bluuebunny/crossref_metadata_2025_split huggingface dataset:
Don't Label Me: A Qualitative Study of Patients’ Perceptions and Experiences of Sedation During Behavioral Emergencies in the Emergency Department
Authors: Yap Celene Y. L. , Knott Jonathan C. , Kong David C. M. , Gerdtz Marie , Stewart Kay , Taylor David M. 
Published: May 2017

AbstractObjectivesBehavioral emergencies are commonly seen in emergency departments (EDs). Acutely agitated patients can be difficult to manage and sedation may be required to decrease dangerous behavior and to ensure the safety of both the patient and the staff. While the experience of staff caring for this population has been reported, patients’ experiences with their overall management remains unknown. We aimed to describe the perceptions and experiences of patients regarding the use of sedation during acute behavioral emergencies.MethodsFace‐to‐face semistructured interviews were conducted with adults aged 18 years or older, who had received parenteral sedative medication for the management of a behavioral emergency and were deemed capable to participate. The participants were asked about their experiences of receiving care in the ED during the episode and their perceptions of sedation. All interviews were transcribed verbatim and analyzed thematically.ResultsData saturation was reached after 13 interviews. Two broad themes emerged: trusting relationships and needs or wants following sedation. A trusting relationship is built through 1) confidence in care, 2) sedation as an appropriate treatment, 3) insight into own behavior, and 4) humane treatment. Four subthemes of needs or wants were identified: 1) empathy, 2) debrief, 3) addressing concerns, and 4) follow‐up.ConclusionsA trusting relationship was identified as crucial to minimize the negative impact of coercive measures used to manage behavioral emergencies. Participants expressed similar needs to patients presenting with medical problems. This study illustrates their needs for compassionate communication, adequate information about the treatment provided, and follow‐up care.
A 0‐Hour/1‐Hour Protocol for Safe, Early Discharge of Chest Pain Patients
Authors: Mokhtari Arash , Lindahl Bertil , Schiopu Alexandru , Yndigegn Troels , Khoshnood Ardavan , Gilje Patrik , Ekelund Ulf 
Published: May 2017

AbstractObjectivesGuidelines recommend a 0‐hour/1‐hour high‐sensitivity cardiac troponin T (hs‐cTnT) diagnostic strategy in acute chest pain patients. There are, however, little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0‐hour/1‐hour hs‐cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and electrocardiogram (ECG) for ruling out major adverse cardiac events (MACE) within 30 days.MethodsThis prospective observational study enrolled consecutive emergency department (ED) chest pain patients. TIMI score variables, ED physicians’ assessments of the ECG, and 0‐ and 1‐hour hs‐cTnT were collected. Thirty‐day MACE was defined as acute myocardial infarction (AMI), unstable angina (UA), cardiogenic shock, ventricular arrhythmia, atrioventricular block, cardiac arrest, or death of cardiac or unknown cause.ResultsA total of 1,020 patients were included in the final analysis. The combination of an adapted TIMI score ≤1, a nonischemic ECG, and either a 0‐hour hs‐cTnT < 5 ng/L or a 0‐hour hs‐cTnT < 12 ng/L combined with a 1‐hour increase < 3 ng/L identified 432 (42.4%) patients as very low risk with a negative predictive value of 99.5% (95% confidence interval [CI] = 98.3%–99.9%) and a negative likelihood ratio of 0.04 (95% CI = 0.01–0.14) for 30‐day MACE. The ADP missed only two patients with UA and no patients with AMI or other forms of MACE.ConclusionAn ADP using the guideline recommended 0‐hour/1‐hour hs‐cTnT strategy rapidly identified patients with a very low risk of 30‐day MACE including UA where no further cardiac testing would be needed. This could potentially allow safe early discharge of about 40% of ED chest pain patients.
Assessment of the effects of transgenic Bt cotton Bollgard II on the abundance of nontarget arthropods in Burkina Faso
Authors: Héma Omer S. A. , Ouédraogo Issoufou , Traoré Oumar , Zagré Blaise K. , Ouattara Delphine 
Published: May 2017

Abstract

The effect of transgenic cotton Bollgard II on the abundance of nontarget arthropods was assessed under field conditions in three areas in Burkina Faso for four successive years (2010–2013).
The experiment was carried out on two 0.5‐ha plots of which one was seeded with the Bollgard II and one with the non‐Bacillus thuringiensis Berliner (Bt) isogenic cultivar.
Over four collection methods [plastic bagging (28 collections), water trap (28 collections), beat cloth (six collections) and pitfall traps (six collections)] and 4 years, no statistically significant differences were detected between Bollgard II and the conventional control for 45 out of 48 comparisons.
Differences detected were rather random and not consistently detected across collection methods, sites and/or years. Thus, these differences were not indicative of a consistent response associated with the trait and are not considered biologically meaningful in terms of an adverse environmental impact (nontarget arthropod abundance) of Bollgard II compared to conventional cotton receiving six insecticide sprays.
Temporal trends in thyroid‐stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing across two phases of iodine fortification in Tasmania (1995‐2013)
Authors: Hong A. , Stokes B. , Otahal P. , Owens D. , Burgess J.R. 
Published: May 2017

SummaryContextTasmania is an island state of the Australian Commonwealth with a well‐documented history of mild iodine deficiency. Between 2001 and 2009, Tasmania experienced two incremental phases of iodine fortification.ObjectiveTo examine trends in thyroid‐stimulating hormone (TSH) and thyroid peroxidase antibody (ATPO) testing and their relationship to different phases of iodine nutrition in the Tasmanian population between 1995 and 2013.DesignRetrospective longitudinal study.Setting and participantsThe major primary care and largest public hospital pathology providers in Tasmania submitted data for all TSH and ATPO tests performed between 1995 and 2013. Data linkage methodology was used to determine trends in TSH and ATPO testing.ResultsA total of 1.66 million TSH assessments, involving 389,910 individual patients, were performed in Tasmania between 1995 and 2013. There was approximately a fourfold increase in the overall rate of TSH testing during this period with the rate of incident TSH assessment remaining relatively stable over the study period. The incidence of overt suppression and elevation of TSH (TSH≤0.1 mIU/L and ≥10 mIU/L) declined 62.3% and 59.7%, respectively, with a trend for increased incidence of borderline TSH elevation ≥4.0 mIU/L. The incidence of thyroid autoimmunity as determined by the proportion of abnormal ATPO results remained stable, with the absolute number of positive test results increasing during the study period.ConclusionIodine supplementation of this mildly iodine‐deficient population was not associated with an obvious increase in incidence of overt thyroid dysfunction or autoimmunity. Whilst the volume of TSH testing increased over the study period, the increase was driven by patients undergoing follow‐up TSH assessments.
Insulin sensitivity in relation to fat distribution and plasma adipocytokines among abusers of anabolic androgenic steroids
Authors: Rasmussen Jon Jarløv , Schou Morten , Selmer Christian , Johansen Marie Louise , Gustafsson Finn , Frystyk Jan , Dela Flemming , Faber Jens , Kistorp Caroline 
Published: May 2017

SummaryObjectiveAbuse of anabolic androgenic steroids (AAS) is prevalent among young men, but information regarding effects on insulin sensitivity and fat distribution is limited. The objective was to investigate insulin sensitivity in relation to fat distribution and adipocytokines among current and former AAS abusers compared with controls.DesignCross‐sectional study among men involved in recreational strength training. Current and former AAS abusers (n=37 and n=33) and controls (n=30) volunteered from the community.MethodsWe assessed insulin sensitivity by Matsuda index (oral glucose tolerance test). Using overnight fasting blood samples, adiponectin and leptin were measured. Body composition and fat distribution, including visceral adipose tissue (VAT), were assessed by dual energy X‐ray absorptiometry.ResultsCurrent and former AAS abusers displayed lower Matsuda index than controls (%‐difference (95%CI) from controls, −26% (−45; −1) and −39% (−55; −18)). Testosterone was markedly higher among current AAS abusers and subnormal among former AAS abusers compared with controls. Current AAS abusers displayed higher mean VAT than controls (388 (17) vs 293 (12) cm3, P<.001) whereas body fat %, adiponectin and leptin concentrations were lower. In contrast, former AAS abusers showed highest leptin concentrations and body fat %. Multivariate linear regressions identified VAT as independent predictor of lower Matsuda index among current AAS abusers compared with controls; while body fat % independently predicted lower Matsuda index among former AAS abusers.ConclusionsBoth current and former AAS abusers displayed lower insulin sensitivity which could be mediated by higher VAT and total body fat %, respectively.
A Review of Social Dilemmas and Social‐Ecological Traps in Conservation and Natural Resource Management
Authors: Cumming Graeme S. 
Published: May 2017

AbstractSuccessful conservation depends as much on people working together as it does on sound science and good governance. Research on cooperation in businesses, economics, psychology, and natural resource management has identified shared social and social‐ecological dynamics, reviewed and categorized in this article that can create unwanted surprises and problems for conservation efforts. Cooperation may fail when: (1) individual and group benefits are in conflict (social dilemmas) or (2) social‐ecological systems become caught in problem‐causing and problem‐enhancing feedbacks (SES traps). Knowing about and recognizing these dynamics can help decision makers to understand and change key elements of problems and learn from the experiences of others. Social dilemmas have winners and losers, and involve give‐some or take‐some choices; SES traps are lose‐lose situations. Solutions to problems of cooperation in conservation contexts involve identifying the conservation objective and context, diagnosing systemic social dilemmas and SES traps, and developing practical solutions that work with group processes and individuals toward shared and positively reinforcing goals, goal structures, and expectations. Research on cooperation in conservation has largely ignored problems of scale, scaling, and group heterogeneity. The field would benefit from a shift from a probabilistic, empirical approach to a stronger theory‐driven, mechanistic, and more diagnostic approach.
‘Real’ wages? Contractors, workers, and pay in London building trades, 1650–1800
Authors: Stephenson Judy Z. 
Published: May 2017

AbstractExisting series suggest wages in London were higher than in other European cities from 1650 to 1800. This article presents new evidence from the construction sites that supplied the underlying wage data, and uncovers the contractual and organizational context in which they were recorded. Institutional records of wages were profoundly affected by structural changes in the seventeenth century, particularly the emergence of large‐scale building contractors. The actual wages paid to London building workers were substantially below current estimates.
Analysis of serum markers of cellular immune activation in patients with bullous pemphigoid
Authors: Bieber Katja , Ernst Anna Lara , Tukaj Stefan , Holtsche Maike M. , Schmidt Enno , Zillikens Detlef , Ludwig Ralf J. , Kasperkiewicz Michael 
Published: May 2017

AbstractExperimental models of bullous pemphigoid (BP), the most frequent subepidermal autoimmune bullous disease, revealed that the immune response leading to blister formation represents an incompletely understood complex process involving different inflammatory cells. In contrast to previous reports commonly focusing on limited molecular and cellular phenotypes of the disease, the aim of this study was to investigate a broad spectrum of markers of cellular immune activation in patients with BP. We found that serum levels of soluble CD4, myeloperoxidase, S100A12, eosinophil cationic protein and soluble P‐selectin were significantly elevated in patients with active BP compared with normal controls. Mast cell tryptase and neopterin serum levels significantly decreased at the time of clinical remission of the patients. Additionally, serum concentrations of soluble IL‐2 receptor, mast cell tryptase and soluble P‐selectin were significantly associated with levels of circulating anti‐BP180 autoantibodies. Our findings confirm and extend previous reports suggesting some concomitant involvement of a panel of molecules representative for a wide spectrum of cellular players (T cells, mast cells, neutrophils, eosinophils, macrophages and platelets) orchestrating the inflammatory reaction in BP. These data may favour the employment of broad‐spectrum or combined immunosuppressants, potentially together with an anticoagulant treatment, over cell‐ or molecule‐specific targeted therapy in patients with this disorder.
Red tattoos, ultraviolet radiation and skin cancer in mice
Authors: Lerche Catharina M. , Heerfordt Ida M. , Serup Jørgen , Poulsen Thomas , Wulf Hans Christian 
Published: May 2017

AbstractUltraviolet radiation (UVR) induces skin cancer. The combination of UVR and red tattoos may be associated with increased risk of skin cancer due to potential carcinogens in tattoo inks. This combination has not been studied previously. Immunocompetent C3.Cg/TifBomTac hairless mice (n=99) were tattooed on their back with a popular red tattoo ink. This often used ink is banned for use on humans because of high content of the potential carcinogen 2‐anisidine. Half of the mice were irradiated with three standard erythema doses UVR thrice weekly. Time to induction of first, second and third squamous cell carcinoma (SCC) was measured. All UV‐irradiated mice developed SCCs. The time to the onset of the first and second tumor was identical in the red‐tattooed group compared with the control group (182 vs 186 days and 196 vs 203 days, P=ns). Statistically, the third tumor appeared slightly faster in the red‐tattooed group than in the controls (214 vs 224 days, P=.043). For the second and third tumor, the growth rate was faster in the red‐tattooed group compared with the control (31 vs 49 days, P=.009 and 30 vs 38 days, P=.036). In conclusion, no spontaneous cancers were observed in skin tattooed with a red ink containing 2‐anisidine. However, red tattoos exposed to UVR showed faster tumor onset regarding the third tumor, and faster growth rate of the second and third tumor indicating red ink acts as a cocarcinogen with UVR. The cocarcinogenic effect was weak and may not be clinically relevant.
The future distribution of river fish: The complex interplay of climate and land use changes, species dispersal and movement barriers
Authors: Radinger Johannes , Essl Franz , Hölker Franz , Horký Pavel , Slavík Ondřej , Wolter Christian 
Published: May 2017

AbstractThe future distribution of river fishes will be jointly affected by climate and land use changes forcing species to move in space. However, little is known whether fish species will be able to keep pace with predicted climate and land use‐driven habitat shifts, in particular in fragmented river networks. In this study, we coupled species distribution models (stepwise boosted regression trees) of 17 fish species with species‐specific models of their dispersal (fish dispersal model FIDIMO) in the European River Elbe catchment. We quantified (i) the extent and direction (up‐ vs. downstream) of predicted habitat shifts under coupled “moderate” and “severe” climate and land use change scenarios for 2050, and (ii) the dispersal abilities of fishes to track predicted habitat shifts while explicitly considering movement barriers (e.g., weirs, dams). Our results revealed median net losses of suitable habitats of 24 and 94 river kilometers per species for the moderate and severe future scenarios, respectively. Predicted habitat gains and losses and the direction of habitat shifts were highly variable among species. Habitat gains were negatively related to fish body size, i.e., suitable habitats were projected to expand for smaller‐bodied fishes and to contract for larger‐bodied fishes. Moreover, habitats of lowland fish species were predicted to shift downstream, whereas those of headwater species showed upstream shifts. The dispersal model indicated that suitable habitats are likely to shift faster than species might disperse. In particular, smaller‐bodied fish (<200 mm) seem most vulnerable and least able to track future environmental change as their habitat shifted most and they are typically weaker dispersers. Furthermore, fishes and particularly larger‐bodied species might substantially be restricted by movement barriers to respond to predicted climate and land use changes, while smaller‐bodied species are rather restricted by their specific dispersal ability.
Factors predicting overall response and overall survival in hepatocellular carcinoma patients undergoing balloon‐occluded transcatheter arterial chemoembolization: A retrospective cohort study
Authors: Hatanaka Takeshi , Arai Hirotaka , Shibasaki Mitsuhiko , Tojima Hiroki , Takizawa Daichi , Toyoda Mitsuo , Takayama Hisashi , Abe Takehiko , Sato Ken , Kakizaki Satoru , Yamada Masanobu 
Published: May 2017

AimThis study aimed to investigate the factors predicting overall response and overall survival in hepatocellular carcinoma patients undergoing balloon‐occluded transcatheter arterial chemoembolization (B‐TACE).MethodsSixty‐six patients treated with B‐TACE at a Japanese tertiary referral hospital between January 2011 and August 2015 were included in this retrospective cohort study.ResultsThe overall response was classified as complete response, partial response, stable disease, and progressive disease in 35 (53.0%), 7 (10.6%), 13 (19.7%), and 11 (16.7%) patients, respectively. The response rate was 63.6%, and the disease control rate was 83.3%. The number of tumors (hazard ratio [HR], 4.44; 95% confidence interval [CI], 1.26–15.7; P = 0.021) and α‐fetoprotein level (HR, 11.40; 95% CI, 2.75–46.9; P < 0.001) were significantly associated with the tumor response in a multivariate analysis. The 1‐, 2‐, and 3‐year survival rates were 76.8% (95% CI, 64.5–85.3%), 57.3% (95% CI, 42.3–69.7%), and 46.7% (95% CI, 30.7–61.2%), respectively. The median survival time was 902 days. Albumin (≥3.4 g/dL) (HR, 0.28; 95% CI, 0.12–0.63; P = 0.002) and overall response (complete response and partial response) (HR, 0.33; 95% CI, 0.16–0.71; P = 0.004) were factors significantly associated with overall survival in a multivariate analysis. No mortalities were observed, but biloma requiring percutaneous transhepatic biliary drainage occurred in one patient (1.5%).ConclusionBalloon‐occluded transcatheter arterial chemoembolization may exert a good antitumor effect and result in good overall survival in select hepatocellular carcinoma patients.
Three phases of changes in carabid assemblages during secondary succession in a pine forest disturbed by windthrow – results from the first 10 years of observations
Authors: Skłodowski Jarosław J. 
Published: May 2017

AbstractA windthrow disturbance alters the functioning and structure of a forest ecosystem and causes substantial economic losses.A 10‐year pitfall study of carabid assemblages (Coleoptera, Carabidae) was carried out in pine stands disturbed by windthrow (Pisz Forest, North Poland) in the first year after the disturbance, with different classes of severity: severely disturbed stands (canopy cover up to 30%), moderately disturbed stands (canopy cover of 40–60%) and least disturbed stands (canopy cover of 70–90%).Based on the number of carabid species and their ecological traits, I confirmed the hypothesis that the amplitude of changes in carabid assemblages inhabiting severely and moderately disturbed stands would be greater than in the least disturbed stands. Variation in carabid assemblages was also linked to soil pH and to carbon and nitrogen content in the soil.The study confirmed my hypothesis regarding the delayed replacement of late successional carabid fauna by early successional fauna, which was linked to the broken pines lying on the soil, allowing late successional fauna to survive in the first few years after the windthrow.The principal response curve analysis identified three phases of post‐disturbance succession in carabid assemblages: (i) slight changes in the number of species and their ecological traits, lasting for 4 years; (ii) ‘rapid’ changes, lasting for 3 years, involving an increase in the number of species and rapid replacement of late successional carabid fauna by early successional fauna; and (iii) the slow recovery of late carabid successional fauna.
Microencapsulated Lactobacillus reuteri combined with modified atmosphere as a way to improve tuna burger shelf life
Authors: Angiolillo Luisa , Conte Amalia , Del Nobile Matteo A. 
Published: May 2017

AbstractIn this study, tuna burgers were subjected to a bio‐preservation treatment combined with modified atmosphere packaging (MAP) in order to prolong the shelf life. After L. reuteri production of reuterin, the antimicrobial compound was microencapsulated and then added to tuna burger formulation. Reuterin content was analysed before and after the spray drying treatment, thus assessing its final concentration. Then, the effects of spray‐dried reuterin on tuna burgers quality were investigated with success on samples packaged under both ordinary and MAP conditions. The efficacy of bio‐control was evident in all the samples. For burgers stored in air, a shelf life of about 7.63 days was recorded for the active samples with respect to the 5.78 days of the reuterin‐free samples. Under MAP, a similar reuterin effectiveness was recorded but a general shelf life improvement was reached, accounting for about 13 days in the active samples and 12 days in the reuterin‐free samples.
A comparative study using thrombin generation and three different INR methods in patients on Vitamin K antagonist treatment
Authors: Riva N. , Vella K. , Meli S. , Hickey K. , Zammit D. , Calamatta C. , Makris M. , Kitchen S. , Ageno W. , Gatt A. 
Published: May 2017

SummaryIntroductionVitamin K antagonist (VKA) treatment requires routine monitoring using the international normalized ratio (INR). However, different INR assays may vary in their results. The aim of this study was to assess the agreement of three different INR methods, compared with thrombin generation, in patients on VKA treatment.MethodsSixty patients attending the Anticoagulation Clinic at Mater Dei Hospital (Msida, Malta) for VKA monitoring between August and September 2015 were enrolled. The INR was tested using a point‐of‐care (POC) device (CoaguChek XS Plus, Roche Diagnostics) for both capillary and venous blood samples, a photo‐optical (Sysmex CS‐2100i/CA‐1500, Siemens) and a mechanical clot detection system (Thrombolyzer XRC, Behnk Elektronik). All assays used human recombinant thromboplastin as reagent. Thrombin generation was performed using the calibrated automated thrombogram.ResultsThere was a negative curvilinear correlation between the endogenous thrombin potential and different INR assays (r≤−.75) and a strong positive linear correlation between the CoaguChek XS Plus on capillary samples and the other INR methodologies (r≥.96).ConclusionAll different INR assays showed good correlation with the thrombin generation potential. The POC INR showed one of the highest correlation coefficients with thrombin generation, confirming the POC devices as an accurate, valid alternative to laboratory INR in VKA patients.