bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of Interventions to Decrease Emergency Department Visits by Adult Frequent Users: A Systematic Review
Authors: Moe Jessica , Kirkland Scott W. , Rawe Erin , Ospina Maria B. , Vandermeer Ben , Campbell Sandy , Rowe Brian H. 
Published: January 2017

AbstractObjectivesFrequent emergency department (ED) users are high‐risk and high‐resource‐utilizing patients. This systematic review evaluates effectiveness of interventions targeting adult frequent ED users in reducing visit frequency and improving patient outcomes.MethodsAn a priori protocol was published in PROSPERO. Two independent reviewers screened, selected, rated quality, and extracted data. Third‐party adjudication resolved disagreements. Rate ratios of post‐ versus pre‐intervention ED visits were calculated. Data sources were from a comprehensive search that included seven databases and the gray literature. Eligibility criteria for selecting studies included experimental studies assessing the effect of interventions on frequent users’ ED visits and patient‐oriented outcomes.ResultsA total of 6,865 citations were identified and 31 studies included. Designs were noncontrolled (n = 21) and controlled (n = 4) before–after studies and randomized controlled trials (n = 6). Frequent user definitions varied considerably and risk of bias was moderate to high. Studies examined general frequent users or those with psychiatric comorbidities, chronic disease, or low socioeconomic status or the elderly. Interventions included case management (n = 18), care plans (n = 8), diversion strategies (n = 3), printout case notes (n = 1), and social work visits (n = 1). Post‐ versus pre‐intervention rate ratios were calculated for 25 studies and indicated a significant visit decrease in 21 (84%) of these studies. The median rate ratio was 0.63 (interquartile range = 0.41 to 0.71), indicating that the general effect of the interventions described was to decrease ED visits post‐intervention. Significant visit decreases were found for a majority of studies in subgroup analyses based on 6‐ or 12‐month follow‐up, definition thresholds, clinical frequent user subgroups, and intervention types. Studies reporting homelessness found consistent improvements in stable housing. Overall, interstudy heterogeneity was high.ConclusionsInterventions targeting frequent ED users appear to decrease ED visits and may improve stable housing. Future research should examine cost‐effectiveness and adopt standardized definitions.
Sustaining Screening, Brief Intervention and Referral to Treatment (SBIRT) services in health‐care settings
Authors: Singh Manu , Gmyrek Amanda , Hernandez Amy , Damon Donna , Hayashi Susan 
Published: January 2017

AbstractAimsTo assess the sustainability of Screening, Brief Intervention and Referral to Treatment (SBIRT) services after cessation of initial start‐up funding.DesignDescriptive study with quantitative and qualitative data collected from 34 staff participants from six grantees (comprising 103 sites) funded previously through a large, federally supported SBIRT program.SettingPrimary care out‐patient clinics and hospitals in the United States.ParticipantsThirty‐four grantee‐related staff members, including administrators, evaluators, key stakeholders and SBIRT service providers from six grantees.MeasurementsChanges to levels and types of service delivery activities after federal funding stopped, alternative sources of funding and obstacles to delivery of services.FindingsOf the 103 original sites in the six SBIRT grantee programs, 69 sites continued providing services in some capacity (same as before, reduced, modified or expanded). Most of the 69 sites (67%) adapted and redesigned the delivery of SBIRT services post‐initial grant funding. In addition, new sites were added after grant funding ended, bringing the total number of sites to 88. Analysis of participant responses identified four primary factors that influenced SBIRT sustainability: presence of champions, funding availability, systemic change and SBIRT practitioner characteristics.ConclusionsAlmost 70% of the Screening, Brief Intervention and Referral to Treatment (SBIRT) services in the United States funded initially through a federal program were able to sustain operations after federal funding ceased and some expanded SBIRT services beyond the original sites. The key factors related to sustainability were securing new funding, having champions, adapting and making system changes and managing program staffing challenges.
Screening, Brief Intervention and Referral to Treatment (SBIRT): rationale, program overview and cross‐site evaluation
Authors: Bray Jeremy W. , Del Boca Frances K. , McRee Bonnie G. , Hayashi Susan W. , Babor Thomas F. 
Published: January 2017

AbstractAimsSince 2003, the US Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (SAMHSA, CSAT) has awarded 32 Screening, Brief Intervention and Referral to Treatment (SBIRT) grants to states, territories and tribal organizations to enhance services for persons with, or at risk for, substance use disorders. The grants supported an expansion of the continuum of care to include screening, brief intervention, brief treatment and referral to treatment in general medical and community settings. This paper describes the SAMHSA SBIRT program in the context of the scientific research that motivated its development, as well as the two cross‐site evaluations that are the subject of subsequent papers in this Supplement.MethodsA narrative review of research evidence pertaining to SBIRT and of the cross‐site evaluation design that made it possible to determine whether the SAMHSA SBIRT grant program achieved its intended aims. The 11 programs within the two cohorts of grant recipients that were the subject of the cross‐site evaluations are described in terms of SBIRT service components, performance sites, providers, management structure/activities and patient/client characteristics.ConclusionThe US SAMHSA SBIRT program is an effective way to introduce a variety of new services that extend the continuum of care for substance‐involved individuals, ranging from early intervention with non‐dependent substance users to referral of more serious cases to specialized substance abuse treatment.
Association analysis of KIT, MITF, and PAX3 variants with white markings in Spanish horses
Authors: Negro S. , Imsland F. , Valera M. , Molina A. , Solé M. , Andersson L. 
Published: January 2017

SummarySeveral variants in the KIT, PAX3 and MITF genes have previously been associated with white markings in horses. In this study, we examined eight variants of these genes in 70 Menorca Purebred horses (PRMe, only black solid‐coloured horses) and 70 Spanish Purebred horses (PRE, different coat colour patterns) that were scored for the extent of white markings. A maximum‐likelihood chi‐square test, logistic regression model and ridge regression analyses showed that a missense mutation (p.Arg682His) in KIT was associated with white facial markings (P < 0.05) and with total white markings (P < 0.05) in PRMe horses. The relative contribution of this variant to white markings in PRMe horses was estimated at 47.6% (head) and 43.4% (total score). In PRE horses, this variant was also associated with hindlimb scores (P < 0.05) with a relative contribution of 41.2%. The g.20147039C>T intronic variant located 29.9 kb downstream from the transcription start site of the MITF gene was associated with less white markings on forelimbs (P < 0.05) in PRMe horses, with a relative contribution of 63.9%, whereas in PRE horses this variant was associated with white facial markings (P < 0.05), with a relative contribution of 63.9%. No significant associations were found for PAX3 variants in these breeds. These results show that KIT and MITF variants are involved in the white marking patterns of both PRMe and PRE horses, providing breeders with an opportunity to use genetic testing to aid in breeding for their desired level of white markings.
Robot‐assisted retinal vein cannulation in an in vivo porcine retinal vein occlusion model
Authors: Willekens Koen , Gijbels Andy , Schoevaerdts Laurent , Esteveny Laure , Janssens Tom , Jonckx Bart , Feyen Jean H. M. , Meers Caroline , Reynaerts Dominiek , Vander Poorten Emmanuel , Stalmans Peter 
Published: January 2017

AbstractPurposeTo evaluate the feasibility of robot‐assisted retinal vein cannulation for retinal vein occlusion.MethodsProspective experimental study performed in in vivo porcine eyes. A standard three port pars plana vitrectomy was followed by laser‐induced branch retinal vein occlusion. Consequently, a retinal vein cannulation with the help of a surgical robot and a microneedle was performed. Complete success was defined as a stable intravenous position of the needle tip confirmed by blood washout for at least 3 min. Secondary outcomes were the occurrence of intra‐operative complications and technical failures.ResultsCannulation was successful in 15 of 18 eyes with a complete success rate (duration of infusion of more than 3 min) of 73% after exclusion of two eyes from analysis due to failure in establishing a blood clot. There were no technical failures regarding the robotic device. The intravessel injections of ocriplasmin in two of two eyes led to a clot dissolution. In a subset of five eyes, a second cannulation attempt at the border of the optic disc resulted in a stable intravessel position and infusion during 362 (±138) seconds.ConclusionRobot‐assisted retinal vein cannulation with prolonged infusion time is technically feasible. Human experiments are required to analyse the clinical benefit of this new therapy.
Family‐oriented services in pediatric rehabilitation: a scoping review and framework to promote parent and family wellness
Authors: King G. , Williams L. , Hahn Goldberg S. 
Published: January 2017

AbstractFamily‐oriented services are not as common as one would expect, given the widespread endorsement of family‐centred care, the role of parents in supporting optimal child outcomes, and legislation and literature indicating that parent outcomes are important in their own right. There are no published service delivery frameworks describing the scope of services that could be delivered to promote parent and family wellness. A scoping review was conducted to identify types of family‐oriented services for parents of children with physical disabilities and/or intellectual impairments. This information was then synthesized into a conceptual framework of services to inform service selection and design. A scoping review of the recent literature was performed to capture descriptions of services targeting parents/families of children with physical disabilities and/or intellectual impairments, published in a six‐year period (2009 to 2014). Six databases were searched and 557 retrieved articles were screened using inclusion and exclusion criteria. Thirty six relevant articles were identified. Based on descriptions of services in these articles, along with seminal articles describing the nature of desirable services, we propose a needs‐based and capacity‐enhancing framework outlining a continuum of family‐oriented services for parents of children with disabilities. The framework includes six types of services to meet parent/family needs, organized as a continuum from fundamental information/education services, to those supporting parents to deliver services to meet their child's needs, to a variety of services addressing parents' own needs (support groups, psychosocial services and service coordination). The framework provides pediatric rehabilitation service organizations with a way to consider different possible family‐oriented services. Implications include the particular importance of providing information resources, support groups and psychosocial services to meet parents' needs, enhance capacity and promote family wellness. There is also an opportunity to provide composite parent–child services to address the needs of both parents and children.
A pathway‐based association study reveals variants from Wnt signalling genes contributing to asthma susceptibility
Authors: Barreto‐Luis A. , Corrales A. , Acosta‐Herrera M. , Gonzalez‐Colino C. , Cumplido J. , Martinez‐Tadeo J. , Carracedo A. , Villar J. , Carrillo T. , Pino‐Yanes M. , Flores C. 
Published: January 2017

SummaryBackgroundGenetic susceptibility to asthma is currently linked to a handful of genes which have a limited ability to predict the overall disease risk, suggesting the existence of many other genes involved in disease development. Accumulated evidence from association studies in genes related by biological pathways could reveal novel asthma genes.ObjectiveTo reveal novel asthma susceptibility genes by means of a pathway‐based association study.MethodsBased on summary data from a previous a genomewide association study (GWAS) of asthma, we first identified significant biological pathways using a gene‐set enrichment analysis. We then mapped all tested single nucleotide polymorphisms (SNPs) on the genes contributing to significant pathways and prioritized those with a disproportionate number of nominal significant associations for further studies. For those prioritized genes, association studies were performed for selected SNPs in independent case–control samples (n = 1765) using logistic regression models, and results were meta‐analysed with those from the GWAS.ResultsTwo biological processes were significantly enriched: the cytokine–cytokine receptor interaction (P = 0.002) and the Wnt signalling (P = 0.012). From the 417 genes interacting in these two pathways, 10 showed an excess of nominal associations, including a known asthma susceptibility locus (encoding SMAD family member 3) and other novel candidate genes. From the latter, association studies of 14 selected SNPs evidenced replication in a locus near the frizzled class receptor 6 (FZD6) gene (P = 9.90 × 10−4), which had a consistent direction of effects with the GWAS findings (meta‐analysed odds ratio = 1.49; P = 5.87 × 10−6) and was in high linkage disequilibrium with expression quantitative trait loci in lung tissues.Conclusions and Clinical RelevanceThis study revealed the importance of two biological pathways in asthma pathogenesis and identified a novel susceptibility locus near Wnt signalling genes.
Müller cells and retinal axons can be primary targets in experimental neuromyelitis optica spectrum disorder
Authors: Zeka Bleranda , Lassmann Hans , Bradl Monika 
Published: January 2017

AbstractRecent work from our laboratory, using different models of experimental neuromyelitis optica spectrum disorder (NMOSD), has led to a number of observations that might be highly relevant for NMOSD patients. For example: (i) in the presence of neuromyelitis optica immunoglobulin G, astrocyte‐destructive lesions can be initiated by CD4+ T cells when these cells recognize aquaporin 4 (AQP4), but also when they recognize other antigens of the central nervous system. The only important prerequisite is that the T cells have to be activated within the central nervous system by “their” specific antigen. Recently activated CD4+ T cells with yet unknown antigen specificity are also found in human NMOSD lesions. (ii) The normal immune repertoire might contain AQP4‐specific T cells, which are highly encephalitogenic on activation. (iii) The retina might be a primary target of AQP4‐specific T cells and neuromyelitis optica immunoglobulin G: AQP4‐specific T cells alone are sufficient to cause retinitis with low‐grade axonal pathology in the retinal nerve fiber/ganglionic cell layer. A thinning of these layers is also observed in NMOSD patients, where it is thought to be a consequence of optic neuritis. Neuromyelitis optica immunoglobulin G might target cellular processes of Müller cells and cause their loss of AQP4 reactivity, when AQP4‐specific T cells open the blood–retina barrier in the outer plexiform layer. Patchy loss of AQP4 reactivity on Müller cells of NMOSD patients has been recently described. Cumulatively, our findings in experimental NMOSD suggest that both CD4+ T cell and antibody responses directed against AQP4 might play an important role in the pathogenesis of tissue destruction seen in NMOSD.
Clinical characteristics of autoimmune optic neuritis
Authors: Kawachi Izumi 
Published: January 2017

AbstractAutoimmune disorders of the central nervous system often involve autoimmune inflammation of the anterior visual pathways. Autoimmune optic neuritis can be categorized as: (i) isolated optic neuritis; (ii) relapsing isolated optic neuritis: (iii) chronic relapsing inflammatory optic neuropathy; (iv) neuromyelitis optica spectrum disorders‐associated optic neuritis; or (v) multiple sclerosis‐associated optic neuritis. Studies of serum‐specific autoantibodies, such as aquaporin‐4 and myelin oligodendrocyte glycoprotein, have revealed some underlying mechanisms of autoimmune optic neuritis. However, the etiology and pathogenesis of most cases of autoimmune optic neuritis remain unclear. The following clinical features of autoimmune optic neuritis are profoundly affected by the unique structure of the human anterior visual pathways: (i) vulnerability to swelling of the intracanalicular optic nerve as a result of the limited space within the bony canal; (ii) inflammatory cell infiltration through the subarachnoid space, pia and pial septa; (iii) compartmentalized dynamics of cerebrospinal fluid as a result of the cul‐de‐sac anatomy of the optic nerve; (iv) permeability of the prelaminar optic nerve head as a result of the lack of classical blood–brain barrier characteristics; and (v) retinal abnormalities, which are a diagnostic window of neurodegenerative processes of the optic nerves and/or brain. Future studies are required to configure a systemic nosology for optic neuritis with international consensus, elucidate specific diagnostic biomarkers, carry out clinical trials of the acute and chronic phases of the disease etiologies, and elucidate possible neuroprotective and remyelinating treatments.
Importance of pulmonary artery to ascending aorta ratio in chronic obstructive pulmonary disease
Authors: Iliaz Sinem , Tanriverdio Elif , Chousein Efsun Gonca Ugur , Ozturk Sakine , Iliaz Raim , Cetinkaya Erdogan , Caglar Emel 
Published: January 2017

AbstractIntroductionRecent articles revealed that an increased main pulmonary artery to ascending aorta ratio (PA/A) in thorax computed tomography (CT) correlated with pulmonary hypertension, and might be linked to a high probability of chronic obstructive pulmonary disease (COPD) exacerbations.ObjectivesIn this study, our aim was to evaluate the clinical importance of PA/A in patients with exacerbations of COPD and investigate its relationship with the number of exacerbations in 1 year or short/long‐term mortality after hospital discharge.MethodsOne hundred fifty‐six patients hospitalized for COPD exacerbations who fulfilled our inclusion criteria were enrolled in the study. We recorded the number of exacerbations in 1 year from hospital records, checked mortality status, and calculated the PA/A ratio from thorax CT images.ResultsPA/A ratio positively correlated with the number of hospitalizations for COPD exacerbations and the total number of exacerbations (hospitalized or not) in 1 year, and baseline PaCO2 level during hospitalization (r = 0.376, P < 0.001, r = 0.230, P = 0.004, and r = 0.328, P < 0.001, respectively). There was no relationship between mortality and PA/A.ConclusionOur study showed that PA/A was related with the number of hospitalizations and the total number of exacerbations due to COPD in 1 year. However, there was no relationship between PA/A and mortality.
Comparison of Bank Profitability in China and the USA
Authors: Ding Ning , Fung Hung‐Gay , Jia Jingyi 
Published: January 2017

AbstractThis paper examines and compares the profitability of banks in the USA and China. The USA has the largest market‐based banking system and the financial system of China is still bank‐based. Our analysis indicates that in terms of profitability, banks in China outperformed those in the USA during our study period (2008–2014). Real estate loans had an adverse effect on US bank profitability during the financial crisis and no effect after the crisis but consistently improved the profitability of Chinese banks. Interest margins have no effect on US bank profitability but a consistently positive effect on Chinese banks, confirming that China is a traditional bank‐based economy. Interbank loans have a positive and significant effect on Chinese bank profitability, while interbank domestic loans have a negative effect on US bank profitability. Finally, size had a positive effect on US banks after the financial crisis period, confirming the scale economies of large US banks, but a negative effect on Chinese banks, indicating diseconomies of scale.
Health Financing Systems, Health Equity and Universal Health Coverage in Arab Countries
Authors: Alami Randa 
Published: January 2017

ABSTRACTThis article provides an overview of health financing structures in Arab countries in the context of their preparedness for universal health coverage. Current arrangements have left large swathes of the population shouldering high financial burdens and facing hardships when using healthcare, with significant impoverishing and deterrent effects. Health protection schemes are most comprehensive for those who can afford healthcare; they are mainly based on contributions and formal employment and thus fail to cater for the poor and the rural and informal sectors. Financing systems also lack the operational bases and institutional prerequisites for effective resource pooling and risk sharing, with segmentation and fragmentation worsening horizontal and vertical inequities. The neglect of public health systems has reinforced inequities by widening the gap between needs and provision, and by emphasizing the ability to pay as a basis for accessing quality care. In a context of informality and poverty, focusing reforms on health insurance is not a panacea. Rather, moving towards universal health coverage and reducing health inequities will require changes in the level of political tolerance for social injustice, and a paradigm shift to a more equity‐based political economy which views health as an investment and an entitlement.
The patient‐worker: A model for human research subjects and gestational surrogates
Authors: Ryman Emma , Fulfer Katy 
Published: January 2017

AbstractWe propose the ‘patient‐worker’ as a theoretical construct that responds to moral problems that arise with the globalization of healthcare and medical research. The patient‐worker model recognizes that some participants in global medical industries are workers and are owed worker's rights. Further, these participants are patient‐like insofar as they are beneficiaries of fiduciary relationships with healthcare professionals. We apply the patient‐worker model to human subjects research and commercial gestational surrogacy. In human subjects research, subjects are usually characterized as either patients or as workers. Through questioning this dichotomy, we argue that some subject populations fit into both categories. With respect to commercial surrogacy, we enrich feminist discussions of embodied labor by describing how surrogates are beneficiaries of fiduciary obligations. They are not just workers, but patient‐workers. Through these applications, the patient‐worker model offers a helpful normative framework for exploring what globalized medical industries owe to the individuals who bear the bodily burdens of medical innovation.