bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of community pharmacists in the identification and ongoing management of women at risk for perinatal depression: A qualitative study
Authors: Elkhodr Sabrine , Saba Maya , O’Reilly Claire , Saini Bandana 
Published: December 2017

Background: While pharmacists are among the most accessible primary health professionals within a mother’s healthcare team to identify potential cases of perinatal depression (PND), very little in the literature suggests that this role has been explored. Aim: The aim of this study was to explore community pharmacists’ perspectives on their potential roles in perinatal mental health promotion (recognition and health education) and the factors affecting these roles. Methods: In total, 20 semi-structured, in-depth interviews were conducted with community pharmacists. Results: Most pharmacists highlighted their significant roles in recognising PND symptoms and providing medication-related support to perinatal mothers. Barriers to service provision included inter-professional role boundaries, the lack of established referral systems and service remuneration and the lack of adequate training in mental health. Conclusion: Pharmacists could potentially reinforce their involvement in mental health promotion activities.
Diplomatic Theory of Kautilya and Sun Tzu
Authors: Dutta Anusmita , Dabhade Manish S. 
Published: December 2017

In the changing sphere of world politics, or more specifically in a multi-polar world, there has been a process of re-territorialization of the theory and practice of diplomacy. The discipline attempts to move away from the dominant Western influences and revive the non-Western understanding. The reading of Kautilya’s Arthashastra and Sun Tzu’s The Art of War in this context seems relevant, as these two ancient texts reinforce this understanding in an extensive manner. This article in its first part deals with the aspect of the diplomatic theory of international relations (IR) and traces its shift. The second part deals with the non-Western understanding of the diplomatic theory. Since this viewpoint is read with respect to the two ancient texts, the third part attempts to give justification of how the historical texts can be approached at without committing the fallacy attached to the study of old historical texts. The fourth and fifth parts of the article deal extensively with the diplomacy enunciated in the texts of Kautilya and Sun Tzu, respectively. The relevance of these two texts in the contemporary period is also evaluated. Thus, the study of the texts further reinforces the view of the presence of alternative understanding to the dominant Eurocentric perspective.
Measuring Relative Coupling Strength in Circadian Systems
Authors: Schmal Christoph , Herzog Erik D , Herzel Hanspeter 
Published: December 2017

Modern imaging techniques allow the monitoring of circadian rhythms of single cells. Coupling between these single cellular circadian oscillators can generate coherent periodic signals on the tissue level that subsequently orchestrate physiological outputs. The strength of coupling in such systems of oscillators is often unclear. In particular, effects on coupling strength by varying cell densities, by knockouts, and by inhibitor applications are debated. In this study, we suggest to quantify the relative coupling strength via analyzing period, phase, and amplitude distributions in ensembles of individual circadian oscillators. Simulations of different oscillator networks show that period and phase distributions become narrower with increasing coupling strength. Moreover, amplitudes can increase due to resonance effects. Variances of periods and phases decay monotonically with coupling strength, and can serve therefore as measures of relative coupling strength. Our theoretical predictions are confirmed by studying recently published experimental data from PERIOD2 expression in slices of the suprachiasmatic nucleus during and after the application of tetrodotoxin (TTX). On analyzing the corresponding period, phase, and amplitude distributions, we can show that treatment with TTX can be associated with a reduced coupling strength in the system of coupled oscillators. Analysis of an oscillator network derived directly from the data confirms our conclusions. We suggest that our approach is also applicable to quantify coupling in fibroblast cultures and hepatocyte networks, and for social synchronization of circadian rhythmicity in rodents, flies, and bees.
Reduction in Central Line–Associated Bloodstream Infections Correlated With the Introduction of a Novel Silver-Plated Dressing for Central Venous Catheters and Maintained for 6 Years
Authors: Karlnoski Rachel , Abboud Elia Charbel , Thompson Peggy , Oxner Asa Z. , Sinnott John T. , Marcet Jorge E. 
Published: December 2017

Objective: To assess a novel silver-plated dressing (SD) for central venous catheters in comparison to chlorhexidine gluconate–impregnated sponge (CHGIS) dressings in preventing central line–associated bloodstream infections (CLABSIs) in adult intensive care unit (ICU) patients. Design: Retrospective cohort study. Setting: Tampa General Hospital, an academic medical tertiary care center. Patients: All adult ICU patients of an academic medical tertiary care center from January 2009 to December 2010. Measurements and Main Results: A total of 3189 patient records were studied from 7 different ICUs during the 2-year period. Patients received either CHGIS dressings (January 2009-December 2009) or SDs (January 2010-December 2010). Primary outcomes measured were CLABSI rates per 1000 catheter days and ICU length of stay. There were 30 696 catheter days with CHGIS dressings and 31 319 catheter days with SDs. There was a statistically significant decrease in the rate of CLABSI per 1000 catheter days in the SD group, from 2.38 to 1.28 ( P = .001), with an absolute risk reduction of 1.1. There was a significantly lower incidence in the rate of CLABSI per 1000 catheter days in the SD group (incidence rate ratio [IRR] = 0.54, 95% confidence interval [CI]: 0.36-0.80). The relative risk of CLABSI in the SD group was 0.502 (95% CI: 0.340-0.730; P < .001). If SDs are used on all catheters, the decreased rate of CLABSIs observed would calculate to a cost savings of US$4070 to US$39 600 per 1000 catheter days. After successful implementation of the SD, we observed significant reductions in CLABSI rates and a sustained reduction in the subsequent 6 years. Conclusion: Use of SDs is associated with a significant decrease in CLABSI rates in adult ICU patients compared to CHGIS dressings, with an estimated cost savings of US$4070 to US$39 600 per 1000 catheter days.
Differential Experimental Effects of a Short Bout of Walking, Meditation, or Combination of Walking and Meditation on State Anxiety Among Young Adults
Authors: Edwards Meghan K. , Rosenbaum Simon , Loprinzi Paul D. 
Published: December 2017

Introduction: Single bouts of aerobic exercise and meditation have been shown to improve anxiety states. Yet to be evaluated in the literature, we sought to examine the effects of a single, short bout of aerobic exercise or meditation, as well as exercise and meditation combined on state anxiety among young adults. Design: Randomized controlled trial. Setting: University. Subjects: Participants (N = 110, mean age = 21.4 years) were randomly assigned to walk, meditate, walk then meditate, meditate then walk, or to sit (inactive control). Measures: All walking and meditation bouts were 10 minutes in duration. Participants’ state anxiety was monitored before and after the intervention using the State Trait Anxiety Inventory questionnaire. Results: Significant group × time interaction effects were observed ( P = .01). Post hoc paired t tests revealed that state anxiety significantly decreased from baseline to postintervention in the meditation ( P = .002), meditation then walk ( P = .002), and walk then meditation ( P = .03) groups but not the walk ( P = .75) or control ( P = .45) groups. Conclusion: Meditation (vs a brisk walk) may be a preferred method of attenuating anxiety symptomology. Individuals desiring the health benefits associated with aerobic exercise may achieve additional anxiolytic benefits if they employ a brief meditation session before or after exercising.
Multiple modes of facilitation in a Norwegian creative musicking project
Authors: Viig Tine Grieg 
Published: December 2017

In recent decades, the teaching and learning of composition has become an important topic for research in music education. Composition is established as one of the three main areas in the Norwegian curriculum Læreplanverket for Kunnskapsløftet (LK06, 2006), and the importance of creative competencies is being increasingly recognized worldwide, inside and outside formal music education institutions. A central research topic within the field of music education addresses the issue of how to facilitate and lead creative musicking projects. This article examines a composition workshop in which pupils from several Norwegian municipal schools of music and performing arts participate. The aim of the workshop was to create a new piece of music that would be performed at the end of the project period. An experienced composition workshop leader led the project, and four professional musicians took part. The empirical data for this study consisted of interviews, participant observation and video-recordings. Analyzed from a sociocultural perspective, the findings led to a deeper understanding of the facilitation role, revealing that it consists of multiple modes, such as scaffolding, co-participation and collaboration, as well as management and distribution of cultural tools. These findings are discussed in terms of understanding the complex knowledge and skills needed to facilitate creative musicking practices.
Traumatic brain injuries in mixed martial arts: A systematic review
Authors: Lockwood Joel , Frape Liam , Lin Steve , Ackery Alun 
Published: December 2017

Introduction Mixed martial arts is an emerging combat sport that is gaining popularity worldwide. We systematically reviewed the literature regarding the prevalence, severity and risk factors of head injuries sustained in mixed martial arts activities. Methods We conducted a comprehensive systematic review of Ovid MEDLINE, Embase, PsycINFO, EBM Reviews, CINAHL, SPORTDiscus, and Web of Science from 1990 to 2016 for studies of any design that reported associations of acute or chronic head injuries in persons participating in mixed martial arts activities. Results The initial database search yielded a total 472 citations, including 264 unique citations after duplications were removed. A total of 18 articles, primarily of observational data, showed ‘technical knockouts’ and ‘knockouts’ are prevalent in this sport (range: 28.3–46.2% of all matches) with other studies showing the lifetime average of 6.2 technical knockouts or knockouts in a career. Studies used inconsistent reporting methods for concussion, and no information regarding long-term follow-up was available. Conclusion Mixed martial arts fighting may be associated with repetitive head injuries and potential long-term neurological consequences; however, data on this topic are poor. Larger studies and stringent medical oversight are needed to improve the management and understanding of mixed martial arts head injuries, with implementation of harm reduction strategies and/or rule modifications to prevent long-term neurological sequelae. Systematic Review Registration: PROSPERO – CRD42014010019.
Oxidative Stress And Prolidase Enzyme Activity In The Pathogenesis Of Primary Varicose Veins
Authors: Akar İlker , İnce İlker , Aslan Cemal , Benli İsmail , Demir Osman , Altındeger Nuray , Dogan Abdullah , Ceber Mehmet 
Published: December 2017

Objectives Vascular endothelial dysfunction leads to the emerging of free oxygen radicals, deficiency of antioxidant system, forming of oxidative stress, inflammatory processes and release of proinflammatory cytokines. These things play big role in the development of primary varicose veins. Prolidase has been reported as an indicator of oxidative stress in diabetes, diabetic neuropathy, non-ulcerous dyspepsia, osteoporosis, polycystic over syndrome and many other diseases. The aim of this study is to evaluate the oxidative stress at venous insufficiency and to provide preliminary knowledge about the role of prolidase enzyme in varicose vein formation. Methods Ninety patients aged between 22 and 80 (47.35 ± 17.69) were included in the study and divided into 3 groups. Group1(n:30)(Serum control group): Patients without venous insufficiency. Group 2(n:30)(Tissue control group(healthy vein group): Patients underwent coronary artery bypass surgery (the remaining portion of great saphenous vein used as coronary artery bypass graft used as normal tissue) . Group 3(n:30)(Varicose vein group): Patients underwent varicose vein surgery (varicose vein and serum of these patients were used for study). Total Oxidant Status (TOS), Total Antioxidant Status (TAS), Oxidative Stress Index (OSI) and Prolidase enzyme levels were detected in tissue and serum samples. Results No significant changes were detected between three groups’ serum samples in oxidative stress parameters and in the prolidase enzyme activity. The tissue TOS and OSI were higher in varicose vein group according to normal vein group and this was found statistically significant. And TAC levels in varicose vein group were significantly lower than normal vein group. Prolidase enzyme activity in varicose vein group was found higher according to normal vein group. Conclusion Oxidative stress plays a role at the development of primary varicose veins at biochemical level. Prolidase enzyme related with oxidative stress may play an important role in the pathogenesis of primary varicose veins.
Subcutaneous interferon β-1a three times weekly and the natural evolution of gadolinium-enhancing lesions into chronic black holes in relapsing and progressive multiple sclerosis: Analysis of PRISMS and SPECTRIMS trials
Authors: Traboulsee A , Li DKB , Tam R , Zhao G , Riddehough A , Fang J , Dangond F , Kappos L ,   on behalf of the PRISMS and SPECTRIMS Working Groups
Published: December 2017

Background Evolution of gadolinium-enhancing lesions into chronic black holes (CBH) may be reduced by interferon (IFN) therapy. Objective The objective of this paper is to assess the effect of IFN β-1a and placebo on CBH evolution and disability in patients with relapsing–remitting multiple sclerosis (RRMS), as well as CBH evolution in patients with secondary progressive multiple sclerosis (SPMS). Methods A post hoc, exploratory analysis of patients with RRMS and SPMS with monthly MRI scans (months –1 to 9) from two separate placebo-controlled clinical trials of IFN β-1a was conducted. Results In RRMS patients, the risk of ≥1 evolved CBH was lower for IFN β-1a versus placebo (odds ratio 0.42; p = 0.024); volume of newly evolved CBH was numerically reduced. A numerically higher proportion of patients with ≥1 evolving CBH vs no evolving CBH had confirmed three-month disability progression (four-year rate 55.8% vs 43.1%, respectively). Proportion of lesions evolving into CBH (patient level: 34.7% vs 12.6%, p < 0.0001; lesion level: 28.8% vs 11.0%, p < 0.0001) and evolved CBH volume (median 33.5 mm3 (Quartile 1, 0.0; Quartile 3, 173.4) vs 0.0 mm3 (0.0; 52.4); p = 0.0008) was higher for SPMS than RRMS patients treated with IFN β-1a. Conclusion In RRMS, IFN β-1a significantly decreased the proportion of new T1 Gd+ lesions evolving into CBH and the risk of developing a CBH. In patients with SPMS, more lesions develop to CBH, indicating reduced repair capacity, and the natural history of lesion development appears to be unaffected by IFN β-1a treatment.
Factors associated with the achievement of cervical smears by general practitioners
Authors: Rochoy Michaël , Raginel Thibaut , Favre Jonathan , Soueres Estelle , Messaadi Nassir , Deken Valérie , Duhamel Alain , Berkhout Christophe 
Published: December 2017

Abstract
Objective
Reliable data about general practitioners performing pap-tests are insufficient. A claim code for the achievement of pap-smears exists in France, but its use by general practitioners is not known. The main purpose of this study was to highlight independent factors associated with the achievement of pap-smears by the general practitioner (GP). We carried out a descriptive and analytic epidemiologic study in 347 GPs and their 244,889 patients, registered at the Health Care Insurance Fund of Flanders. The European Deprivation Index (EDI) in the area of GP’s surgeries was specified. All GPs were questioned by telephone about their performance of pap-tests. The claim database of the insurance fund was analyzed to describe characteristics of GPs.

Results
The answer rate among questioned GPs was 98.8%. Pap-smears were performed in their surgeries by 182 GPs (53.1%). Among males, 45.7% performed pap-smears versus 78.4% of the female (adjusted odds-ratio = 4.5, p < 0.001). The mean rate of screened women in the target population was 44% when GPs were performing smears versus 42% when they were not (adjusted odds-ratio = 1.04, p = 0.03). Only 19.5% of GPs used the claim code. The number of patients, and the EDI were not associated with pap-smears.
Trial registration ClinicalTrials.gov NCT02749110 (April 22, 2016)
Blockchain protocols in clinical trials: Transparency and traceability of consent
Authors: Benchoufi Mehdi , Porcher Raphael , Ravaud Philippe 
Published: December 2017

Clinical trial consent for protocols and their revisions should be transparent for patients and traceable for stakeholders. Our goal is to implement a process allowing for collection of patients’ informed consent, which is bound to protocol revisions, storing and tracking the consent in a secure, unfalsifiable and publicly verifiable way, and enabling the sharing of this information in real time. For that, we build a consent workflow using a trending technology called Blockchain. This is a distributed technology that brings a built-in layer of transparency and traceability. From a more general and prospective point of view, we believe Blockchain technology brings a paradigmatical shift to the entire clinical research field. We designed a Proof-of-Concept protocol consisting of time-stamping each step of the patient’s consent collection using Blockchain, thus archiving and historicising the consent through cryptographic validation in a securely unfalsifiable and transparent way. For each protocol revision, consent was sought again. We obtained a single document, in an open format, that accounted for the whole consent collection process: a time-stamped consent status regarding each version of the protocol. This document cannot be corrupted and can be checked on any dedicated public website. It should be considered a robust proof of data. However, in a live clinical trial, the authentication system should be strengthened to remove the need for third parties, here trial stakeholders, and give participative control to the peer users. In the future, the complex data flow of a clinical trial could be tracked by using Blockchain, which core functionality, named Smart Contract, could help prevent clinical trial events not occurring in the correct chronological order, for example including patients before they consented or analysing case report form data before freezing the database. Globally, Blockchain could help with reliability, security, transparency and could be a consistent step toward reproducibility.
Syphilis screening and treatment in pregnant women in Kinshasa, Democratic Republic of the Congo and in Lusaka, Zambia: a cross-sectional study
Authors: Berrueta Mabel , Cafferata Maria Luisa , Mwenechanya Musaku , Nkamba Mukadi Dalau , Althabe Fernando , Bergel Eduardo , Gibbons Luz , Ciganda Alvaro , Klein Karen , Mwapule Tembo Abigail , Habulembe Mwanakalanga Friday , Banda Ernest , Mavila Kilonga Arlette , Lusamba Dikassa Paul , Xiong Xu , Chomba Elwyn , Tshefu Antoinette K. , Buekens Pierre 
Published: December 2017

Background: Congenital syphilis is associated with perinatal deaths, preterm births and congenital malformations. Low rates of syphilis screening during pregnancy and treatment of those found seropositive have been reported in the Democratic Republic of the Congo (DRC) and Zambia. We report the rates on antenatal syphilis screening, the seroprevalence of syphilis infection, and the frequency of antibiotic treatment in pregnant women screened positive for syphilis during their attendance at antenatal care (ANC) clinics in Kinshasa, DRC and Lusaka, Zambia. Methods: Women attending their first ANC were enrolled consecutively during a 9-month period in 16 and 13 ANC clinics in Kinshasa and Lusaka respectively, in the context of the baseline period of a cluster trial. Study personnel collected data on women’s characteristics, the syphilis screening practices, the test results, and the frequency of treatment, that were done under routine ANC conditions and registered in the clinic records. Results: 4,153 women in Kinshasa and 18,097 women in Lusaka were enrolled. The frequency of screening at the first visit was 59.7% (n= 2,479) in Kinshasa, and 27.8% (n=5,025) in Lusaka. Screening test availability varied. In the periods in which tests were available the screening rates were 92.8% in Kinshasa and 52.0% in Lusaka. The frequency of women screened seropositive was 0.4% (n=10) in Kinshasa and 2.2% (n=109) in Lusaka. Respectively, 10% (n=1) and 11.9% (n= 13) among seropositive women received treatment at the first visit. Conclusions: The results of the study show that screening for syphilis in pregnancy is not universal even when supplies are available. Our ongoing trial will evaluate the impact of a behavioral intervention on changing health providers’ practices to increase screening and treatment rates when supplies are available.
The Biological Variation Data Critical Appraisal Checklist: A Standard for Evaluating Studies on Biological Variation
Authors: Aarsand Aasne K , Røraas Thomas , Fernandez-Calle Pilar , Ricos Carmen , Díaz-Garzón Jorge , Jonker Niels , Perich Carmen , González-Lao Elisabet , Carobene Anna , Minchinela Joana , Coşkun Abdurrahman , Simón Margarita , Álvarez Virtudes , Bartlett William A , Fernández-Fernández Pilar , Boned Beatriz , Braga Federica , Corte Zoraida , Aslan Berna , Sandberg Sverre 
Published: December 2017

Abstract

BACKGROUND
Concern has been raised about the quality of available biological variation (BV) estimates and the effect of their application in clinical practice. A European Federation of Clinical Chemistry and Laboratory Medicine Task and Finish Group has addressed this issue. The aim of this report is to (a) describe the Biological Variation Data Critical Appraisal Checklist (BIVAC), which verifies whether publications have included all essential elements that may impact the veracity of associated BV estimates, (b) use the BIVAC to critically appraise existing BV publications on enzymes, lipids, kidney, and diabetes-related measurands, and (c) apply metaanalysis to deliver a global within-subject BV (CVI) estimate for alanine aminotransferase (ALT).

METHODS
In the BIVAC, publications were rated as A, B, C, or D, indicating descending compliance for 14 BIVAC quality items, focusing on study design, methodology, and statistical handling. A D grade indicated that associated BV estimates should not be applied in clinical practice. Systematic searches were applied to identify BV studies for 28 different measurands.

RESULTS
In total, 128 publications were identified, providing 935 different BV estimates. Nine percent achieved D scores. Outlier analysis and variance homogeneity testing were scored as C in &gt;60% of 847 cases. Metaanalysis delivered a CVI estimate for ALT of 15.4%.

CONCLUSIONS
Application of BIVAC to BV publications identified deficiencies in required study detail and delivery, especially for statistical analysis. Those deficiencies impact the veracity of BV estimates. BV data from BIVAC-compliant studies can be combined to deliver robust global estimates for safe clinical application.