bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal positioning to correct occiput posterior fetal position during the first stage of labour: a randomised controlled trial
Authors: Guittier MJ , Othenin‐Girard V , de Gasquet B , Irion O , Boulvain M 
Published: January 2016

ObjectiveTo evaluate the efficacy of the hands and knees position during the first stage of labour to facilitate the rotation of the fetal head to the occiput anterior position.DesignRandomised controlled trial.SettingGeneva University Hospitals, Switzerland.PopulationA total of 439 women with a fetus in the occiput posterior position during the first stage of labour.MethodsThe women in the intervention group were invited to take a hands and knees position for at least for 10 minutes. Women allocated to the control group received the usual care. For both groups, 15 minutes after randomisation, women completed a short questionnaire to report their perceived pain and the comfort of their position.Main outcome measuresThe rotation of the fetal head in occiput anterior position confirmed by ultrasonography 1 hour after randomisation.ResultsOne hour after the randomisation, 35 of 203 (17%) fetuses were diagnosed as being in the occiput anterior position in the intervention group compared with 24 of 209 (12%) in the control group. This difference was not statistically significant (relative risk 1.50; 95% CI 0.93–2.43; P = 0.13). The change in the evaluation of comfort between the randomisation and 15 minutes after showed an improvement in 70 and 39 women, no change in 82 and 78 women and a decrease in 56 and 86 women in the intervention and control groups, respectively (P = 0.02).ConclusionsThis study could not demonstrate a benefit of the hands and knees position to correct the occiput posterior position of the fetus during the first stage of labour, but the women reported an increase in their comfort level.Tweetable abstractHands and knees position does not facilitate rotation into occiput anterior but increases the comfort level of women.
Over‐commitment and backsliding in international trade
Authors: KUCIK JEFFREY , PELC KRZYSZTOF J. 
Published: January 2016

Abstract‘International commitments pay’ could be the mantra of the current literature on international organisations: tying their hands at the international level is a means for governments to push through politically costly, but ultimately welfare‐enhancing reforms. It is argued in this article that this logic has a limit, which can be empirically observed. Past a given point, further depth of integration increases odds of backsliding. This belief is tested in the context of accession to an institution whose rules have been heavily scrutinised: the World Trade Organization (WTO). Countries with low rule of law are imposed a risk premium in the form of demands for deeper concessions, making ‘over‐committing’ possible. This relationship is used to assess the extent to which deeper commitments lead to backsliding. Industry‐level analysis supports these beliefs: deep commitments lead to increased odds of backtracking through a range of legal and extra‐legal mechanisms. Ambitious international commitments can backfire.
Development of Food‐Grade Curcumin Nanoemulsion and its Potential Application to Food Beverage System: Antioxidant Property and In Vitro Digestion
Authors: Joung Hee Joung , Choi Mi‐Jung , Kim Jun Tae , Park Seok Hoon , Park Hyun Jin , Shin Gye Hwa 
Published: January 2016

AbstractCurcumin nanoemulsions (Cur‐NEs) were developed with various surfactant concentrations by using high pressure homogenization and finally applied to the commercial milk system. Characterization of Cur‐NEs was performed by measuring the droplet size and polydispersity index value at different Tween 20 concentrations. The morphology of the Cur‐NEs was observed by confocal laser scanning microscopy and transmission electron microscopy. Antioxidant activity and in vitro digestion ability were tested using 2,2‐diphenyl‐1‐picrylhydrazyl, 2,2′‐azino‐bis(3‐ethylbenzothiazoline‐6‐sulfonic acid) diammonium salt, pH‐stat method, and thiobarbituric acid reactive substances assays. Cur‐NEs were found to be physically stable for 1 mo at room temperature. The surfactant concentration affects particle formation and droplet size. The mean droplet size decreased from 122 to 90 nm when surfactant concentration increased 3 times. Cur‐NEs had shown an effective oxygen scavenging activity. Cur‐NEs‐fortified milk showed significantly lower lipid oxidation than control (unfortified) milk and milk containing curcumin‐free nanoemulsions. These properties make Cur‐NEs suitable systems for the beverage industry.
Perceived Appropriateness of Shared Decision‐making in the Emergency Department: A Survey Study
Authors: Probst Marc A. , Kanzaria Hemal K. , Frosch Dominick L. , Hess Erik P. , Winkel Gary , Ngai Ka Ming , Richardson Lynne D. 
Published: January 2016

AbstractObjectivesThe objective was to describe perceptions of practicing emergency physicians (EPs) regarding the appropriateness and medicolegal implications of using shared decision‐making (SDM) in the emergency department (ED).MethodsWe conducted a cross‐sectional survey of EPs at a large, national professional meeting to assess perceived appropriateness of SDM for different categories of ED management (e.g., diagnostic testing, treatment, disposition) and in common clinical scenarios (e.g., low‐risk chest pain, syncope, minor head injury). A 21‐item survey instrument was iteratively developed through review by content experts, cognitive testing, and pilot testing. Descriptive and multivariate analyses were conducted.ResultsWe approached 737 EPs; 709 (96%) completed the survey. Two‐thirds (67.8%) of respondents were male; 51% practiced in an academic setting and 44% in the community. Of the seven management decision categories presented, SDM was reported to be most frequently appropriate for deciding on invasive procedures (71.5%), computed tomography (CT) scanning (56.7%), and post‐ED disposition (56.3%). Among the specific clinical scenarios, use of thrombolytics for acute ischemic stroke was felt to be most frequently appropriate for SDM (83.4%), followed by lumbar puncture to rule out subarachnoid hemorrhage (73.8%) and CT head for pediatric minor head injury (69.9%). Most EPs (66.8%) felt that using and documenting SDM would decrease their medicolegal risk while a minority (14.2%) felt that it would increase their risk.ConclusionsAcceptance of SDM among EPs appears to be strong across management categories (diagnostic testing, treatment, and disposition) and in a variety of clinical scenarios. SDM is perceived by most EPs to be medicolegally protective.
Usability of the Massachusetts Prescription Drug Monitoring Program in the Emergency Department: A Mixed‐methods Study
Authors: Poon Sabrina J. , Greenwood‐Ericksen Margaret B. , Gish Rebecca E. , Neri Pamela M. , Takhar Sukhjit S. , Weiner Scott G. , Schuur Jeremiah D. , Landman Adam B. 
Published: January 2016

AbstractObjectivesPrescription drug monitoring programs (PDMPs) are underutilized, despite evidence showing that they may reduce the epidemic of opioid‐related addiction, diversion, and overdose. We evaluated the usability of the Massachusetts (MA) PDMP by emergency medicine providers (EPs), as a system's usability may affect how often it is used.MethodsThis was a mixed‐methods study of 17 EPs. We compared the time and number of clicks required to review one patient's record in the PDMP to three other commonly performed computer‐based tasks in the emergency department (ED: ordering a computed tomography [CT] scan, writing a prescription, and searching a medication history service integrated within the electronic medical record [EMR]). We performed semistructured interviews and analyzed participant comments and responses regarding their experience using the MA PDMP.ResultsThe PDMP task took a longer time to complete (mean = 4.22 minutes) and greater number of mouse clicks to complete (mean = 50.3 clicks) than the three other tasks (CT‐pulmonary embolism = 1.42 minutes, 24.8 clicks; prescription = 1.30 minutes, 19.5 clicks; SureScripts = 1.45 minutes, 9.5 clicks). Qualitative analysis yielded four main themes about PDMP usability, three negative and one positive: 1) difficulty accessing the PDMP, 2) cumbersome acquiring patient medication history information within the PDMP, 3) nonintuitive display of patient medication history information within the PDMP, and 4) overall perceived value of the PDMP despite an inefficient interface.ConclusionsThe complicated processes of gaining access to, logging in, and using the MA PDMP are barriers to preventing its more frequent use. All states should evaluate the PDMP usability in multiple practice settings including the ED and work to improve provider enrollment, login procedures, patient information input, prescription data display, and ultimately, PDMP data integration into EMRs.
Use of a Dedicated, Non–Physician‐led Mental Health Team to Reduce Pediatric Emergency Department Lengths of Stay
Authors: Uspal Neil G. , Rutman Lori E. , Kodish Ian , Moore Ann , Migita Russell T. 
Published: January 2016

AbstractObjectivesUtilization of emergency departments (EDs) for pediatric mental health (MH) complaints is increasing. These patients require more resources and have higher admission rates than those with nonpsychiatric complaints.MethodsA multistage, multidisciplinary process to reduce length of stay (LOS) and improve the quality of care for patients with psychiatric complaints was performed at a tertiary care children's hospital's ED using Lean methodology. This process resulted in the implementation of a dedicated MH team, led by either a social worker or a psychiatric nurse, to evaluate patients, facilitate admissions, and arrange discharge planning. We conducted a retrospective, before‐and‐after study analyzing data 1 year before through 1 year after new process implementation (March 28, 2011). Our primary outcome was mean ED LOS.ResultsAfter process implementation there was a statistically significant decrease in mean ED LOS (332 minutes vs. 244 minutes, p < 0.001). An x‐bar chart of mean LOS shows special cause variation. Significant decreases were seen in median ED LOS (225 minutes vs. 204 minutes, p = 0.001), security physical interventions (2.0% vs. 0.4%, p = 0.004), and restraint use (1.7% vs. 0.1%, p < 0.001). No significant change was observed in admission rate, 72‐hour return rate, or patient elopement/agitation events. Staff surveys showed improved perception of patient satisfaction, process efficacy, and patient safety.ConclusionsUse of quality improvement methodology led to a redesign that was associated with a significant reduction in mean LOS of patients with psychiatric complaints and improved ED staff perception of care.
Loss of δ‐GABAA receptor‐mediated tonic currents in the adult prelimbic cortex following adolescent alcohol exposure
Authors: Centanni Samuel W. , Burnett Elizabeth J. , Trantham‐Davidson Heather , Chandler L. Judson 
Published: January 2016

AbstractDelayed maturation of the adolescent prefrontal cortex may render it particularly vulnerable to insults, including those associated with drugs of abuse. Using a rat model of binge alcohol exposure, the present study examined the effect of adolescent intermittent ethanol (AIE) exposure during postnatal days 28–42 on γ‐aminobutyric acid (GABA)ergic neurotransmission in the prelimbic cortex. In control rats, patch‐clamp electrophysiology in acute slices obtained at different postnatal ages revealed a developmental increase in the GABAA receptor‐mediated tonic current in layer V pyramidal neurons but no change in layers II/III when measured in the adult. In slices from AIE‐exposed rats, the amplitude of the tonic current was significantly reduced compared with controls when tested at postnatal days 45, 60 and 90–120. This AIE‐induced reduction in tonic current was found to reflect attenuation of currents mediated by δ‐subunit containing receptors. Consistent with this, facilitation of the tonic current by bath application of either ethanol or allopregnanolone was attenuated in slices from AIE‐exposed adult rats compared with control rats. However, expression of this facilitation as a percent of the amplitude of the total current mediated by δ‐GABAA receptors revealed that AIE did not alter their sensitivity to either agonist. Lastly, immunohistochemistry and Western blot analysis revealed no change in the expression of δ‐GABAA subunits or their surface expression. Taken together, these studies reveal that AIE exposure results in persistent deficits in δ‐GABAA tonic currents in the adult prelimbic cortex that may contribute to deficits in decision‐making and behavioral control in adulthood.
Maternal and paternal genetic diversity of ancient sheep in Estonia from the Late Bronze Age to the post‐medieval period and comparison with other regions in Eurasia
Authors: Rannamäe E. , Lõugas L. , Niemi M. , Kantanen J. , Maldre L. , Kadõrova N. , Saarma U. 
Published: January 2016

SummarySheep were among the first domesticated animals to appear in Estonia in the late Neolithic and became one of the most widespread livestock species in the region from the Late Bronze Age onwards. However, the origin and historical expansion of local sheep populations in Estonia remain poorly understood. Here, we analysed fragments of the hypervariable D‐loop of mitochondrial DNA (mtDNA; 213 bp) and the Y‐chromosome SRY gene (130 bp) extracted from 31 archaeological sheep bones dated from approximately 800 BC to 1700 AD. The ancient DNA data of sheep from Estonia were compared with ancient sheep from Finland as well as a set of contemporary sheep breeds from across Eurasia in order to place them in a wider phylogeographical context. The analysis shows that: (i) 24 successfully amplified and analysed mtDNA sequences of ancient sheep cluster into two haplogroups, A and B, of which B is predominant; (ii) four of the ancient mtDNA haplotypes are novel; (iii) higher mtDNA haplotype diversity occurred during the Middle Ages as compared to other periods, a fact concordant with the historical context of expanding international trade during the Middle Ages; (iv) the proportion of rarer haplotypes declined during the expansion of sheep from the Near Eastern domestication centre to the northern European region; (v) three male samples showed the presence of the characteristic northern European haplotype, SNP G‐oY1 of the Y‐chromosome, and represent the earliest occurrence of this haplotype. Our results provide the first insight into the genetic diversity and phylogeographical background of ancient sheep in Estonia and provide basis for further studies on the temporal fluctuations of ancient sheep populations.
Analysis of colorectal cancer outcomes for the Australian National Bowel Cancer Screening Program
Authors:   Australian Institute of Health and Welfare,   the Australian Government Department of Health
Published: January 2016

AbstractThe Australian National Bowel Cancer Screening Program (NBCSP) was introduced in Australia in 2006 with the aim of reducing morbidity and mortality from colorectal cancer. This study looked to evaluate the effectiveness of the NBCSP against this aim. The study linked 2006–2008 NBCSP invitees to colorectal cancer incidence and mortality data and categorized NBCSP invitees diagnosed with colorectal cancer into screen‐detected, interval cancer and nonparticipant subgroups. Colorectal cancers in those not invited into the NBCSP were categorized as the never invited group. Proportional hazards and logistic regression were used to compare mortality, summary stage and other characteristics between groups. Of 12 689 people diagnosed with colorectal cancer in 2006–2008, the never invited group (10 080 cases) had a 15% higher risk of colorectal cancer death by 31 December 2011, compared with NBCSP invitees (after correcting for lead‐time bias). Of the colorectal cancers with “summary stage at first presentation” data (27% of total), diagnoses in the never invited group had 38% higher odds of being more advanced than those diagnosed in NBCSP invitees (distant cancer 19% vs 11%). NBCSP invitees had less risk of dying from colorectal cancer, and were more likely to have less‐advanced colorectal cancers when diagnosed, than noninvitees.
Customized humanoptics silicone iris prosthesis in eyes with posttraumatic iris loss: outcomes and complications
Authors: Spitzer Martin Stephan , Nessmann Anja , Wagner Julia , Yoeruek Efdal , Bartz‐Schmidt Karl Ulrich , Szurman Peter , Szurman Gesine B. 
Published: January 2016

AbstractPurposePosttraumatic partial or total iris defects often cause significant debilitating glare, photophobia, decreased vision and cosmetic problems. Currently, the best cosmetic results can be obtained with a customized silicone iris prosthesis. However, little is known about the functional results and the rate of complication if this type of iris prosthesis is implanted into severely traumatized eyes. The aim of this study is to analyse the functional and cosmetic outcomes as well as complications after Artificial Iris implantation.MethodsA consecutive series of 34 patients who received a customized silicone iris prosthesis after severe globe injury with total or sub‐total iris loss was analysed retrospectively. Additionally, patients were interviewed regarding change in subjective complaints.ResultsMedian follow‐up was 24 months (range 12.0–48.8). Mean visual acuity prior to Artificial Iris implantation was 1.1 logMAR (range 0.3–2.6). Five patients (15%) had pre‐existing glaucoma and eight patients (24%) had pre‐existing hypotony. Visual acuity 12 months after surgery was 1.4 logMAR (range 0.2–2.6). Complications included newly diagnosed glaucoma in three eyes (9%) and hypotony in three eyes (9%), persisting intraocular inflammation or macular oedema in seven patients (21%), and corneal endothelial decompensation requiring corneal transplantation in six patients (18%). Patients’ satisfaction increased by reducing glare and enhanced cosmetic appearance.ConclusionThe customized silicone iris prosthesis is an individualized treatment approach with appealing cosmetic results. Therefore, especially traumatized eyes with highly different posttraumatic conditions could benefit. However, in some patients, the implantation of this device may cause an increase of intraocular pressure, corneal endothelial decompensation or persisting inflammation.
Retinal vessel diameters in a Japanese population: the Locomotive Syndrome and Health Outcome in Aizu Cohort Study
Authors: Tano Takatoshi , Ono Koichi , Hiratsuka Yoshimune , Otani Koji , Sekiguchi Miho , Konno Shinichi , Kikuchi Shinichi , Onishi Yoshihiro , Takegami Misa , Yamada Masakazu , Fukuhara Shunichi , Murakami Akira 
Published: January 2016

AbstractPurposeTo describe the relationship between retinal vascular calibre and cardiovascular risk factors in a Japanese population.MethodsThe Locomotive Syndrome and Health Outcome in Aizu Cohort Study is a population‐based, cross‐sectional survey that included 2346 persons (56.1% of the eligible population) aged 40 to 74 years old. Retinal vascular calibre was measured from digital retinal photographs using a validated standardized protocol. Data on major cardiovascular risk factors were collected from all participants.ResultsOf the 1787 participants with available retinal vascular calibre data, the mean retinal arteriolar calibre (CRAE) was 141.6 ± 18.6 μm, the mean venular calibre (CRVE) was 209.3 ± 26.1 μm, and the mean arteriole‐to‐venule ratio was 0.68 ± 0.08. A smaller CRAE was associated with male sex, increasing quartiles of systolic blood pressure and diastolic blood pressure, history of hypertension, current alcohol intake and higher quartiles of serum creatinine. A larger CRAE was associated with increasing quartiles of total cholesterol. A larger CRVE was associated with current cigarette smoking. Multivariate analyses showed that a smaller CRAE was associated with male sex, elevated mean arterial blood pressure and a history of hypertension; and a larger CRVE was associated with cigarette smoking.ConclusionsThe results of this study suggest that a narrowed diameter of the retinal arteriole in Japanese people is related to hypertension and sex (male) and that an enlarged retina venular diameter is related to a history of smoking. The pattern of these associations is similar to that in white populations and other Asian populations.
Genetic basis of TNF‐α antagonist associated psoriasis in inflammatory bowel diseases: a genotype‐phenotype analysis
Authors: Vedak P. , Kroshinsky D. , St. John J. , Xavier R. J. , Yajnik V. , Ananthakrishnan A. N. 
Published: January 2016

SummaryBackgroundAnti‐tumour necrosis factor (anti‐TNF) biologic associated psoriasis has been reported in inflammatory bowel disease (IBD) patients. However, little is known regarding its pathogenesis.AimTo identify potential genetic predispositions to anti‐TNF associated psoriasis in IBD patients.MethodsThis retrospective chart review included IBD patients enrolled in a prospective registry. Cases of anti‐TNF associated psoriasis and idiopathic psoriasis unrelated to anti‐TNF exposure were confirmed by an expert dermatologist. All patients were genotyped on the Illumina Immunochip. A weighted genetic risk score ascertaining genetic pre‐disposition towards psoriasis was calculated and overall genetic pre‐disposition as well as differential distribution of individual polymorphisms was compared across the three groups.ResultsOur study included 724 IBD patients who initiated anti‐TNF therapy and did not develop psoriasis, 35 patients with anti‐TNF associated psoriasis, and 38 patients with idiopathic psoriasis. Anti‐TNF users who developed psoriasis had a modest but statistically significantly greater psoriasis genetic risk score than anti‐TNF controls (mean 0.64 vs. 0.61, P = 0.04), and had a similar genetic risk score as those with idiopathic psoriasis (0.64 vs. 0.62, P = 0.22). Two loci associated with NOS2 and ETS1 genes achieved P < 0.05 when comparing anti‐TNF associated psoriasis to anti‐TNF controls. Three loci were significantly different between anti‐TNF associated psoriasis and idiopathic psoriasis including a polymorphism near NOS2 encoding for inducible nitric oxide synthase that is produced by dendritic cells in skin lesions in psoriasis.ConclusionPatients with anti‐TNF associated psoriasis had a modestly greater genetic pre‐disposition towards psoriasis but no single causative polymorphism was identified.
Nanosize of zinc oxide and the effects on zinc digestibility, growth performances, immune response and serum parameters of weanling piglets
Authors: Li Ming‐Zhe , Huang Jie‐Ting , Tsai Yi‐Hao , Mao Syuan‐Yian , Fu Chao‐Ming , Lien Tu‐Fa 
Published: January 2016

AbstractThe aim of this study was to investigate the effect of dietary supplementation of nanosize zinc on zinc digestibility, growth performances, immune response and serum parameters of weanling piglets. Ninety‐six LYD weanling piglets were assigned to control, zinc oxide (ZnO), organic‐Zn (Zn‐methionine) and nanosize ZnO (nano‐Zn) groups with four replicates. The zinc was at the 120 mg/kg level in the treatment group's diet, while the control group's was 80 mg/kg Zn. The experiment results indicated that the nano‐Zn and organic‐Zn groups had significantly higher Zn digestibility compared to the ZnO and control groups. For the immune response traits, the IgG level and goat red blood cells (GRBC) antibody titer were nano‐Zn and organic‐Zn>ZnO>control; in the phytohemagglutinin (PHA) challenge test result, nano‐Zn>organic‐Zn>ZnO>control; in regard to the γ‐globulin level, nano‐Zn and organic‐Zn>ZnO and control, with significant difference between groups. In the serum parameters aspect, serum Zn concentration in nano‐Zn and organic‐Zn groups were higher than in the ZnO and control groups, serum growth hormone concentration was increased in the nano‐Zn group than in the other groups. In conclusion, nanosize zinc oxide for dietary supplementation can increase zinc digestibility, serum growth hormone levels and carbonic anhydrase activity and enhance the immune response of weanling piglets.