bluuebunny/crossref_metadata_2025_split huggingface dataset:
Durability of Hearing Preservation after Cochlear Implantation with Conventional‐Length Electrodes and Scala Tympani Insertion
Authors: Sweeney Alex D. , Hunter Jacob B. , Carlson Matthew L. , Rivas Alejandro , Bennett Marc L. , Gifford Rene H. , Noble Jack H. , Haynes David S. , Labadie Robert F. , Wanna George B. 
Published: February 2016

ObjectivesTo analyze factors that influence hearing preservation over time in cochlear implant recipients with conventional‐length electrode arrays located entirely within the scala tympani.Study DesignCase series with planned chart review.SettingSingle tertiary academic referral center.Subjects and MethodsA retrospective review was performed to analyze a subgroup of cochlear implant recipients with residual acoustic hearing. Patients were included in the study only if their electrode arrays remained fully in the scala tympani after insertion and serviceable acoustic hearing (≤80 dB at 250 Hz) was preserved. Electrode array location was verified through a validated radiographic assessment tool. Patients with <6 months of audiologic follow‐up were excluded. The main outcome measure was change in acoustic hearing thresholds from implant activation to the last available follow‐up.ResultsA total of 16 cases met inclusion criteria (median age, 70.6 years; range, 29.4‐82.2; 50% female). The average follow‐up was 18.0 months (median, 16.1; range, 6.2‐36.4). Patients with a lateral wall electrode array were more likely to have stable acoustic thresholds over time (P <. 05). Positive correlations were seen between continued hearing loss following activation and larger initial postoperative acoustic threshold shifts, though statistical significance was not achieved. Age, sex, and noise exposure had no significant influence on continued hearing preservation over time.ConclusionsTo control for hearing loss associated with interscalar excursion during cochlear implantation, the present study evaluated patients only with conventional electrode arrays located entirely within the scala tympani. In this group, the style of electrode array may influence residual hearing preservation over time.
The E point: a new echographic great saphenous identification sign in specific anatomical variants and applications
Authors: Ricci Stefano , Moro Leo , Ferrini Alessandro , Rossi Bartoli Isaura , Antonelli Incalzi Raffaele 
Published: February 2016

Objective To describe a new ultrasound marker of the Great Saphenous Vein at the groin. Method An ultrasound marker of the Great Saphenous Vein was identified as follows: the Great Saphenous Vein was tracked in cross-sectionally starting from the Sapheno Femoral Junction and optimally visualized where it crosses the Adductor Longus muscle, i.e., 3–5 cm below the junction. This marker, corresponding to a very superficial position of Great Saphenous Vein, was named “E Point,” where E means easy to find. The search for the E point was performed on 230 limbs of 126 subjects with or without chronic venous insufficiency (training population) and the method was validated in 58 subjects (testing population). Results The E point was successfully recorded in 128/144 (89%) pathologic and in 85/86 (99%) healthy limbs. Being free from other structures, at the E point the Great Saphenous Vein was always easily calibrated. In 17 cases, the E point could not be identified due to an hypoplasic Great Saphenous Vein; in such instances, the Anterior Accessory Saphenous Vein was well evident and substituted for the Great Saphenous Vein as the main draining vein at the groin. Conclusion The E point identifies the Great Saphenous Vein in healthy and varicose patients. Failure to identify the E point indicates Anterior Accessory Saphenous Vein dominance over a hypoplasic Great Saphenous Vein.
Nurses’ care practices at the end of life in intensive care units in Bahrain
Authors: O’Neill Catherine S , Yaqoob Maryam , Faraj Sumaya , O’Neill Carla L 
Published: February 2016

Background: The process of dying in intensive care units is complex as the technological environment shapes clinical decisions. Decisions at the end of life require the involvement of patient, families and healthcare professionals. The degree of involvement can vary depending on the professional and social culture of the unit. Nurses have an important role to play in caring for dying patients and their families; however, their knowledge is not always sought. Objectives: This study explored nurses’ care practices at the end of life, with the objective of describing and identifying end of life care practices that nurses contribute to, with an emphasis on culture, religious experiences and professional identity. Research Design and context: Grounded theory was used. In all, 10 nurses from intensive care unit in two large hospitals in Bahrain were participated. Ethical Considerations: Approval to carry out the research was given by the Research Ethics Committee of the host institution, and the two hospitals. Findings: A core category, Death Avoidance Talk, was emerged. This was supported by two major categories: (1) order-oriented care and (2) signalling death and care shifting. Discussion: Death talk was avoided by the nurses, doctors and family members. When a decision was made by the medical team that a patient was not to be resuscitated, the nurses took this as a sign that death was imminent. This led to a process of signalling death to family and of shifting care to family members. Conclusion: Despite the avoidance of death talk and nurses’ lack of professional autonomy, they created awareness that death was imminent to family members and ensured that end of life care was given in a culturally sensitive manner and aligned to Islamic values.
Correlates of rehospitalisation in schizophrenia
Authors: Dey Sangeeta , Menkes David B , Obertova Zuzana , Chaudhuri Sreemanti , Mellsop Graham 
Published: February 2016

Objectives: Schizophrenia typically has a fluctuating course; rehospitalisation is common. We studied associations between discharge variables and subsequent two-year rehospitalisation rates. Method: Using a New Zealand national database, we obtained rehospitalisation rates and bed days for 451 patients with schizophrenia discharged from three inpatient facilities between July 2009 and December 2011. Results: Nearly half (44%) of the cohort were rehospitalised within two years. Patients over 50 were less likely [hazard ratio (HR) = 0.58, 95% confidence interval (CI) = 0.35–0.97, p = 0.04] to be rehospitalised. Patients whose index admission included compulsory treatment appeared more likely (HR = 1.3, 95% CI = 0.98–1.71, p = 0.06) to be rehospitalised and spent longer rehospitalised ( p = 0.05). Those whose index admission was three weeks or longer were less likely (HR = 0.53, 95% CI = 0.39–0.72, p = 0.001) to be rehospitalised. Antipsychotic types, routes and dosages were not significantly associated with rehospitalisation rate, except for those prescribed clozapine (HR = 0.61, 95% CI = 0.41–0.89, p = 0.01). Conclusions: Rehospitalisation rates were higher for patients under the age of 50 and those with shorter index admissions; the latter finding requires further study. Other than the beneficial effect of clozapine, the type and route of prescribed antipsychotics did not significantly affect rehospitalisation rates.
Biaxial system using the Benchmark intracranial guide catheter for placement of a Pipeline Embolization Device for intracranial aneurysms
Authors: Patel Apar S , Griessenauer Christoph J , Ogilvy Christopher S , Thomas Ajith J 
Published: February 2016

Background The Benchmark (Penumbra, Alameda, CA) is a novel intracranial guide catheter that provides optimized proximal stability combined with a hyperflexible and atraumatic tip. We assessed the use of a biaxial catheter system consistent with the Benchmark and Marksman microcatheter for placement of a Pipeline embolization device (PED) for intracranial aneurysms. Methods We reviewed consecutive patients with aneurysms undergoing Pipeline embolization for an aneurysm using the biaxial system from April to October 2015 at a major academic institution in the United States. Benchmark performance was measured by the number of 90° turns the catheter could safely cross. Landing and final positions of the Benchmark were recorded. Results A total of 26 procedures were performed in 25 patients (mean age 59.5 ± 10.3 years; male:female = 1:4). In one case (3.8%) the biaxial system had to be substituted for a traditional triaxial system. The Benchmark was able to cross one, two, or three 90° turns in 48%, 40%, and 8% of cases, respectively. There was one (3.8%) thromboembolic event and no arterial dissections. In the period from January 2014 to March 2015 and prior to adopting the biaxial system we encountered three thromboembolic events (6.4%) and one (2.1%) dissection potentially related to the triaxial system in 47 PED procedures. Conclusion Preliminary experience shows that a biaxial system using the Benchmark is a safe and efficacious alternative to the traditional triaxial guide catheter system for placement of PED and may reduce the complexity and duration of the procedure.
Transition From Intravenous to Subcutaneous Insulin in Critically Ill Adults
Authors: Doolin Meagan K. , Walroth Todd A. , Harris Serena A. , Whitten Jessica A. , Fritschle-Hilliard Andrew C. 
Published: February 2016

Background: Glycemic control decreases morbidity and mortality in critically ill patients. However, limited guidance exists regarding the transition from intravenous (IV) to subcutaneous insulin therapy. A validated protocol for transition is necessary since glycemic variability, hyperglycemia, and hypoglycemia adversely impact patient outcomes. Method: The objective was to determine the safest and most effective method to transition critically ill adults from IV to subcutaneous insulin. This single-center, retrospective, observational study included adults admitted to the burn, medical, or surgical/trauma intensive care units from January 1, 2011, to September 30, 2014. A computer-based program provided a reflection of the patient’s total daily IV insulin requirements. This information was then utilized to stratify patients into groups according to their initial dose of subcutaneous insulin as a percentage of the prior 24-hour IV requirements (group stratification: 0-49%, 50-59%, 60-69%, 70-79%, ≥80%). The primary endpoint was the percentage of blood glucose (BG) concentrations within target range (70-150 mg/dL) 48 hours following transition. Results: One hundred patients with 1394 BG concentrations were included. The 50-59% group achieved the highest rate of BG concentrations in goal range (68%) ( P < .001). The 0-49% group, which was the transition method utilized most often, resulted in the lowest rate of goal achievement (46%). Conclusions: This retrospective study suggests critically ill adults may be safely transitioned to 50-59% of their 24-hour IV insulin requirements. A dosing protocol will be implemented to transition to 50-70% subcutaneous insulin. Follow-up data will be reviewed to assess the protocol’s safety and efficacy.
The Effects of Temperature and Relative Humidity on Point-of-Care Glucose Measurements in Hospital Practice in a Tropical Clinical Setting
Authors: Pratumvinit Busadee , Charoenkoop Nattakom , Niwattisaiwong Soamsiri , Kost Gerald J. , Tientadakul Panutsaya 
Published: February 2016

Background: Hospitals in tropical countries experience conditions that exceed manufacturer temperature and humidity limits for point-of-care (POC) glucose reagents. Our goal was to assess the effects of out-of-limits storage temperature, operating temperature, and operating humidity on POC glucose measurement reliability. Methods: Quality control measurements were performed monthly using glucose test strips stored under controlled conditions and in inpatient wards under ambient conditions. Glucose test strips were evaluated in groups organized by operating temperatures of 24-25 (group 1), 28-29 (group 2), and 33-34°C (group 3), and relative humidity (RH) of ≤70 (group A), ~80 (group B), and ~90% (group C). Results: Glucose results for different storage conditions were inconsistent. Measurements at higher operating temperatures had lower values with mean differences of −2.4 ( P < .001) and −36.5 ( P < .001) mg/dL (28-29 vs 24-25°C), and −3.6 ( P < .001) and −37.4 ( P < .001) mg/dL (33-34 vs 24-25°C) for low and high control levels, respectively. Measurements at higher RH had lower values with mean differences of −4.0 ( P < .001) and −13.2 ( P < .001) mg/dL (~80 vs ≤70% RH), and −5.8 ( P < .001) and −16.6 ( P < .001) mg/dL (~90 vs ≤70% RH) for low and high levels, respectively. Conclusions: High temperature and high RH decreased glucose concentrations for the POC oxidase-based system we evaluated. We recommend that individual hospitals perform stress testing, then determine if maximum absolute differences, which represent highest risk for patients, are clinically significant for decision making by using error grid analysis.
Water-adsorption properties of Xiazijie montmorillonite intercalated with polyamine
Authors: Zhang Shifeng , Qiu Zhengsong , Huang Weian 
Published: February 2016

AbstractPolyamine is a novel inhibitor applied to water-based drilling fluids in order to reduce hydration of clays, especiallymontmorillonite (MT). In the present study, thewater-adsorption properties of montmorillonite intercalated with polyamine were characterized by X-ray diffraction (XRD), diffuse reflectance infrared Fourier transform spectroscopy (DRIFT) and adsorption isotherm tests using water, benzene and heptane. According to the XRD, DRIFT and water-adsorption test results, polyamine (PA)- intercalated montmorillonite (PA-MT) adsorbs less water than either K+- or NH+4-intercalated montmorillonite (K-MT, NH4-MT). The surface energy of MT was analysed using the van Oss- Chaudhury-Good (VCG) approach based on thewater, benzene and heptane adsorption results. The surface energy between PA-MTand water was less than that of NH4-MT and K-MT. Compared with K-MT and NH4-MT, the surface energy of the Lewis acid portion of PA-MT underwent a more significant decrease, suggesting that the hydration of unexchanged Na+ did not make a discernible contribution. The experimental water-adsorption data were fitted using Langmuir, Brunauer-Emmett-Teller (BET), and Freundlich adsorption models. The Langmuir adsorption models can be used to fit the data for water adsorption on PA-MTacross the entire p/p0 range. After plotting the experimental data in the linear format of the Freundlichmodel, only one linear region for PA-MTwas observed, indicating a singlewater-adsorption mechanism for PA-MT. When compared with PA in the absence of clay, DRIFT spectroscopy showed that the NH2 bending mode for PA-MT shifted from 1571 cm–1 to 1619.7 cm–1. This suggested an increase in hydrogen bonding (H bonding) between the ammonium group and the interlayer water. Across the entire p/p0 range, water is suggested to have adsorbed onto PA-MT through H-bonding interactions between the ammonium group and the interlayer water.
Computational prediction and experimental validation of novel Hedgehog-responsive enhancers linked to genes of the Hedgehog pathway
Authors: Gurdziel Katherine , Vogt Kyle R. , Schneider Gary , Richards Neil , Gumucio Deborah L. 
Published: February 2016

Abstract
Background
The Hedgehog (Hh) signaling pathway, acting through three homologous transcription factors (GLI1, GLI2, GLI3) in vertebrates, plays multiple roles in embryonic organ development and adult tissue homeostasis. At the level of the genome, GLI factors bind to specific motifs in enhancers, some of which are hundreds of kilobases removed from the gene promoter. These enhancers integrate the Hh signal in a context-specific manner to control the spatiotemporal pattern of target gene expression. Importantly, a number of genes that encode Hh pathway molecules are themselves targets of Hh signaling, allowing pathway regulation by an intricate balance of feed-back activation and inhibition. However, surprisingly few of the critical enhancer elements that control these pathway target genes have been identified despite the fact that such elements are central determinants of Hh signaling activity. Recently, ChIP studies have been carried out in multiple tissue contexts using mouse models carrying FLAG-tagged GLI proteins (GLIFLAG). Using these datasets, we tested whether a meta-analysis of GLI binding sites, coupled with a machine learning approach, could reveal genomic features that could be used to empirically identify Hh-regulated enhancers linked to loci of the Hh signaling pathway.

Results
A meta-analysis of four existing GLIFLAG datasets revealed a library of GLI binding motifs that was substantially more restricted than the potential sites predicted by previous in vitro binding studies. A machine learning method (kmer-SVM) was then applied to these datasets and enriched k-mers were identified that, when applied to the mouse genome, predicted as many as 37,000 potential Hh enhancers. For functional analysis, we selected nine regions which were annotated to putative Hh pathway molecules and found that seven exhibited GLI-dependent activity, indicating that they are directly regulated by Hh signaling (78 % success rate).

Conclusions
The results suggest that Hh enhancer regions share common sequence features. The kmer-SVM machine learning approach identifies those features and can successfully predict functional Hh regulatory regions in genomic DNA surrounding Hh pathway molecules and likely, other Hh targets. Additionally, the library of enriched GLI binding motifs that we have identified may allow improved identification of functional GLI binding sites.
An ethnobotanical analysis of parasitic plants (Parijibi) in the Nepal Himalaya
Authors: O’Neill Alexander Robert , Rana Santosh Kumar 
Published: February 2016

Abstract
Background
Indigenous biocultural knowledge is a vital part of Nepalese environmental management strategies; however, much of it may soon be lost given Nepal’s rapidly changing socio-ecological climate. This is particularly true for knowledge surrounding parasitic and mycoheterotrophic plant species, which are well represented throughout the Central-Eastern Himalayas but lack a collated record. Our study addresses this disparity by analyzing parasitic and mycoheterotrophic plant species diversity in Nepal as well as the ethnobotanical knowledge that surrounds them.

Methods
Botanical texts, online databases, and herbarium records were reviewed to create an authoritative compendium of parasitic and mycoheterotrophic plant species native or naturalized to the Nepal Central-Eastern Himalaya. Semi-structured interviews were then conducted with 141 informants to better understand the biocultural context of these species, emphasizing ethnobotanical uses, in 12 districts of Central-Eastern Nepal.

Results
Nepal is a hotspot of botanical diversity, housing 15 families and 29 genera of plants that exhibit parasitic or mycoheterotrophic habit. Over 150 of the known 4500 parasitic plant species (~3 %) and 28 of the 160 mycoheterotrophic species (~18 %) are native or naturalized to Nepal; 13 of our surveyed parasitic species are endemic. Of all species documented, approximately 17 % of parasitic and 7 % of mycoheterotrophic plants have ethnobotanical uses as medicine (41 %), fodder (23 %), food (17 %), ritual objects (11 %), or material (8 %).

Conclusions
Parasitic and mycoheterotrophic plant species exhibit high diversity in the Nepal Central-Eastern Himalaya and are the fodder for biocultural relationships that may help inform future environmental management projects in the region.
Labor market integration of new immigrants in Spain
Authors: Rodríguez-Planas Núria , Nollenberger Natalia 
Published: February 2016

Abstract
Immigrants’ employment status has worsened during the Great Recession in Spain. How much of this worsening is due to the recession, and how much to a composition effect? Using Spanish Labor Force Survey data from 2000 through 2011, we compare the employment trajectories of different cohorts of immigrants and natives and find that those who arrived before the 2008 recession had little trouble finding work immediately. In contrast, those who arrived after 2008 struggled to find work as Spanish unemployment rates skyrocketed. In addition, although many immigrants who arrived in Spain between 2000 and 2007 were able to find work and eventually move out of the low-skilled positions, the nature of their jobs did not shield them from the recession. Hence, many became unemployed as the economy shed low- and middle-skilled jobs in sectors dominated by immigrants. Immigrants’ individual characteristics, such as gender, country of origin, or educational level, had a limited effect on their employment trajectories. These findings suggest that for many workers, finding middle-skilled work alone isn’t enough. Hence, integration policies could aim to help workers transition from the secondary to the primary labor market in order to find their way into more stable employment.

JEL codes: J15, J24, J61, J62
Challenges of medicines management in the public and private sector under Ghana’s National Health Insurance Scheme – A qualitative study
Authors: Ashigbie Paul G. , Azameti Devine , Wirtz Veronika J. 
Published: February 2016

Abstract
Background
Ghana established its National Health Insurance Scheme (NHIS) in 2003 with the goal of ensuring more equitable financing of health care to improve access to health services. This qualitative study examines the challenges and consequences of medicines management policies and practices under the NHIS as perceived by public and private service providers.

Methods
This study was conducted in health facilities in the Eastern, Greater Accra and Volta regions of Ghana between July and August 2014. We interviewed 26 Key Informants (KIs) from a purposively selected sample of public and private sector providers (government and mission hospitals, private hospitals and private standalone pharmacies), pharmaceutical suppliers and NHIS district offices. Data was collected using semi-structured interview guides which covered facility accreditation, reimbursement practices, medicines selection, purchasing and pricing of medicines, and utilization of medicines. Codes for data analysis were developed based on the study questions and also in response to themes that emerged from the transcripts and notes.

Results
Most KIs agreed that the introduction of the NHIS has increased access to and utilization of medicines by removing cost barriers for patients; however, some pointed out the increased utilization could also be corollary to moral hazard. Common concerns across all facilities were the delays in receiving NHIS reimbursements, and low reimbursement rates for medicines which result in providers asking patients to pay supplementary fees. KIs reported important differences between private and public sectors including weak separation of prescribing and dispensing and limited use of drugs and therapeutic committees in the private sector, the disproportionate effects of unfavorable reimbursement prices for medicines, and inadequate participation of the private sector providers (especially pharmacies and licensed chemical sellers) in the NHIS.

Conclusions
Health providers generally perceive the NHIS to have had a largely positive impact on access to medicines. However, concerns remain about equity in access to medicines and the differences in quality of pharmaceutical care delivered by private and public providers. Routine monitoring of medicines use during the implementation of health insurance schemes is important to identify and address the potential consequences of medicines policies and practices under the scheme.