bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study on community pharmacists' decision‐making process when making a diagnosis
Authors: Sinopoulou Vassiliki , Summerfield Paul , Rutter Paul 
Published: October 2017

AbstractRationale, aims, and objectivesSelf‐care policies are increasingly directing patients to seek advice from community pharmacists. This means pharmacists need to have sound diagnostic decision‐making skills to enable them to recognise a variety of conditions. The aim of this study was to investigate the process by which pharmacists manage patient signs and symptoms and to explore their use of decision‐making for diagnostic purposes.MethodsData were collected through semi‐structured, face‐to‐face interviews with community pharmacists working in England, between August 2013 and November 2014. Pharmacists were asked to share their experiences on how they performed patient consultations, and more specifically how they would approach a hypothetical headache scenario. As part of the interview, their sources of knowledge and experience were also explored. Framework analysis was used to identify themes and subthemes.ResultsEight interviews were conducted with pharmacists who had a wide range of working practice, from 1 year through to 40 years of experience. The pharmacists' main motivations during consultations were product selection and risk minimisation. Their questioning approach and decision‐making relied heavily on mnemonic methods. This led to poor quality information gathering—although pharmacists acknowledged they needed to “delve deeper” but were often unable to articulate how or why. Some pharmacists exhibited elements of clinical reasoning in their consultations, but this seemed, mostly, to be unconscious and subsequently applied inappropriately. Overall, pharmacists exhibited poor decision‐making ability, and often decisions were based on personal belief and experiences rather than evidence.ConclusionsCommunity pharmacists relied heavily on mnemonic methods to manage patients' signs and symptoms with diagnosis‐based decision‐making being seldom employed. These findings suggest practicing pharmacists should receive more diagnostic training.
Monitoring of Potentially Inappropriate Prescriptions in Older Inpatients: A French Multicenter Study
Authors: Pandraud‐Riguet Irène , Bonnet‐Zamponi Dominique , Bourcier Elsa , Buyse Marion , Laribe‐Caget Sandra , Frémont Patrick , Pautas Eric , Verny Christiane , Hindlet Patrick , Fernandez Christine 
Published: October 2017

ObjectivesTo determine whether potentially inappropriate medications (PIMs) or potentially inappropriate associations (PIAs) prescribed knowingly are associated with patient monitoring.DesignProspective observational study.SettingGeriatric units (n = 56) in 28 hospitals.ParticipantsInpatients aged 75 and older (N = 1,327).MeasurementsPotentially inappropriate prescriptions (PIP) were defined as a PIM or a PIA selected by an expert board from lists of explicit criteria (Beers, Priscus, Laroche, French Health Agency) using a Delphi process. They were considered to be prescribed knowingly if they were maintained after reassessment by the geriatrician and the clinical pharmacist. Primary outcome was the rate of PIPs maintained (prescribed knowingly) and for which a geriatrician declared that specific monitoring was performed. Secondary outcomes were the parameters monitored and the rate of participants receiving knowingly a PIP.ResultsOne thousand sixty‐three PIPs were detected in 607 participants (46%). After reassessment, 826 (78%) PIPs were maintained in 490 participants (37%), the main reasons being participant's regular treatment and lack of alternative. Psychotropic (36%), cardiovascular (including antithrombotics) (29%), and laxative or antiemetic drugs (16%) were the most‐frequent classes prescribed knowingly. The geriatricians declared to perform clinical or biological monitoring for 69% (n = 570) of PIMs or PIAs prescribed knowingly. Three types of specific monitoring were identified: clinical, biological, and follow‐up with a specialist.ConclusionApproximately three‐quarters of PIMs or PIAs were prescribed knowingly, of which 69% were monitored, with wide variations in occurrence and in quality according to drug classes. This underlines the need for accurate guidelines on PIP monitoring.
Predicting Discharge to Institutional Long‐Term Care After Stroke: A Systematic Review and Metaanalysis
Authors: Burton Jennifer K. , Ferguson Eilidh E. C. , Barugh Amanda J. , Walesby Katherine E. , MacLullich Alasdair M. J. , Shenkin Susan D. , Quinn Terry J. 
Published: October 2017

Background/ObjectivesStroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long‐term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke.DesignWe registered and conducted a systematic review and meta‐analysis (PROSPERO: CRD42015023497) of observational studies. We searched MEDLINE, EMBASE, and CINAHL Plus to February 2017. Quantitative synthesis was performed where data allowed.SettingAcute and rehabilitation hospitals.ParticipantsAdults hospitalized for stroke who were newly admitted directly to long‐term institutional care at the time of hospital discharge.MeasurementsFactors associated with new institutionalization.ResultsFrom 10,420 records, we included 18 studies (n = 32,139 participants). The studies were heterogeneous and conducted in Europe, North America, and East Asia. Eight studies were at high risk of selection bias. The proportion of those surviving to discharge who were newly discharged to long‐term care varied from 7% to 39% (median 17%, interquartile range 12%), and the model of care received in the long‐term care setting was not defined. Older age and greater stroke severity had a consistently positive association with the need for long‐term care admission. Individuals who had a severe stroke were 26 times as likely to be admitted to long‐term care than those who had a minor stroke. Individuals aged 65 and older had a risk of stroke that was three times as great as that of younger individuals. Potentially modifiable factors were rarely examined.ConclusionAge and stroke severity are important predictors of institutional long‐term care admission directly from the hospital after an acute stroke. Potentially modifiable factors should be the target of future research. Stroke outcome studies should report discharge destination, defining the model of care provided in the long‐term care setting.
Note on the Rate and Energy Efficiency Limits for Additive Manufacturing
Authors: Gutowski Timothy , Jiang Sheng , Cooper Daniel , Corman Gero , Hausmann Michael , Manson Jan‐Anders , Schudeleit Timo , Wegener Konrad , Sabelle Matias , Ramos‐Grez Jorge , Sekulic Dusan P. 
Published: October 2017

SummaryWe review the process rates and energy intensities of various additive processing technologies and focus on recent progress in improving these metrics for laser powder bed fusion processing of metals, and filament and pellet extrusion processing of polymers and composites. Over the last decade, observed progress in raw build rates has been quite substantial, with laser metal processes improving by about 1 order of magnitude, and polymer extrusion processes by more than 2 orders of magnitude. We develop simple heat transfer models that explain these improvements, point to other possible strategies for improvement, and highlight rate limits. We observe a pattern in laser metal technologies that mimics the development of machine tools; an efficiency plateau, where faster rates require more power with no change in energy nor rate efficiency.
Comparing the broad socio‐cognitive profile of youth with Williams syndrome and 22q11.2 deletion syndrome
Authors: Weisman O. , Feldman R. , Burg‐Malki M. , Keren M. , Geva R. , Diesendruck G. , Gothelf D. 
Published: October 2017

AbstractBackgroundNumerous studies have assessed the socio‐cognitive profile in Williams syndrome (WS) and, independently, in 22q11.2 deletion syndrome (22q11.2DS). Yet, a cross‐syndrome comparison of these abilities between individuals with these two syndromes with known social deficits has not been conducted.MethodsEighty‐two children participated in four study groups: WS (n = 18), 22q112.DS (n = 24), age‐matched individuals with idiopathic developmental disability (IDD; n = 20) and typically developing (TD) controls (n = 20). Participants completed four socio‐cognitive tests: facial emotion recognition, mental state attribution, differentiating real from apparent emotions and trait inference based on motives and actions‐outcomes.ResultsThe current findings demonstrate that children with WS were better in labelling happy faces compared with children with 22q11.2DS, partially reflecting their exaggerated social drive. In the false belief task, however, the WS and IDD groups performed poorly compared with the 22q11.2DS group, possibly due to their difficulty to interpret subtle social cues. When asked to identify the gap between real‐negative vs. apparent‐positive emotions, the 22q11.2DS group performed similarly to TD children but better than the WS group, possibly due to their anxious personality and their innate bias towards negatively valence cues. Finally, individuals with WS were more willing to become friends with a story character even when the character's motives were negative, reflecting their difficulty to avoid potentially harmful real‐life situations.ConclusionsOverall, our multi‐facet socio‐cognitive battery uncovered strengths and weaknesses in social cognition that are syndrome‐specific, shared among the genetic syndromes, or common to the three clinical groups compared with healthy controls. Our findings underscore the need to devise age‐specific and condition‐specific assessment tools and intervention programs towards improving these children's socio‐cognitive deficits.
Arterial stiffness, cognitive impairment and dementia: confounding factor or real risk?
Authors: Iulita M. Florencia , Noriega de la Colina Adrián , Girouard Hélène 
Published: October 2017

AbstractLarge artery stiffness is a frequent condition that arises with ageing, and is accelerated by the presence of co‐morbidities like hypertension, obesity and diabetes. Although epidemiological studies have indicated an association between arterial stiffness, cognitive impairment and dementia, the precise effects of stiff arteries on the brain remains obscure. This is because, in humans, arterial stiffness is often accompanied by other factors such as age, high blood pressure, atherosclerosis and inflammation, which could themselves damage the brain independently of stiffness. Therefore, the question remains: is arterial stiffness a true risk for cognitive decline? Or, is it a confounding factor? In this review, we provide an overview of arterial stiffness and its impact on brain function based on human and animal studies. We summarize the evidence linking arterial stiffness to cognitive dysfunction and dementia, and discuss the role of new animal models to better understand the mechanisms by which arterial stiffness affects the brain. We close with an overview of treatments to correct stiffness and discuss the challenges to translate them to real patient care.
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This article is part of the Special Issue “Vascular Dementia”.
Rapid changes in brain aromatase activity in the female quail brain following expression of sexual behaviour
Authors: de Bournonville C. , Ball G. F. , Balthazart J. , Cornil C. A. 
Published: October 2017

In male quail, oestrogens produced in the brain (neuro‐oestrogens) exert a dual action on male sexual behaviour: they increase sexual motivation within minutes via mechanisms activated at the membrane but facilitate sexual performance by slower, presumably nuclear‐initiated, mechanisms. Recent work indicates that neuro‐oestrogens are also implicated in the control of female sexual motivation despite the presence of high circulating concentrations of oestrogens of ovarian origin. Interestingly, aromatase activity (AA) in the male brain is regulated in time domains corresponding to the slow “genomic” and faster “nongenomic” modes of action of oestrogens. Furthermore, rapid changes in brain AA are observed in males after sexual interactions with a female. In the present study, we investigated whether similar rapid changes in brain AA are observed in females allowed to interact sexually with males. A significant decrease in AA was observed in the medial preoptic nucleus after interactions that lasted 2, 5 or 10 minutes, although this decrease was no longer significant after 15 minutes of interaction. In the bed nucleus of the stria terminalis, a progressive decline of average AA was observed between 2 and 15 minutes, although it never reached statistical significance. AA in this nucleus was, however, negatively correlated with the sexual receptivity of the female. These data indicate that sexual interactions affect brain AA in females as in males in an anatomically specific manner and suggest that rapid changes in brain oestrogens production could also modulate female sexual behaviour.
Response of in ovo administration of zinc on egg hatchability and immune response of commercial broiler chicken
Authors: Jose N. , Elangovan A. V. , Awachat V. B. , Shet D. , Ghosh J. , David C. G. 
Published: October 2017

SummaryAn experiment was conducted to determine the effect of in ovo administration of different forms of zinc with respect to hatchability and performance of commercial broiler chicken. In trial 1, the fertile eggs on day 18 were divided into six treatment groups: Group I as control without any supplementation of zinc, group II to IV were supplemented with 0.5 mg zinc per egg as zinc sulphate, zinc methionine or nano zinc, respectively, and Group V with nano zinc at 0.25 mg zinc per egg. Sixth group received 0.5 ml citric acid per egg as sham control. The results of the first trial indicated that in ovo administration of nano zinc at both levels and zinc methionine resulted in complete failure of hatchability. A second trial to validate the result of trial 1 consisted of Group I control (no administration). Group II and Group III were supplemented with zinc sulphate and zinc methionine, respectively, at 0.5 mg zinc per egg. Group IV and Group V were supplemented with nano zinc at 0.04 and 0.08 mg per egg. In the second trial, again there was a similar pattern for zinc sulphate and zinc methionine. Administration of Zn by nano form had around 80% hatchability on fertile eggs in comparison with the unadministered control eggs (92%). There was no difference (p > .05) in body weight gain, feed intake and FCR. No difference (p > .05) was observed between treatments for cell‐mediated immune response and humoral immune response. Nano Zn‐administered group showed a non‐significant downregulation of MUC2 gene. It could be concluded that in ovo administration of higher levels of zinc has to be with caution for the developing embryo of commercial broiler chicken.
Growth performance of piglets during the first two weeks of lactation affects the development of the intestinal microbiota
Authors: Morissette B. , Talbot G. , Beaulieu C. , Lessard M. 
Published: October 2017

SummaryThe aim of this study was to evaluate the effect of newborn piglet weight gain during the first 2 weeks of lactation on the luminal and mucosal microbiota of the ileum and colon. The microbiota from high‐weight‐gain (HWG) and low‐weight‐gain (LWG) 2‐week‐old piglets was characterized by amplicon length heterogeneity PCR (LH‐PCR) and compared using diversity indices and multivariate statistical analyses. At birth, LWG piglets weighted in average 0.26 kg less than HWG piglets (p = .002). The weight difference between LWG and HWG piglets increased with time and reached 2.1 kg after 16 days of lactation (p < .0001). Based on these growth performance differences, estimated colostrum and milk intake was greater in HWG than in LWG piglets (p < .0001). Analysis of the LH‐PCR data of the microbiota using non‐metric multidimensional scaling (NMS) and blocked multiresponse permutation procedure (MRBP) revealed that the microbiota of the HWG and LWG piglets tended to differ in ileal mucosa (p = .097) and differed in colonic lumen (p = .024). The microbiota of HWG piglets had higher levels of Bacteroidetes, Bacteroides and Ruminoccocaceae, and lower proportions of Actinobacillus porcinus and Lactobacillus amylovorus when compared with those of LWG piglets. As the weight gain of nursing piglets is highly correlated with the amount of ingested colostrum and milk, the results strongly suggest that colostrum and milk intake in the first 2 weeks of life influenced the development of the gut microbiota.
Effect of feed intake level and dietary protein content on the body temperature of pigs housed under thermo neutral conditions
Authors: Morales A. , Ibarra N. , Chávez M. , Gómez T. , Suárez A. , Valle J. A. , Camacho R. L. , Cervantes M. 
Published: October 2017

SummaryFeed intake and diet composition appear to affect the body temperature of pigs. Two trials were conducted to analyse the effect of feed intake level and dietary protein content on the intestinal temperature (IT) of pigs housed under thermo neutral conditions. Ten pigs (64.1 ± 1.3 kg initial body weight) fitted with an ileal cannula were used. A thermometer set to register the IT at 5‐min intervals was implanted into the ileum through the cannula. In both trials, the ambient temperature ranged from 19.1 to 21.6°C and the pigs were fed at 07:00 and 19:00 hr (same amount each time). In trial 1, the pigs were fed daily 1.2 or 1.8 kg of a wheat–soybean meal diet. The IT followed a similar pattern along a 24‐hr period regardless the feed intake level. The IT rapidly increased up to 0.61 and 0.74°C after the morning meal and up to 0.53 and 0.47°C after the evening meal in pigs fed 1.2 and 1.8 kg/d respectively. The postprandial IT was higher in pigs fed 1.8 kg after each meal (p < .05). In trial 2, pigs were fed daily 1.8 kg of a low (11%) or a high (22%) crude protein diet. The IT followed a similar pattern along the 24‐hr period regardless the dietary protein level. The postprandial IT did not differ between pigs fed the low protein or the high protein (p > .10). The IT rapidly increased up to 0.66 and 0.62°C after the morning meal in pigs fed the high‐ and low‐protein diet (p < .05), but there was no change after the evening meal (p > .10). In conclusion, the feed intake level affected the IT of pigs housed under TN conditions, but the dietary protein content had no effect.
The efficacy of using exogenous enzymes cocktail on production, egg quality, egg nutrients and blood metabolites of laying hens fed distiller's dried grains with solubles
Authors: Abd El‐Hack M. E. , Chaudhry M. T. , Mahrose K. M. , Noreldin A. , Emam M. , Alagawany M. 
Published: October 2017

SummaryAn experiment was performed using 120 Hisex Brown laying hens for evaluating the effects of different inclusion levels of corn distiller's dried grains with solubles (DDGS) as a replacement of soybean meal (SBM) with or without enzyme cocktail on performance, egg quality, egg nutrients and blood metabolites in laying hens through 22–42 weeks of age. A 4 × 2 factorial design experiment was performed including four substitution levels of DDGS (0, 250, 500 and 750 g/kg respectively) and two enzyme cocktail levels (0 and 250 mg/kg diet). The used enzyme in this study “Gallazyme” composed of xylanase, Trichoderma longibrachiatum (600 units/g), protease, Bacillus subtilis (8,000 units/g) and amylase and Bacillus amyloliquofaciens (800 units/g). The control diet showed the best feed efficiency followed by the intermediate levels of DDGS. The lowest value of feed efficiency was found in the group fed the highest level of DDGS. Enzyme addition improved feed efficiency and decreased laying rate. Increasing DDGS levels was associated with albumin and shell thickness increases. Dietary DDGS depressed all egg components except the organic matter which maximised in enzyme‐treated groups. Increasing DDGS level was accompanied by increase in yolk cholesterol and total lipids. No significant impacts were detected with enzymes supplementation on yolk lipids profile. Excepting serum calcium and phosphorous, all serum constituents increased with increasing level of DDGS. Using enzyme markedly depressed serum ammonia by 15.02% and increased calcium by 6.44% compared with enzyme‐free diets. Interaction between DDGS and enzyme was significant on most of studied parameters. It could be concluded that using enzyme cocktail in DDGS‐based diets may improve feed efficiency and egg quality, in addition to lowering blood ammonia and increasing blood calcium. It is recommended to substitute SBM by DDGS up to 500 g/kg diet.
Milk fatty acid profile from cows fed with mixed rations and different access time to pastureland during early lactation
Authors: Barca J. , Carriquiry M. , Olazabal L. , Fajardo M. , Chilibroste P. , Meikle A. 
Published: October 2017

SummaryMilk fatty acid (FA) profiles were determined in Holstein cows (n = 27) fed total mixed rations (TMR) ad libitum (G0) or diet composed by TMR (50% dry matter [DM] offered) plus grazing of pasture with 6 hr of access time to paddock in one session (G1) or 9 hr in two sessions (G2) at 45 days in milk (DIM). Moreover, milk FA was determined at 65 DIM when G0 cows turned out to G1 diet without adaptation period (Post‐G0), G1 remained as controls. Milk FA was quantified using gas chromatography and mass spectrometry. Preformed FA at 45 DIM was greater (+27%) for G2 than G0 cows (p < .05). Stearic acid (C18:0) was 30% greater for G2 cows (p < .05). De novo FA was lowest for G2 cows (p < .05). Conjugated linoleic acid (CLA) did not differ (p < .12), while vaccenic acid (C18:1trans) was twofold greater for grazing treatments (p < .01). Linolenic acid [C18:3(n‐3)] was greatest for G2 and lowest for G0 cows (p < .01). Omega 6 FA was greater for G0 than grazing cows, mainly due to linoleic acid [18:2cis(n‐6); p < .05]. These results determined that n‐6/n‐3 ratio was almost threefold greater for G0 than grazing cows (p < .001). When diet of G0 cows changed to include pasture (Post‐G0), preformed FA increased (p < .05), explained mainly by the increase (p < .05) of stearic (C18:0) and C18:1trans, while de novo FA tended to decrease (p < .1). Moreover, the amount of CLA and C18:3(n‐3) tended to increase (p < .1) in Post‐G0 cows. Offering 50% of dietary DM from pasture modified milk FA profile in early lactation potentially beneficial for human health. When TMR‐fed cows were turned out to 50% pasture, milk FA profile reflected dietary change without need of an adaptation period.