressure (BP) measurement compared with reference standards for the diagnosis of hypertension in patients with obesity with a large arm circumference.DesignSystematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Bland-Altman analyses where individual patient data were available. Methodological quality appraised using Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS2) criteria.Data sourcesMEDLINE, EMBASE, Cochrane, DARE, Medion and Trip databases were searched.Eligibility criteriaCross-sectional, randomised and cohort studies of diagnostic test accuracy that compared any non-invasive BP tests (upper arm, forearm, wrist, finger) with an appropriate reference standard (invasive BP, correctly fitting upper arm cuff, ambulatory BP monitoring) in primary care were included.Results4037 potentially relevant papers were identified. 20 studies involving 26 different comparisons met the inclusion criteria. Individual patient data were available from 4 studies. No studies satisfied all QUADAS2 criteria. Compared with the reference test of invasive BP, a correctly fitting upper arm BP cuff had a sensitivity of 0.87 (0.79 to 0.93) and a specificity of 0.85 (0.64 to 0.95); insufficient evidence was available for other comparisons to invasive BP. Compared with the reference test of a correctly fitting upper arm cuff, BP measurement at the wrist had a sensitivity of 0.92 (0.64 to 0.99) and a specificity of 0.92 (0.85 to 0.87). Measurement with an incorrectly fitting standard cuff had a sensitivity of 0.73 (0.67 to 0.78) and a specificity of 0.76 (0.69 to 0.82). Measurement at the forearm had a sensitivity of 0.84 (0.71 to 0.92) and a specificity 0.75 of (0.66 to 0.83). Bland-Altman analysis of individual patient data from 3 studies comparing wrist and upper arm BP showed a mean difference of 0.46 mm Hg for systolic BP measurement and 2.2 mm Hg for diastolic BP measurement.ConclusionsBP measurement with a correctly fitting upper arm cuff is sufficiently sensitive and specific to diagnose hypertension in patients with obesity with a large upper arm circumference. If a correctly fitting upper arm cuff cannot be applied, an incorrectly fitting standard size cuff should not be used and BP measurement at the wrist should be considered.
Using a simple point-prevalence survey to define appropriate antibiotic prescribing in hospitalised children across the UK
Authors: Gharbi Myriam , Doerholt Katja , Vergnano Stefania , Bielicki Julia Anna , Paulus Stéphane , Menson Esse , Riordan Andrew , Lyall Hermione , Patel Sanjay Valabh , Bernatoniene Jolanta , Versporten Ann , Heginbothom Maggie , Goossens Herman , Sharland Mike 
Published: November 2016

BackgroundThe National Health Service England, Commissioning for Quality and Innovation for Antimicrobial Resistance (CQUIN AMR) aims to reduce the total antibiotic consumption and the use of certain broad-spectrum antibiotics in secondary care. However, robust baseline antibiotic use data are lacking for hospitalised children. In this study, we aim to describe, compare and explain the prescription patterns of antibiotics within and between paediatric units in the UK and to provide a baseline for antibiotic prescribing for future improvement using CQUIN AMR guidance.MethodsWe conducted a cross-sectional study using a point prevalence survey (PPS) in 61 paediatric units across the UK. The standardised study protocol from the Antibiotic Resistance and Prescribing in European Children (ARPEC) project was used. All inpatients under 18 years of age present in the participating hospital on the day of the study were included except neonates.ResultsA total of 1247 (40.9%) of 3047 children hospitalised on the day of the PPS were on antibiotics. The proportion of children receiving antibiotics showed a wide variation between both district general and tertiary hospitals, with 36.4% ( 95% CI 33.4% to 39.4%) and 43.0% (95% CI 40.9% to 45.1%) of children prescribed antibiotics, respectively. About a quarter of children on antibiotic therapy received either a medical or surgical prophylaxis with parenteral administration being the main prescribed route for antibiotics (>60% of the prescriptions for both types of hospitals). General paediatrics units were surprisingly high prescribers of critical broad-spectrum antibiotics, that is, carbapenems and piperacillin-tazobactam.ConclusionsWe provide a robust baseline for antibiotic prescribing in hospitalised children in relation to current national stewardship efforts in the UK. Repeated PPS with further linkage to resistance data needs to be part of the antibiotic stewardship strategy to tackle the issue of suboptimal antibiotic use in hospitalised children.
Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide, Troponin-T, and Growth-Differentiation Factor 15 in Adult Congenital Heart Disease
Authors: Baggen Vivan J.M. , van den Bosch Annemien E. , Eindhoven Jannet A. , Schut Anne-Rose W. , Cuypers Judith A.A.E. , Witsenburg Maarten , de Waart Monique , van Schaik Ron H.N. , Zijlstra Felix , Boersma Eric , Roos-Hesselink Jolien W. 
Published: November 2016

Background:
The number of patients with adult congenital heart disease (ACHD) is rapidly increasing. To optimize patient management, there is a great need to accurately identify high-risk patients. Still, no biomarker has been firmly established as a clinically useful prognostic tool in this group. We studied the association of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitive troponin-T, and growth-differentiation factor 15 with cardiovascular events in ACHD.

Methods:
Clinically stable patients with ACHD who routinely visited the outpatient clinic between April 2011 and April 2013 underwent clinical assessment, electrocardiography, echocardiography, and biomarker measurement (NT-proBNP, high-sensitive troponin-T, and growth-differentiation factor 15) at the time of study inclusion. Patients were prospectively followed for the occurrence of cardiovascular events (death, heart failure, hospitalization, arrhythmia, thromboembolic events, and reintervention). Survival curves were derived by the Kaplan-Meier method, and Cox regression was performed to investigate the relation between biomarkers and events with adjustment for multiple clinical and echocardiographic variables.

Results:

In total, 595 patients were included (median age, 33 years; interquartile range, 25–41 years; 58% male; 90% New York Heart Association class I). Patients were followed during a median of 42 (interquartile range, 37–46) months. Of the 3 evaluated biomarkers, NT-proBNP in the upper quartile (>33.3 pmol/L) was most strongly associated with cardiovascular events (n=165, adjusted hazard ratio, 9.05 [3.24–25.3],
P
<0.001) and with death or heart failure (n=50, adjusted hazard ratio, 16.0 [2.04–126],
P
<0.001). When NT-proBNP was analyzed as a continuous variable, similar findings were retrieved. The cumulative proportion of patients with death and heart failure was only 1% in the lowest 2 NT-proBNP quartiles. Elevated NT-proBNP (>14 pmol/L), elevated high-sensitive troponin-T (>14 ng/L), and elevated growth-differentiation factor 15 (>1109 ng/L) identified those patients at highest risk of cardiovascular events (log-rank
P
<0.0001).

Conclusions:
NT-proBNP provides prognostic information beyond a conventional risk marker model in patients with ACHD and can reliably exclude the risk of death and heart failure. Elevated levels of NT-proBNP, high-sensitive troponin-T, and growth-differentiation factor 15 identify patients at highest risk of cardiovascular events. These biomarkers therefore may play an important role in the monitoring and management of patients with ACHD.
Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association
Authors: Wechsler Lawrence R. , Demaerschalk Bart M. , Schwamm Lee H. , Adeoye Opeolu M. , Audebert Heinrich J. , Fanale Christopher V. , Hess David C. , Majersik Jennifer J. , Nystrom Karin V. , Reeves Mathew J. , Rosamond Wayne D. , Switzer Jeffrey A. 
Published: November 2016

Purpose—
Telestroke is one of the most frequently used and rapidly expanding applications of telemedicine, delivering much-needed stroke expertise to hospitals and patients. This document reviews the current status of telestroke and suggests measures for ongoing quality and outcome monitoring to improve performance and to enhance delivery of care.

Methods—
A literature search was undertaken to examine the current status of telestroke and relevant quality indicators. The members of the writing committee contributed to the review of specific quality and outcome measures with specific suggestions for metrics in telestroke networks. The drafts were circulated and revised by all committee members, and suggestions were discussed for consensus.

Results—
Models of telestroke and the role of telestroke in stroke systems of care are reviewed. A brief description of the science of quality monitoring and prior experience in quality measures for stroke is provided. Process measures, outcomes, tissue-type plasminogen activator use, patient and provider satisfaction, and telestroke technology are reviewed, and suggestions are provided for quality metrics. Additional topics include licensing, credentialing, training, and documentation.
Demographic history of Trinorchestia longiramus (Amphipoda, Talitridae) in South Korea inferred from mitochondrial DNA sequence variation
Authors: Woo Jiyoung , An Hyesuck , Lim Byung-Jin , Song Ha Yeun , Kim Min-Seop , Jung Tae Won , Jeong Seungjin , Cho In-Young , Oh Sumin , Han Donguk , Yoon Moongeun 
Published: November 2016

We investigated the demographic history ofTrinorchestia longiramusJo, 1988 using the nucleotide sequence analysis of the mitochondrial cytochrome oxidase subunit I (COI) gene from 277 individuals collected from eight Korean populations. From the low haplotype diversity and nucleotide diversity in all populations, a neutrality test, and mismatch distribution analysis, the species appears to have recently experienced a prolonged or severe demographic bottleneck. Pairwise populationFSTestimates and AMOVA [= Analysis of Molecular Variance] results showed that substantial differentiation is present between the southern and eastern populations. The population structure ofT. longiramusmay have been influenced by glacial population extinctions and interglacial colonization during the Pleistocene ice-ages.