bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondhand smoke risk perception and smoke-free rules in homes: a cross-sectional study in Barcelona (Spain)
Authors: Lidón-Moyano Cristina , Martínez-Sánchez Jose M , Fu Marcela , Ballbè Montse , Martín-Sánchez Juan Carlos , Martínez Cristina , Fernández Esteve 
Published: January 2017

ObjectiveTo describe the voluntary adoption of smoke-free homes in Spain among general population and to identify variables associated with its voluntary adoption.MethodsCross-sectional study of a representative sample (n=731) of the adult population (>26 years) of Barcelona, Spain, in 2013–2014. We defined smoking rules inside the households as complete indoor rules (when smoking was not allowed inside the house), and partial or absent indoor rules (when smoking was allowed in some designated places inside the house or when smoking was allowed everywhere) and described them according to the perceived risk of the secondhand smoke (SHS) exposure. We calculated the prevalence and prevalence ratios (PR) according to sociodemographic variables.Results57.4% of households had complete indoor smoke-free rules. The prevalence of households with complete indoor rules was higher among women (PRa: 1.15; 95% CI 1.00 to 1.33), married (PRa: 1.18; 95% CI 1.01 to 1.38), never-smokers (PRa: 2.68; 95% CI 2.06 to 3.50) and in households where a minor lived (PRa: 1.40; 95% CI: 1.20–1.65). Believe that breathing tobacco smoke from smokers is dangerous for non-smokers (PRa: 1.77; 95% CI: 1.06–2.97) is associated with the voluntary adoption of complete indoor smoke-free home.ConclusionsRisk perceptions of SHS exposure were associated with the voluntary adoption of indoor smoke-free homes.
Ultrasound detects subclinical joint inflammation in the hands and wrists of patients with systemic lupus erythematosus without musculoskeletal symptoms
Authors: Ruano Carina A , Malheiro Rui , Oliveira João F , Pinheiro Sofia , Vieira Luís S , Moraes-Fontes Maria Francisca 
Published: January 2017

ObjectivesTo assess the prevalence and severity of ultrasonographic abnormalities of the hand and wrist of asymptomatic patients with systemic lupus erythematosus (SLE) and compare these findings with those from patients with SLE with musculoskeletal signs or symptoms and healthy controls.MethodsWe conducted a prospective cross-sectional study that evaluated bilaterally, with grey-scale and power Doppler (PD) ultrasound (US), the dorsal hand (2nd to 5th metacarpophalangeal and 2nd to 5th proximal interphalangeal joints) and wrist (radiocarpal, ulnocarpal and intercarpal joints) of 30 asymptomatic patients with SLE, 6 symptomatic patients with SLE and 10 controls. Synovial hypertrophy (SH) and intra-articular PD signal were scored using semiquantitative grading scales (0–3). Individual scores were graded as normal (SH≤1 and PD=0) or abnormal (SH≥2 or PD≥1). Global indexes for SH and PD were also calculated. US findings were correlated with clinical and laboratory data and disease activity indexes.ResultsUS detected SH (score ≥1) in 77% asymptomatic patients with SLE, mostly graded as minimal (score 1: 63%). 23% of the asymptomatic patients with SLE showed abnormal US PD findings (SH≥2 or PD≥1). SH was present in all symptomatic patients with SLE, mostly graded as moderate (grade 2: 67%), and with associated PD signal (83%). SH (score 1) was identified in 50% of controls, however, none presented abnormal US PD findings. SH index in the asymptomatic SLE group was higher than in the control group (2.0 (0–5) vs 0.5 (0–2), median (range), p=0.01) and lower than in the symptomatic SLE group (7.0 (4–23), median (range), p<0.001). No significant correlation was demonstrated between US PD findings and clinical or laboratory variables and disease activity indexes.ConclusionA small subgroup of asymptomatic patients with SLE may present subclinical joint inflammation. Global US scores and PD signal may be important in disease evaluation and therapeutic monitoring.
Reducing unnecessary testing: an intervention to improve resident ordering practices
Authors: Melendez-Rosado Jose , Thompson Kristine M , Cowdell Jed C , Sanchez Alvarez Catalina , Ung Ryan L , Villanueva Armando , Jeffers Kayin B , Imam Jaafer S , Mitkov Mario V , Kaleem Tasneem A , Jacob Lewis , Dawson Nancy L 
Published: January 2017

ABSTRACTPurpose of the studyTo reduce the number of unnecessary laboratory tests ordered through a measurement of effects of education and cost awareness on laboratory ordering behaviour by internal medicine residents for common tests, including complete blood cell count (CBC) and renal profile (RP), and to evaluate effects of cost awareness on hospitalisation, 30-day readmission rate and mortality rate.Study design567 patients admitted during February, March and April 2014 were reviewed as the control group. Total CBC, CBC with differential and RP tests were counted, along with readmission and mortality rates. Interventions were education and visual cost reminders. The same tests were reassessed for 629 patients treated during 12 months after intervention in 2015.ResultsData showed a significant increase in CBCs ordered after the intervention (mean number per hospitalisation changed from 1.7 to 2.3 (p&lt;0.001)), a decrease in CBCs with differential (mean number changed from 1.7 to 1.2 (p&lt;0.001)) and no change in RPs ordered (mean number, 3.7 both before and after intervention (p=0.23)). No change was found in mortality rate, but the decrease in the readmission rate was significant (p=0.008).ConclusionsEducation in the form of cost reminders did not significantly reduce the overall ordering of the most common daily laboratory testing in our academic teaching service. We believe further research is needed to fully evaluate the effectiveness of other education forms on the redundant ordering of tests in the hospital setting.
RCAD/BiP pathway is necessary for the proper synthesis of digestive enzymes and secretory function of the exocrine pancreas
Authors: Miller Camille , Cai Yafei , Patton Tadd , Graves Sarai Hacker , Li Honglin , Sabbatini Maria Eugenia 
Published: January 2017

Alcoholism causes an imbalance of endoplasmic reticulum (ER) homeostasis in pancreatic acini. In those cells, the ER is involved in the synthesis and folding of pancreatic enzymes. Ubiquitin-fold modifier 1 (Ufm1) is part of a novel ubiquitin-like modification system involved in maintaining ER homeostasis. Among the components of the Ufm1 system, Regulator of C53 and DDRGK1 (RCAD) has recently been identified as a Ufm1-specific E3 ligase that promotes ufmylation of DDRGK1, an RCAD-interacting protein. We determined the importance of RCAD in the proper synthesis and secretion of pancreatic enzymes using mice with genetically deleted RCAD. The pancreas of RCAD-deficient mice was of normal size and histology. Using quantitative PCR and Western blotting, we found that amylase was upregulated in pancreas organs from RCAD-knockout (KO) mice. Constitutive amylase secretion was much higher in isolated pancreatic acini from RCAD KO mice, whereas CCK-stimulated amylase secretion was disturbed. RCAD deficiency caused a downregulation in expression of ER chaperone BiP, which affected ER homeostasis and activated both apoptosis and trypsin. We also found that both RCAD and DDRGK1 transcript levels were upregulated in pancreatic acini from alcohol-preferring rats. Elevated expression of RCAD and DDRGK1 was associated with increased ER stress and UPR activation. Because of the lack of BiP expression, caspase 3 and trypsin activation we enhanced in RCAD-deficient pancreatic acini upon treatment with ethanol and CCK. In conclusion, the RCAD/BiP pathway is required for proper synthesis and secretion of pancreatic enzymes. In alcoholism, increased levels of components of the Ufm1 system could prevent the deleterious effects of alcohol in the pancreas by regulating BiP levels.NEW & NOTEWORTHY RCAD/BiP pathway is required for the proper synthesis and secretion of amylase from pancreatic acini, as well as for the maintenance of the ER homeostasis. In alcoholism, the exocrine pancreas could increase the levels of components of the Ufm1 system to protect itself from alcohol's deleterious effects by regulating the expression of ER chaperone BiP.
Prothrombin Loading of Vascular Smooth Muscle Cell–Derived Exosomes Regulates Coagulation and Calcification
Authors: Kapustin Alexander N. , Schoppet Michael , Schurgers Leon J. , Reynolds Joanne L. , McNair Rosamund , Heiss Alexander , Jahnen-Dechent Willi , Hackeng Tilman M. , Schlieper Georg , Harrison Paul , Shanahan Catherine M. 
Published: January 2017

Objective—
The drug warfarin blocks carboxylation of vitamin K–dependent proteins and acts as an anticoagulant and an accelerant of vascular calcification. The calcification inhibitor MGP (matrix Gla [carboxyglutamic acid] protein), produced by vascular smooth muscle cells (VSMCs), is a key target of warfarin action in promoting calcification; however, it remains unclear whether proteins in the coagulation cascade also play a role in calcification.

Approach and Results—
Vascular calcification is initiated by exosomes, and proteomic analysis revealed that VSMC exosomes are loaded with Gla-containing coagulation factors: IX and X, PT (prothrombin), and proteins C and S. Tracing of Alexa488-labeled PT showed that exosome loading occurs by direct binding to externalized phosphatidylserine (PS) on the exosomal surface and by endocytosis and recycling via late endosomes/multivesicular bodies. Notably, the PT Gla domain and a synthetic Gla domain peptide inhibited exosome-mediated VSMC calcification by preventing nucleation site formation on the exosomal surface. PT was deposited in the calcified vasculature, and there was a negative correlation between vascular calcification and the levels of circulating PT. In addition, we found that VSMC exosomes induced thrombogenesis in a tissue factor–dependent and PS-dependent manner.

Conclusions—
Gamma-carboxylated coagulation proteins are potent inhibitors of vascular calcification suggesting warfarin action on these factors also contributes to accelerated calcification in patients receiving this drug. VSMC exosomes link calcification and coagulation acting as novel activators of the extrinsic coagulation pathway and inducers of calcification in the absence of Gla-containing inhibitors.
Trends in Recruitment Rates for Acute Stroke Trials, 1990–2014
Authors: Feldman William B. , Kim Anthony S. , Chiong Winston 
Published: January 2017

Background and Purpose—
Slow recruitment in acute stroke trials hampers the evaluation of new therapies and delays the adoption of effective therapies into clinical practice. This systematic review evaluates whether recruitment efficiency and rates have increased in acute stroke trials from 1990 to 2014.

Methods—
Acute stroke trials from 2010 to 2014 were identified by a search of PubMed, Medline, the Cochrane Database of Research in Stroke, and the Stroke Trials Registry. These trials were compared to a previously published data set of trials conducted from 1990 to 2004.

Results—

The median recruitment efficiency of trials from 1990 to 2004 was 0.41 participants/site/month compared with 0.26 participants/site/month from 2010 to 2014 (
P
=0.14). The median recruitment rate of trials from 1990 to 2004 was 26.8 participants/month compared with 19.0 participants/month from 2010 to 2014 (
P
=0.13).

Conclusions—
For acute stroke trials, neither recruitment efficiency nor recruitment rates have increased over the past 25 years and, if anything, have declined.
An Experimental Investigation of the Interaction between Problem Load and Level of Training
Authors: Behan Richard A. , Bughman Charles R. , Bumpus James N. , Gilbert Sally 
Published: January 2017

An experiment was made to determine the relation between performance in a linear information processing system, level of training and the input load on the system. Level of training was determined by number of problem experiences. Load was defined as the number of task units to be processed. The task was to detect, display, transform, re-display and correlate data concerning the temporal position and direction of sequences displayed on a rectangular grid. Two noise dots were included with each display presentation. Experimental variables were presented in a mixed factorial design. Experimental problems had a constant number of sequences to be processed after a short build-up period. The sequences in any one problem appeared at regular intervals and all bad the same time duration. Four experimental problems presented 2, 4, 8 or 12 sequences to the subjects. Analysis of total error indicated that performance is a linear function of load, and that an interaction between total error and system position resulted in no significant reduction in error as a function of training.
Incremental Transfer Effectiveness of a Ground-Based General Aviation Trainer
Authors: Povenmire H. Kingsley , Roscoe Stanley N. 
Published: January 2017

Link trainers and similar synthetic flight-training devices have been used with varying effectiveness since before World War II. Currently available ground-based flight trainers differ widely in their degree and fidelity of simulation and in their associated costs. To provide a rational basis for trainer procurement, a method of assessing their cost effectiveness is needed. An experiment was conducted to establish the incremental transfer effectiveness of a representative ground-based general aviation trainer to serve as a basis for the evaluation of its incremental cost effectiveness. Four groups of student pilots were given, respectively, 0, 3, 7, and 11 hours of instruction in the Link GAT-1 concurrently with flight instruction in the Piper Cherokee airplane. Average flight times for the four groups to reach the private pilot criterion reflected the postulated negatively decelerated nature of the incremental transfer effectiveness function.
Mathematical Concepts for Modeling Human Behavior in Complex Man-Machine Systems
Authors: JOHANNSEN GUNNAR , ROUSE WILLIAM B. 
Published: January 2017

Many useful mathematical models for manual control, monitoring, and decision-making tasks in man-machine systems have been designed and successfully applied. However, critical comments have occasionally been made, mainly by practitioners concerned with the design of complex man-machine systems. They especially blame models which seem to explain only data from abstract subtask experiments designed particularly for these models. In this review paper, an initial approach to bridging the gap between these two perspectives of models is presented. From the manifold of possible human tasks, a very popular baseline scenario has been chosen, namely car driving. A hierarchy of human activities is derived by analyzing this task in general terms. A structural description leads to a block diagram and a timesharing computer analogy. The range of applicability of existing mathematical models is considered with respect to the hierarchy of human activities in real complex tasks. Also, other mathematical tools so far not often applied to man-machine systems are discussed. The mathematical descriptions at least briefly considered here include utility, estimation, control, queueing, and fuzzy set theory as well as artificial intelligence techniques. Some thoughts are given as to how these methods might be integrated and how further work might be pursued.
Genital Injury: Is it Significant? A Review of the Literature
Authors: Lincoln Cathy 
Published: January 2017

The purpose of this review was to critically evaluate the available literature on genital injury in order to facilitate an understanding of its significance in relation to sexual offence trials. Wide variation exists in research objectives, study populations and methodology, hindering interpretation considerably. The most valuable research in this field identifies the range of normal genital findings and those associated with consensual sexual intercourse, to enable interpretation of genital findings in sexual assault victims. However, there are, unfortunately, few studies of this nature. Difficulties arise when examining doctors are not experienced in the genital examination of those other than sexual assault victims, limiting their ability to draw conclusions about genital injury if it is detected. If the methods of genital examination employed are not the same as those used to examine a wide range of non-sexual assault victims, comparison and thus valuable interpretation is further limited. This review of the literature finds that the most appropriate genital examinations and indeed the most legally valuable as far as interpretation is concerned, are done macroscopically by doctors with considerable experience in the examination of normal, diseased and traumatized genitalia, and a sound knowledge of the principles of injury interpretation. A deficiency exists in the literature in relation to macroscopic genital examination findings in consensually sexually active women who have been examined by forensically trained doctors. This deficiency must be addressed before the medicolegal significance of genital injury relating to sexual assault can be accurately interpreted, and before any decision is made to incorporate colposcopy or staining techniques into the routine assessment of sexual assault victims.
The Youth Justice and Criminal Evidence Act 1999: Achieving Best Evidence?
Authors: Macpherson Camilla 
Published: January 2017

The Youth Justice and Criminal Evidence Act 1999 (YJCEA) aims to help vulnerable and intimidated witnesses give the best evidence they can in criminal proceedings. This is to be achieved by allowing certain witnesses access to a range of special measures where it is felt that their evidence will thereby be improved. Reducing the stress associated with a court case will, it is hoped, mean that vulnerable witnesses are more confident and give better testimony. In addition, individuals who in the past would have been unable to participate in proceedings and were therefore considered incompetent to give evidence will now have a voice. The reasoning behind the YJCEA is clear. In cases of abuse in particular, the prosecution case is often based almost entirely on the evidence of one witness, often a child. It is important that what evidence there is in such situations is presented as well as possible. In the past, witnesses and complainants in criminal proceedings have not always been given the help they deserved when giving evidence. Over the years, many measures have been introduced to render the court process less intimidating, deriving mainly from the experiences of the judiciary in both criminal and family proceedings. These include familiarization visits, live-links and the like. The YJCEA will now bring many of these measures under one statutory roof. It is hoped, first, that this will encourage greater consistency in their application and, secondly, that criminal proceedings will be demystified for those that have to go through them. Many believe it is a step that is long overdue. Thus, vulnerable and intimidated witnesses, who might previously have been considered unable to give evidence in criminal proceedings, or at a disadvantage in giving evidence, will have a proper opportunity to do so. Such witnesses include the mentally and physically disabled, those in fear of intimidation such as the complainant of racial or domestic violence, and of course children. Rendering the court process less traumatic for those who have already been traumatized enough and maximizing the numbers of complainants and witnesses who can actually give evidence is commendable. However, the YJCEA also has its problems and as has been pointed out by Di Birch (2000) ‘this is an Act which leaves us in no doubt where our sympathies lie’. The YJCEA is a complex Act that may well have a considerable impact on the way in which criminal proceedings in the UK are handled. I will consider the following areas: interpretation special measures and their application; and areas for concern.
Application of the Petroleum Ether-Methanol Solvent System to the Analysis of Common Barbiturates by Paper Chromatography
Authors: Neil Michael W. , Payton Jean E. 
Published: January 2017

Paper chromatography is an analytical method for the separation of the components of mixtures of substances. A droplet of such a mixture in solution is placed on a small area of a piece of prepared filter paper, and a solvent is allowed to seep slowly through the paper. The compounds are washed along the paper at differing rates and, ideally, the mixture is separated into a series of spots along the paper, each spot consisting of a single component of the mixture. The sort of mixture which can be separated by this technique ranges from writing inks to complex mixtures of drugs extracted from biological materials. This paper describes an improved paper chromatographic technique for separating for identification the intermediate- and short-acting barbiturate hypnotic drugs—butobarbitone ( soneryl), amylobarbitone ( amytal), pentobarbitone ( nembutal) and quinal-barbitone ( Seconal). It is pointed out that 76 per cent. of cases of barbiturate poisoning studied in the Department of Forensic Medicine of the London Hospital Medical College in 1960 involved intermediate- or short-acting barbiturates and that in 20 per cent. of the cases two or more of these occurred together. The necessity of being able to separate and identify these barbiturates is of considerable importance both for medico-legal and statistical reasons.
On the Possible Relationship between Diarrhoea and o-Chlorobenzylidene Malononitrile (CS)
Authors: Ballantyne Bryan , Beswick F. W. 
Published: January 2017

Several species of animal were given single doses of CS, dissolved in polyethylene glycol 300, by stomach tube and their stools subsequently examined for consistency. Wet stool production was seen infrequently, and occurred in both CS-treated animals and controls receiving the solvent alone. In another group of animals given 5 consecutive daily doses of CS by stomach tube, only 4 out of 21 animals had minimal lesions of the gastric mucosa, but there was no evidence of an irritant effect on the intestine. Furthermore, the repeated dosing of animals with CS did not cause detectable lesions in lung, liver, kidney, spleen, pancreas, or adrenal gland. In a series of inhalation experiments, rabbits exposed to thermally-generated CS did not show any evidence of an increase in the amount of material defaecated or its water content. There is no evidence from the experiments reported here that exposure to CS smokes can cause a diarrhoea-like condition; this is discussed.
Paradoxical Undressing Due to Hypothermia in a Child
Authors: Sivaloganathan S. 
Published: January 2017

The phenomenon of people removing their clothes whilst suffering from the effects of extreme cold is well recognized, but the references have been almost anecdotal (Gee, 1974). Victims of hypothermia have been found to have discarded their clothes just before becoming unconscious (Gormsen, 1972; Wedin et al., 1979). In all the cases described in the literature, the victims have always been adults. This paper concerns such a phenomenon occurring in a child.
Deaths in the Bath
Authors: Devos Ch. , Timperman J. , Piette M. 
Published: January 2017

A retrospective survey of fatalities in the bath during the period 1934–83 is presented. The deaths were investigated in the Department of Legal Medicine at the University of Ghent. More than half of the deaths were caused by carbon monoxide intoxication (52 per cent). The remaining deaths were due to suicide (20 per cent), natural causes, e.g. epilepsy or cardiac arrest (8.5 per cent) or to accidental drowning, e.g. unattended infants (8.5 per cent). We found two cases of homicide; one being the murder of a child, the other a case of manual strangulation, the body having subsequently been placed in the bath. In one unusual case the autopsy was not performed until after the body had been buried for eight months. Although murder was suspected, neither the autopsy nor toxicological findings revealed the exact cause of death.