bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstetric anal sphincter injury and incontinence 15–23 years after vaginal delivery
Authors: Halle Tuva K. , Salvesen Kjell Å. , Volløyhaug Ingrid 
Published: March 2016

AbstractIntroductionThe primary aim was to study prevalence of obstetric anal sphincter injuries (OASIS) after normal vaginal deliveries (NVD) and operative vaginal deliveries (OVD) with a subgroup analysis of forceps (FD) vs. vacuum deliveries (VD). The secondary aim was to study the association betweenOASISand anal incontinence 15–23 years later.Material and methodsThis was a cross‐sectional study including 8137 primiparous women in Trondheim, Norway, from 1990 to 1997. The outcome measure was the adjusted odds ratio (aOR) forOASISbetween delivery groups. A total of 1122 women responded to a postal questionnaire containing the Colorectal‐Anal Distress Inventory (CRADI) in 2013. TheaORfor anal incontinence and the difference inCRADIscore between women with and withoutOASISwere calculated.ResultsOASISprevalence was 2% forNVDand 10% forOVD(10%FD, 9%VD).aORforOASISwas 5.01 (95%CI3.85–6.51) comparingOVDwithNVD. There was no difference betweenFDandVD(aOR1.15, 95%CI0.79–1.67).FDwas associated with higher risk of fourth degree perineal tear thanVD(aOR5.08, 95%CI1.47–17.49).OASISwas associated with increased risk of leakage of well‐formed (aOR8.61, 95%CI3.08–24.12) and loose stool (aOR2.75, 95%CI1.43–5.27) and higherCRADIscore (Mann–WhitneyU‐test,p= 0.01).ConclusionsOVDwas associated with increased risk ofOASIS.FDwas associated with higher risk of fourth degree perineal tear compared withVD.OASISwas associated with increased risk of anal incontinence and higherCRADIscore 15–23 years later.
Volvulus in term and preterm infants ‐ clinical presentation and outcome
Authors: Horsch Sandra , Albayrak Bilge , Tröbs Ralf‐Bodo , Roll Claudia 
Published: March 2016

AbstractAimOur aim was to assess if term and preterm infants with volvulus showed different patterns with regard to pathogenesis, clinical presentation and outcome.MethodsWe reviewed the medical records and imaging data of infants aged less than six months with volvulus treated in a single surgical referral centre from 2006–2013.ResultsVolvulus was diagnosed in 19 infants, with no anatomical anomaly in three of the 12 preterm infants and one of the seven term infants. Most cases (74%) presented during the first eight days of life. Later presentations occurred exclusively in preterm infants, with only one of the five having no anatomic anomalies. Bilious vomiting was the leading symptom in six of the seven term infants, while the symptoms in preterm infants were rather nonspecific. Intestinal necrosis, with the need for bowel resection, occurred in one term (14%) infant and nine (75%) preterm infants.ConclusionThe clinical presentation and outcome of volvulus differed between preterm and term infants, but the rate and distribution of underlying anomalies did not differ. Symptoms in preterm infants were often nonspecific and led to a delay in diagnosis. This might have contributed to the higher rate of intestinal necrosis in preterm infants.
Parent and adolescent reports in assessing adolescent sleep problems: results from a large population study
Authors: Fatima Yaqoot , Doi Suhail A.R. , O'Callaghan Michael , Williams Gail , Najman Jake M. , Mamun Abdullah Al 
Published: March 2016

AbstractAimTo compare parent and adolescent reports in exploring adolescent sleep problems and to identify the factors associated with adolescent sleep problem disclosures.MethodsParent (n = 5185) and adolescent reports (n = 5171, age=13.9 ± 0.3 years), from a birth cohort were used to explore adolescent sleep problems. Kappa coefficients were used to assess the agreement, whereas, conditional agreement and disagreement ratios were used to identify the optimal informant. Logistic regression analysis was used to determine the factors affecting adolescent sleep problem disclosure.ResultsParental reports identified only about one‐third of the sleep problems reported by adolescents. Whereas adolescent reports identified up to two‐thirds of the sleep problems reported by parents. Combined reports of parents and adolescent did not show any considerable difference from the adolescent report. Adolescent and parent health, maternal depression, and family communication were significantly associated with adolescents sleep problem disclosures.ConclusionAdolescent reports could be used as the preferred source to explore adolescent sleep problems. Parental reports should be used when parents as observers are more reliable reporters, or where adolescents are cognitively unable to report sleep problems. Additionally, the impact of poor health, maternal depression and family communication on sleep problems disclosure should be considered for adolescent sleep problem diagnosis.
Metabolomic profiling reveals differential effects of glucagon‐like peptide‐1 and insulin on nutrient partitioning in ovine liver
Authors: El‐Sabagh Mabrouk , Taniguchi Dai , Sugino Toshihisa , Obitsu Taketo 
Published: March 2016

AbstractThis study was conducted to identify the insulin‐independent actions of glucagon‐like peptide‐1 (GLP‐1 (7‐36 amide)) in partitioning nutrient metabolism in ovine liver. Four Suffolk wethers (60.0 ± 6.7 kg body weight (BW)) were used in a repeated‐measure design under euglycemic‐‐hyperinsulinemic and hyper ‐GLP‐1 clamps for 150 min with intravenous infusion of insulin (0.5 mU/kg BW/min; from 0 to 90 min), GLP‐1 (0.5 µg/kg BW/min; from 60 to 150 min) and both hormones co‐administered from 60 to 90 min. Liver biopsies were collected at 0, 60, 90 and 150 min to represent the metabolomic profiling of baseline, insulin, insulin plus GLP‐1, and GLP‐1, respectively, and were analyzed for metabolites using Capillary Electrophoresis Time‐of‐Flight Mass Spectrometer. Metabolomics analysis reveals 51 metabolites as being significantly altered (P < 0.05) by insulin and GLP‐1 infusion compared to baseline values. Insulin infusion enhanced glycolysis, lipogenesis, oxidative stress defense and cell proliferation pathways, but reduced protein breakdown, gluconeogenesis and ketogenesis pathways. Conversely, GLP‐1 infusion promoted lipolytic and ketogenic pathways accompanied by a lowered lipid clearance from the liver as well as elevated oxidative stress defense and nucleotide degradation. Despite further research still being warranted, our data suggest that GLP‐1 may exert insulin‐antagonistic effects on hepatic lipid and nucleotide metabolism in ruminants.
Sprucification in protected forests: myth or veracity? – Clues from 60 yrs survey data
Authors: Hedwall Per‐Ola , Mikusiński Grzegorz 
Published: March 2016

AbstractQuestionsThe purpose of this study was to examine how compositional characteristics of forest reserves in production landscapes change over time and to explore the local site conditions that drive these processes. Our hypothesis was according to the general paradigm that suppression of natural disturbance regimes and lack of active management causes protected forest areas (PFAs) to develop into forests of high density dominated by late successional tree species.LocationBoreal and hemiboreal forests of Sweden.MethodsWe used long‐term (60 yrs) data from the Swedish National Forest Inventory (NFI), representing all the PFAs in Sweden, to study changes in tree species composition in relation to site factors and the initial state of the forest.ResultsDuring the period of our study the average density expressed by the growing stock (GS) increased from 70 to 140 m3·ha−1. This increase concerned both early and late successional tree species and there was no evidence for a faster increase of the late successional species Norway spruce (Picea abies) and the species composition was stable over time. A net volume increment (NVINCR) in spruce was mostly related to sites where spruce already was present, sites with high productivity and forest of high age. The probability of an increase in Scots pine (Pinus sylvestris) was negatively linked to productivity and stand age, while the NVINCR was higher on more productive sites. The NVINCR of deciduous trees was unrelated to site productivity and age but positively affected by the initial GS, increasing slope and soil depth.ConclusionsOur results suggest that the relative composition of species is stable over time and balanced by site productivity, which is in accordance with the resource‐ratio hypothesis. An important cause of this stability could be the low number of tree species in northern Europe, which limits the number of potential successional pathways.
The impact of genetic polymorphisms on the pharmacokinetics of efavirenz in African children
Authors: Bienczak Andrzej , Cook Adrian , Wiesner Lubbe , Olagunju Adeniyi , Mulenga Veronica , Kityo Cissy , Kekitiinwa Addy , Owen Andrew , Walker A. Sarah , Gibb Diana M. , McIlleron Helen , Burger David , Denti Paolo 
Published: March 2016

AimsUsing a model‐based approach, the efavirenz steady‐state pharmacokinetics in African children is characterized, quantifying demographic and genotypic effects on the drug's disposition. Simulations are also conducted allowing prediction of optimized doses of efavirenz in this population.MethodsWe modelled the steady‐state population pharmacokinetics of efavirenz in Ugandan and Zambian children using nonlinear mixed‐effects modelling. Individual mid‐dose efavirenz concentrations were derived and simulations explored genotype‐based dose optimization strategies.ResultsA two‐compartment model with absorption through transit compartments well described 2086 concentration‐time points in 169 children. The combined effect of single nucleotide polymorphisms (SNPs) 516G>T and 983T>C explained 44.5% and 14.7% of the variability in efavirenz clearance and bioavailability, respectively. The detected frequencies of composite CYP2B6 genotype were 0.33 for 516GG|983TT, 0.35 for 516GT|983TT, 0.06 for 516GG|983TC, 0.18 for 516TT|983TT, 0.07 516GT|983TC and 0.01 for 516GG|983CC. The corresponding estimated clearance rates were 6.94, 4.90, 3.93, 1.92, 1.36, and 0.74 l h−1 for a 15.4 kg child and median (95% CI) observed mid‐dose concentrations 1.55 (0.51–2.94), 2.20 (0.97–4.40), 2.03 (1.19–4.53), 7.55 (2.40–14.74), 7.79 (3.66–24.59) and 18.22 (11.84–22.76) mg l−1, respectively. Simulations showed that wild‐type individuals had exposures at the bottom of therapeutic range, while slower metabolizers were overexposed.ConclusionsDosage guidelines for African children should take into consideration the combined effect of SNPs CYP2B6 516G>T and 983T>C.
Risk of acute and serious liver injury associated to nimesulide and other NSAIDs: data from drug‐induced liver injury case–control study in Italy
Authors: Donati Monia , Conforti Anita , Lenti Maria Carmela , Capuano Annalisa , Bortolami Oscar , Motola Domenico , Moretti Ugo , Vannacci Alfredo , Rafaniello Concetta , Vaccheri Alberto , Arzenton Elena , Bonaiuti Roberto , Sportiello Liberata , Leone Roberto ,   on behalf of DILI-IT Study Group
Published: March 2016

AimDrug‐induced liver injury is one of the most serious adverse drug reactions and the most frequent reason for restriction of indications or withdrawal of drugs. Some nonsteroidal anti‐inflammatory drugs (NSAIDs) were withdrawn from the market because of serious hepatotoxicity. We estimated the risk of acute and serious liver injury associated with the use of nimesulide and other NSAIDs, with a prevalence of use greater than or equal to 5%.MethodsThis is a multicentre case–control study carried out in nine Italian hospitals from October 2010 to January 2014. Cases were adults, with a diagnosis of acute liver injury. Controls presented acute clinical disorders not related to chronic conditions, not involving the liver. Adjusted odds ratio (ORs) with 95% confidence interval (CI) were calculated initially with a bivariate and then multivariate analysis.ResultsWe included 179 cases matched to 1770 controls. Adjusted OR for acute serious liver injury associated with all NSAIDs was 1.69, 95% CI 1.21–2.37. Thirty cases were exposed to nimesulide (adjusted OR 2.10, 95% CI 1.28–3.47); the risk increased according to the length of exposure (OR > 30 days: 12.55, 95% CI 1.73–90.88) and to higher doses (OR 10.69, 95% CI 4.02–28.44). Risk of hepatotoxicity was increased also for ibuprofen, used both at recommended dosages (OR 1.92, 95% CI 1.13–3.26) and at higher doses (OR 3.73, 95% CI 1.11–12.46) and for ketoprofen ≥ 150 mg (OR 4.65, 95% CI 1.33–10.00).ConclusionAmong all NSAIDs, nimesulide is associated with the higher risk, ibuprofen and high doses of ketoprofen are also associated with a modestly increased risk of hepatotoxicity.
Impact of patient characteristics on the pharmacokinetics of corifollitropin alfa during controlled ovarian stimulation
Authors: Zandvliet Anthe S. , Prohn Marita , de Greef Rik , van Aarle Frank , McCrary Sisk Christine , Stegmann Barbara J. 
Published: March 2016

AimThe aim of the present study was to characterize the pharmacokinetic profile of corifollitropin alfa and examine the relationships between dose, intrinsic factors [body weight, body mass index (BMI), age and race] and corifollitropin alfa pharmacokinetics.MethodsData from five phase II and III clinical trials of corifollitropin alfa were evaluated. All subjects included in the analysis received 60 – 180 μg corifollitropin alfa for controlled ovarian stimulation in a gonadotrophin‐releasing hormone antagonist protocol followed by daily recombinant follicle stimulating hormone (rFSH) from day 8 onwards. Serum corifollitropin alfa levels (across the entire range of treatment) and total follicle stimulating hormone immunoreactivity levels (up to the start of rFSH treatment) were indicators of drug exposure. The analyses were performed using a nonlinear mixed‐effects modelling approach.ResultsA total of 2630 subjects were treated with corifollitropin alfa, and 2557 subjects were evaluable for analysis. Body weight, BMI and race (Asian and Black vs. Caucasian) were significant determinants of corifollitropin alfa exposure. Dose‐normalized corifollitropin alfa exposure was ~89% higher in women with a body weight of 50 kg vs. 90 kg (in subjects with a similar BMI of 24 kg m−2); 14% higher in women with a BMI of 18 kg m−2 vs. 32 kg m−2 (provided they were of similar body weight); and ~15.7% lower in Asian subjects and 13% higher in Black subjects vs. Caucasian subjects.ConclusionsBody weight was the major determinant of corifollitropin alfa exposure; BMI and race (Asian and Black) were also determinants but to a lesser extent and without associated effects on clinical outcomes. Corifollitropin alfa dose adjustment is indicated, based on body weight but not for BMI or race. These recommendations are consistent with the product label.
Potential Future Pharmacological Treatment of Bladder Dysfunction
Authors: Andersson Karl‐Erik 
Published: March 2016

AbstractIn the last decades, a number of new antimuscarinic drugs have been introduced for treatment of the overactive bladder (OAB), defined symptomatically (OAB syndrome) or urodynamically (detrusor overactivity). Recently, three new drug principles have been approved for clinical use, the β3‐adrenoceptor agonist, mirabegron, the phosphodiesterase‐5 inhibitor, tadalafil and the blocker of afferent and efferent nerves, botulinum toxin. However, new alternatives are continuously being explored. OAB is a filling disorder, and ATP is involved in the generation of afferent impulses. One way of blocking the ATP afferent pathway is through the use of P2X3 receptor antagonists. In animal models, this strategy appears to work very well, but whether it translates effectively to man remains to be established. Evidence suggests that components of the endocannabinoid system are involved in regulation of bladder function. Clinical studies of cannabinoid extracts on LUTS are scarce and essentially restricted to patients with MS, and the results have so far not been convincing. Amplification of endocannabinoid activity by inhibiting their degradation via fatty acid amide hydrolase inhibitors may be an attractive approach, but no clinical experiences in OAB have been reported. Studies of the lower urinary tract have indicated that several transient receptor potential (TRP) channels, including TRPV1, TRPV2, TRPV4, TRPM8 and TRPA1, are expressed in the bladder and may act as sensors of stretch and/or chemical irritation. Animal studies have shown that inhibition of these pathways can be effective for the reduction in bladder activity. However, the roles of these channels for normal function and in pathological states have not been established, and so far adverse effects (hyperthermia) have hampered development of antagonists.
Health Security and Risk Aversion
Authors: Herington Jonathan 
Published: March 2016

AbstractHealth security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision‐making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy.
Propensity Score Matching and Subclassification in Observational Studies with Multi-Level Treatments
Authors: Yang Shu , Imbens Guido W. , Cui Zhanglin , Faries Douglas E. , Kadziola Zbigniew 
Published: March 2016

SummaryIn this article, we develop new methods for estimating average treatment effects in observational studies, in settings with more than two treatment levels, assuming unconfoundedness given pretreatment variables. We emphasize propensity score subclassification and matching methods which have been among the most popular methods in the binary treatment literature. Whereas the literature has suggested that these particular propensity-based methods do not naturally extend to the multi-level treatment case, we show, using the concept of weak unconfoundedness and the notion of the generalized propensity score, that adjusting for a scalar function of the pretreatment variables removes all biases associated with observed pretreatment variables. We apply the proposed methods to an analysis of the effect of treatments for fibromyalgia. We also carry out a simulation study to assess the finite sample performance of the methods relative to previously proposed methods.
Amount, Source, and Quality of Support as Predictors of Women's Birth Evaluations
Authors: Simon Richard M. , Johnson Katherine M. , Liddell Jessica 
Published: March 2016

AbstractBackgroundThis paper examines the separate effects of the perceived amount, source, and quality of support during labor and delivery on women's positive and negative evaluations of their birth experiences.MethodsData come from the Listening to Mothers I and II (LTM) surveys (n = 2,765). Women's perception of support was regressed separately onto indices of positive and negative words that women associated with their labor and delivery.ResultsThe total number of support sources, type of support person, and quality of support all impacted women's birth evaluations across different regression models, controlling for demographics, birth interventions, and other birth characteristics. Support overall had a greater effect on increasing women's positive evaluations, but was not as protective against negative evaluations. Support from medical and birth professionals (doctors, nurses, doulas) had the greatest effect on women's positive evaluations. Good partner support was complexly related: it was associated with less positive evaluations but also appeared to have a protective effect against negative birth evaluations.DiscussionSupport in childbirth is a complex concept with multiple dimensions that matter for women's birth evaluations. Support from nursing staff, doctors, and doulas is important for enabling positive evaluations while support from partners is more complexly related to women's evaluations. Research on support for laboring women should more extensively address the division of labor between different sources of support.
Trends and Characteristics of United States Out‐of‐Hospital Births 2004–2014: New Information on Risk Status and Access to Care
Authors: MacDorman Marian F. , Declercq Eugene 
Published: March 2016

AbstractBackgroundOut‐of‐hospital births are increasing in the United States. Our purpose was to examine trends in out‐of‐hospital births from 2004 to 2014, and to analyze newly available data on risk status and access to care.MethodsNewly available data from the revised birth certificate for 47 states and Washington, DC, were used to examine out‐of‐hospital births by characteristics and to compare them with hospital births. Trends from 2004 to 2014 were also examined.ResultsOut‐of‐hospital births increased by 72 percent, from 0.87 percent of United States births in 2004 to 1.50 percent in 2014. Compared with mothers who had hospital births, those with out‐of‐hospital births had lower prepregnancy obesity (12.5% vs 25.0%) and smoking (2.8% vs 8.5%) rates, and higher college graduation (39.3% vs 30.0%) and breastfeeding initiation (94.3% vs 80.8%) rates. Among planned home births, 67.1 percent were self‐paid, compared with 31.9 percent of birth center and 3.4 percent of hospital births. Vaginal births after cesarean (VBACs) comprised 4.6 percent of planned home births and 1.6 percent of hospital and birth center births. Sociodemographic and medical risk status of out‐of‐hospital births improved substantially from 2004 to 2014.ConclusionsImprovements in risk status of out‐of‐hospital births from 2004 to 2014 suggest that appropriate selection of low‐risk women is improving. High rates of self‐pay for the costs of out‐of‐hospital birth suggest serious gaps in insurance coverage, whereas higher‐than‐average rates of VBAC could reflect lack of access to hospital VBACs. Mandating private insurance and Medicaid coverage could substantially improve access to out‐of‐hospital births. Improving access to hospital VBACs might reduce the number of out‐of‐hospital VBACs.