bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Transfusion Strategy in Acute Non‐variceal Upper Gastrointestinal Bleeding: A Nationwide Study of 5861 Hospital Admissions in Denmark
Authors: Fabricius Rasmus , Svenningsen Peter , Hillingsø Jens , Svendsen Lars Bo , Sillesen Martin 
Published: December 2015

AbstractBackgroundAcute non‐variceal upper gastrointestinal bleeding (NVUGIB) is a common cause of admissions as well as aggressive transfusion of blood products. Whether the transfusion strategy in NVUGIB impacts on hemostasis is unknown and constitutes the focus of this study.MethodRetrospective analysis of all hospital admissions in Denmark between 2011 and 2013 where hemostatic endoscopic interventions in either the stomach or duodenum had been employed. Regression modeling was used to predict the effect of units transfused of packed red blood cells (PRBC), fresh frozen plasma (FFP), and platelets (PLT) on primary outcome 30‐day mortality as well as secondary hemostasis‐related outcomes and need for re‐endoscopy and conversion to surgery. The model was corrected for confounders, including transfusion of other blood products (PRBC, FFP, and PLT, respectively), patient age as well as pre‐existing medical conditions.Results5107 patients received 10783 therapeutic endoscopic interventions. Units of PRBC transfused were identified as a predictor of re‐endoscopy, surgery, and 30‐day mortality with odds ratio (OR) 1.08 (1.06–1.09, p < 0.01), 1.05 (1.03–1.07, p < 0.01), and 1.04 (1.01–1.06, p < 0.01), respectively. Units of FFP transfused were associated with a higher risk of surgery and 30‐day mortality with OR 1.05 (1.02–1.08, p < 0.01) and 1.04 (1.02–1.07, p < 0.01), respectively. Units of PLTs transfused were independently associated with a reduction in risk of re‐endoscopy 0.93 (0.87–0.98, p = 0.02). A high ratio of PRBC:FFP:PLT (1:1:1) was associated with reduced need for re‐endoscopy OR 0.23 (0.06–0.67, p = 0.01) but increased mortality with OR 3.60 (1.34–11.38, p = 0.02).ConclusionPRBC transfusion was associated with adverse events, including 30‐day mortality and failure of hemostasis. In contrast, transfusion of PLT was associated with a reduction in need for re‐endoscopy.
Cost Per DALY Averted in a Surgical Unit of a Private Hospital in India
Authors: Chatterjee Susmita , Laxminarayan Ramanan , Gosselin Richard A. 
Published: December 2015

AbstractBackgroundsCost‐effectiveness analysis plays an important role to guide resource allocation decisions, however, information on cost per disability‐adjusted life year (DALY) averted by health facilities is not available in many developing economies, including India. We estimated cost per DALY averted for 2611 patients admitted for surgical interventions in a 106‐bed private for‐profit hospital in northern India.MethodsCosts were calculated using standard costing methods for the financial year 2012–2013, and effectiveness was measured in DALYs averted using risk of death/disability, effectiveness of treatment and disability weights from 2010 global burden of disease study.ResultsDuring the study period, total operating cost of the hospital for treating surgical patients was USD 1,554,406 and the hospital averted 9401 DALYs resulting in a cost per DALY averted of USD 165.ConclusionsEven though this study was based on one hospital in India, however, the hospital is a private hospital which is expected to have less surgical case load compared to government health facilities, cost per DALY averted for the surgical interventions is much lower than the cost‐effectiveness threshold for India (USD 1508 in 2012). This study therefore provides evidence to re‐think the common notion that surgical care is expensive and therefore of lower value than other health interventions.
EBSLN and Factors Influencing its Identification and its Safety in Patients Undergoing Total Thyroidectomy: A Study of 456 Cases
Authors: Ravikumar Krishnan , Sadacharan Dhalapathy , Muthukumar Sankaran , Mohanpriya Gajrajan , Hussain Zahir , Suresh R. V. 
Published: December 2015

AbstractBackground
The external branch of the superior laryngeal nerve (EBSLN) is at surgical risk during superior thyroid pole ligation during thyroidectomy. Majority of studies have addressed the identification of these nerves and its reported incidence. Very few studies have addressed the relationship of these nerves with the volume of the thyroid gland and presence of toxicity.Materials and methods
A retrospective evaluation of 456 patients who underwent total thyroidectomy were analysed from the prospectively maintained database. The EBSLN was diligently identified and preserved before individual ligation of the superior thyroid pedicle. The nerve was graded as per the Cernea classification (type I, IIa and IIb). Goitres are classified into toxic & non‐toxic based on hyperthyroidism, further sub classified as large (>50 cc) and small (≤50 cc) based on volume of each lobe. The grading of EBSLN was correlated with hyperthyroidism and volume of each lobe.ResultsIn 456 patients (912 nerves), EBSLN was identified in 849/912(93.09 %), type I in 156/912(17.1 %), type IIa in 522/912(57.23 %) and type IIb in 171/912(18.75 %). The prevalence of large goitres was 180/912(19.73 %).Type IIb nerve was predominantly seen in 161/180(89.4 %) of large goitres. Type IIb nerves was more common in toxic 141/372(37.9 %) than non‐toxic lobes 25/540(5.46 %).ConclusionLarge goitres are not uncommon in toxic cases. The EBSLN is at highest risk of injury in this subgroup of patients and surgical expertise is essential to identify this entity of EBSLN to perform a safe thyroidectomy.
Electrophysiological validation of total atrial conduction time measurement by tissue doppler echocardiography according to age and sex in healthy adults
Authors: Erdem Fatma Hizal , Erdem Alim , Özlü Fatih , Ozturk Serkan , Ayhan Suzi Selim , Çağlar Sabri Onur , Yazici Mehmet 
Published: December 2015

AbstractBackgroundWe sought to validate total atrial conduction time (TACT) measurement via tissue Doppler imaging (TDI) by comparing the electrophysiological study (EPS) measurements of healthy subjects, according to age and sex.MethodsEighty patients with normal EPS results were included. TACT was measured by EPS and TDI. For validation, the results of TDI were compared with those of EPS. TACT was assessed by measuring the time interval between the beginning of the P‐wave on the surface ECG, and the peak A‐wave on TDI from the left atrial lateral wall, just over the mitral annulus. Electrophysiological TACT was defined as the time from the high right atrial electrogram to the distal coronary sinus atrial electrogram around the left lateral portion of the mitral ring.ResultsEPS and TDI measurements of the TACT were significantly and positively correlated among men and women in 20–30 years (p=0.008, r=0.412; p>0.001, r=0.706, respectively), and those in the 30–40 years group (p=0.001, r=0.649; p=0.001, r=0.696). In contrast, EPS and TDI measurements of TACT were not significantly different among men and women in the 20–30 years and those in the 30–40 years group (p>0.05, for both). On univariate regression analyses, TACT was independently associated with age (β=0.342, =0.001).ConclusionsWhen assessed according to the age and sex of healthy participants, TDI and EPS measurements during TACT assessments were similar and correlated with each other. The measurement of TACT via TDI may be used accurately and confidently than the measurement via EPS in healthy individuals.
Predictors of Receiving a Prosthesis for Adults With Above‐Knee Amputations in a Well‐Defined Population
Authors: Mundell Benjamin F. , Kremers Hilal Maradit , Visscher Sue , Hoppe Kurtis M. , Kaufman Kenton R. 
Published: December 2015

AbstractBackgroundPrior studies have identified age as a factor in determining an individual's likelihood of receiving a prosthesis following a lower limb amputation. These studies are limited to specific subsets of the general population and are unable to account for preamputation characteristics within their study populations. Our study seeks to determine the effect of preamputation characteristics on the probability of receiving a prosthesis for the general population in the United States.ObjectiveTo identify preamputation characteristics that predict of the likelihood of receiving a prosthesis following an above‐knee amputation.DesignA retrospective, population‐based cohort study.SettingOlmsted County, Minnesota (2010 population: 144,248).ParticipantsIndividuals (n = 93) over the age of 18 years who underwent an above‐knee amputation, that is, knee disarticulation or transfemoral amputation, while residing in Olmsted County, MN, between 1987 and 2013.MethodsCharacteristics affecting the receipt of a prosthesis were analyzed using a logistic regression and a random forest algorithm for classification trees. Preamputation characteristics included age, gender, amputation etiology, year of amputation, mobility, cognitive ability, comorbidities, and time between surgery and the prosthesis decision.Main Outcome MeasuresThe association of preamputation characteristics with the receipt of a prosthesis following an above‐knee amputation.ResultsTwenty‐four of the participants received a prosthesis. The odds of receiving a prosthesis were almost 30 times higher in those able to walk independently prior to an amputation relative to those who could not walk independently. A 10‐year increase in age was associated with a 53.8% decrease in the likelihood of being fit for a prosthesis (odds ratio = 0.462, P =.030). Time elapsed between surgery and the prosthesis decision was associated with a rise in probability of receiving a prosthesis for the first 3 months in the random forest algorithm. No other observed characteristics were associated with receipt of a prosthesis.ConclusionsThe association of preamputation mobility and age with the likelihood of being fit for a prosthesis is well understood. The effect of age, after controlling for confounders, still persists and is associated with the likelihood of being fit for a prosthesis.
Nonlinear dynamics of large-scale coherent structures in turbulent free shear layers
Authors: Wu Xuesong , Zhuang Xiuling 
Published: December 2015

Fully developed turbulent free shear layers exhibit a high degree of order, characterized by large-scale coherent structures in the form of spanwise vortex rollers. Extensive experimental investigations show that such organized motions bear remarkable resemblance to instability waves, and their main characteristics, including the length scales, propagation speeds and transverse structures, are reasonably well predicted by linear stability analysis of the mean flow. In this paper, we present a mathematical theory to describe the nonlinear dynamics of coherent structures. The formulation is based on the triple decomposition of the instantaneous flow into a mean field, coherent fluctuations and small-scale turbulence but with the mean-flow distortion induced by nonlinear interactions of coherent fluctuations being treated as part of the organized motion. The system is closed by employing a gradient type of model for the time- and phase-averaged Reynolds stresses of fine-scale turbulence. In the high-Reynolds-number limit, the nonlinear non-equilibrium critical-layer theory for laminar-flow instabilities is adapted to turbulent shear layers by accounting for (1) the enhanced non-parallelism associated with fast spreading of the mean flow, and (2) the influence of small-scale turbulence on coherent structures. The combination of these factors with nonlinearity leads to an interesting evolution system, consisting of coupled amplitude and vorticity equations, in which non-parallelism contributes the so-called translating critical-layer effect. Numerical solutions of the evolution system capture vortex roll-up, which is the hallmark of a turbulent mixing layer, and the predicted amplitude development mimics the qualitative feature of oscillatory saturation that has been observed in a number of experiments. A fair degree of quantitative agreement is obtained with one set of experimental data.
Inertial and dimensional effects on the instability of a thin film
Authors: González Alejandro G. , Diez Javier A. , Sellier Mathieu 
Published: December 2015

We consider here the effects of inertia on the instability of a flat liquid film under the effects of capillary and intermolecular forces (van der Waals interaction). Firstly, we perform a linear stability analysis within the long-wave approximation, which shows that the inclusion of inertia does not produce new regions of instability other than the one previously known from the usual lubrication case. The wavelength, ${\it\lambda}_{m}$, corresponding to the maximum growth, ${\it\omega}_{m}$ and the critical (marginal) wavelength do not change. The most affected feature of the instability under an increase of the Laplace number is the noticeable decrease of the growth rates of the unstable modes. In order to put in evidence the effects of the bidimensional aspects of the flow (neglected in the long-wave approximation), we also calculate the dispersion relation of the instability from the linearized version of the complete Navier–Stokes (N–S) equations. Unlike the long-wave approximation, the bidimensional model shows that ${\it\lambda}_{m}$ can vary significantly with inertia when the aspect ratio of the film is not sufficiently small. We also perform numerical simulations of the nonlinear N–S equations and analyse to which extent the linear predictions can be applied depending on both the amount of inertia involved and the aspect ratio of the film.
Association of protein intake with the change of lean mass among elderly women: The Osteoporosis Risk Factor and Prevention – Fracture Prevention Study (OSTPRE-FPS)
Authors: Isanejad Masoud , Mursu Jaakko , Sirola Joonas , Kröger Heikki , Rikkonen Toni , Tuppurainen Marjo , Erkkilä Arja T. 
Published: December 2015

AbstractLow protein intake can lead to declined lean mass (LM) in elderly. We examined the associations of total protein (TP), animal protein (AP) and plant protein (PP) intakes with LM. The association of TP intake with LM change was further evaluated according to weight change status. This cross-sectional and prospective cohort study included 554 women aged 68 (sd 1·9) years from the Osteoporosis Risk Factor and Prevention – Fracture Prevention Study (OSTPRE-FPS). The intervention group (n 270) received daily cholecalciferol (800 IU; 20 μg) and Ca (1000 mg) for 3 years while the control group received neither supplementation nor placebo (n 282). Participants filled out a questionnaire on lifestyle factors and a 3-d food record in 2002 and underwent dual-energy X-ray absorptiometry for body composition measurements at baseline and 3 years. Multiple linear regressions evaluated the association between protein intake and LM, adjusting for relevant covariates. At the baseline TP and AP intakes were positively associated with LM and trunk LM, TP was associated also with appendicular LM (aLM). Follow-up results showed that in the total population and the intervention group, higher TP and AP were associated with increased LM and aLM (P ≤ 0·050). No such associations were observed in the control group. PP intake was also associated with aLM change in the total population. Overall, the associations were independent of fat mass. Further, among weight maintainers, TP intake was positively associated with LM, aLM and trunk LM changes (P ≤ 0·020). In conclusion, dietary TP, especially AP, intake may be a modifiable risk factor for sarcopenia by preserving LM in the elderly.
Middle-range exploratory activity in adult rats suggests higher resilience to chronic social defeat
Authors: Matrov Denis , Kõiv Kadri , Kanarik Margus , Peet Krista , Raudkivi Karita , Harro Jaanus 
Published: December 2015

ObjectiveStressful life events play an important role in the aetiology of human mood disorders and are frequently modelled by chronic social defeat (SD) in rodents. Exploratory phenotype in rats is a stable trait that is likely related to inter-individual differences in reactivity to stress. The aim of the study was to confirm that low levels of exploratory activity (LE) are, in rodents, a risk factor for passive stress coping, and to clarify the role of medium (ME) and high (HE) exploratory disposition in the sensitivity to SD.MethodsWe examined the effect of SD on male Wistar rats with LE, ME, and HE activity levels as measured in the exploration box. After SD, the rats were evaluated in social preference, elevated zero maze, and open-field tests. Brain tissue levels of monoamines were measured by high-performance liquid chromatography.ResultsRats submitted to SD exhibited lower weight gain, higher sucrose consumption, showed larger stress-induced hyperthermia, lower levels of homovanillic acid in the frontal cortex, and higher levels of noradrenaline in the amygdala and hippocampus. Open-field, elevated zero maze, and social preference tests revealed the interaction between stress and phenotype, as only LE-rats were further inhibited by SD. ME-rats exhibited the least reactivity to stress in terms of changes in body weight, stress-induced hyperthermia, and sucrose intake.ConclusionBoth low and high novelty-related activity, especially the former, are associated with elevated sensitivity to social stress. This study shows that both tails of a behavioural dimension can produce stress-related vulnerability.
Effects of supplementation with a calcium-rich marine-derived multi-mineral supplement and short-chain fructo-oligosaccharides on serum lipids in postmenopausal women
Authors: Cronin Barbara E. , Allsopp Philip J. , Slevin Mary M. , Magee Pamela J. , Livingstone M. Barbara E. , Strain J. J. , McSorley Emeir M. 
Published: December 2015

AbstractRecent literature suggests that Ca supplements have adverse effects on cardiovascular health. The effects of a Ca-rich supplement administered alone or in combination with short-chain fructo-oligosaccharides (scFOS) on serum lipids in postmenopausal women were examined using secondary data from a 24-month double-blind randomised controlled study. A total of 300 postmenopausal women were randomly assigned to daily supplements of 800 mg of Ca (2·4 g Aquamin) (Ca), 800 mg of Ca with 3 g of scFOS (CaFOS) or control (maltodextrin) (MD). A full lipid profile, body composition, blood pressure and a range of cytokines were measured at baseline and after 24 months. Intention-to-treat ANCOVA assessed treatment effects between the groups. A significant time-by-treatment effect was observed for LDL and total cholesterol for the Ca and CaFOS groups, with both groups having lower LDL and total cholesterol concentrations compared with MD after 24 months. The control group had mean (5·2 mmol/l) total cholesterol concentrations above the normal range (≤5 mmol/l) at 24 months, whereas values remained within the normal range in the treatment groups. There was no significant treatment effect on HDL-cholesterol, TAG, body composition, blood pressure or cytokine concentrations at 24 months, with the exception of IL-4, where there was a significant increase in the CaFOS group compared with the placebo. This study demonstrates a lipid-lowering effect of both the Ca-rich supplement alone and the supplement with scFOS. At the 4-year follow-up, there was no significant difference between the groups for reported diagnosed cardiovascular conditions.
Research Note: A Profile of Ministerial Policy Staff in the Government of Canada
Authors: Wilson R. Paul 
Published: December 2015

AbstractAlthough ministerial political advisors are prominent and influential actors within the core executive in Canada and elsewhere, information is scarce with respect to their personal and professional backgrounds and career trajectory. This article uses recent survey data and publicly available biographical information to analyse the demographic composition of senior ministerial policy advisors within the Government of Canada. It finds that, while ministerial policy staffers are young and politically committed, they are not so young nor so professionally inexperienced as sometimes thought. Nor are they always personally and tightly bound to their current ministers but often work for different ministers in different departments. This suggests that advisors are agents of the whole government as much as agents of their individual ministers and raises questions about the degree to which they are responsive to the Prime Minister's Office, thereby increasing centralization.
“Bringing Cities Back In” To Canadian Political Science: Municipal Public Policy and Immigration
Authors: Fourot Aude-Claire 
Published: December 2015

AbstractUsually, the state of urban research in Canadian political science leads to pessimistic evaluations. This pessimism is belied by one emerging area of study: research on Canadian municipal public policies and immigration, which has flourished over the last 20 years. This article tracks the evolution of this research. First, I retrace how municipal policies for immigrants have been studied, and show how comparison is a central component of this literature. Second, I analyze the dynamics of agenda setting, as well as variables for decision making and implementation. Third, I make three propositions for future research, which are i) to examine the reciprocal relationship between attitudes towards immigration and local public policies and politics; ii) to study local public policy as constructions rather than responses and iii) to revisit the use of national models of integration for cities. In conclusion, I underline the positive outcomes of “bringing cities back in” to Canadian political science, not only to better understand political regulation and Canadian federalism, but also to have a more complete view of the immigrant integration policies.
Hate Speech and Identity Politics in Germany, 1848–1914
Authors: Goldberg Ann 
Published: December 2015

AbstractA dramatic paradigm shift has occurred in European and German hate-speech laws, from their nineteenth-century origins in repressive campaigns against the Left to their present association with pluralism, tolerance, and minority rights. This article rethinks the timing and causes of that shift, arguing that, contrary to the prevailing scholarship, the decade of the 1890s—not 1945—constituted the first key turning point toward a human-rights model of hate-speech law. Departing from a more traditional legal historiography focused on formal legal institutions and laws, the article examines law “from below” as social and political practice. The results show how, in the 1890s, a new vision of hate speech began to take shape when a grassroots Jewish defense movement began to appropriate and reshape the law in order to oppose antisemites. In theoretical terms, the article's method of examining the interaction of law and politics shows that from the 1840s onward, the politics surrounding hate-speech law refutes simple binary constructions that cast German legal culture as “dignitarian” and distinct from U.S. “libertarianism.”