bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Point‐of‐care Ultrasonography on Emergency Department Length of Stay and Computed Tomography Utilization in Children With Suspected Appendicitis
Authors: Elikashvili Inna , Tay Ee Tein , Tsung James W. 
Published: February 2014

AbstractObjectivesThe role of clinician‐performed ultrasonography (US) for suspected appendicitis is unclear. Published data conclude that US has high specificity to rule in the diagnosis of appendicitis, with variable sensitivity to rule it out. Newer data suggest that point‐of‐care (POC) US may have similar test characteristics. Our objective was to evaluate the effect of POC US in children with suspected appendicitis and its effect on emergency department (ED) length of stay (LOS) and computed tomography (CT) utilization.MethodsThis was a prospective observational convenience sample of children with suspected appendicitis requiring imaging evaluation that adhered to the Standards for the Reporting of Diagnostic accuracy studies (STARD) criteria. Outcomes were determined by operative or pathology report in those who had appendicitis, and 3‐week phone follow‐up in those patients who were nonoperative. Differences in ED LOS were analyzed by one‐way analysis of variance (ANOVA) between patients who received dispositions after POC US, radiology US, or CT. Test performance characteristics were calculated for all imaging modalities.ResultsAmong 150 enrolled patients, 50 had appendicitis (33.3%). There were no missed cases of appendicitis in discharged patients at 3‐week phone follow‐up, nor negative laparotomies in those who went to the operating room. Those who had dispositions after POC US (n = 25) had a significantly decreased mean ED LOS (154 minutes, 95% confidence interval [CI] = 115 to 193 minutes) compared with those requiring radiology US (288 minutes, 95% CI = 257 to 319 minutes) or CT scan (487 minutes; 95% CI = 434 to 540 minutes). Baseline CT rate was 44.2% (95% CI = 30.7% to 57.7%) prior to study start and decreased to 27.3% (95% CI = 20.17% to 34.43%) during the study. CTs were avoided in four patients with conclusive POC US results and inconclusive radiology US results. The sensitivity, specificity, positive likelihood ratio (LR+), and negative likelihood ratio (LR–) for POC US were 60% (95% CI = 46% to 72%), 94% (95% CI = 88% to 97%), 10 (95% CI = 4 to 23), and 0.4 (95% CI = 0.3 to 0.6). For radiology US they were 63% (95% CI = 48% to 75%), 99% (95% CI = 94% to 99%), 94 (95% CI = 6 to 1,500), and 0.4 (95% CI = 0.3 to 0.6); and for CT they were 83% (95% CI = 58% to 95%), 98% (95% CI = 85% to 99%), 45 (95% CI = 3 to 707), and 0.2 (95% CI = 0.05 to 0.5).ConclusionsIt may be feasible to reduce ED LOS and avoid CT scan when using POC US to evaluate children with suspected appendicitis. Test characteristics for POC US have high specificity to rule in appendicitis, similar to radiology US. Addition of POC US prior to sequential radiology imaging was safe, without missed cases of appendicitis or negative laparotomies.
Group I metabotropic glutamate receptor‐mediated activation of PKC gamma in the nucleus accumbens core promotes the reinstatement of cocaine seeking
Authors: Schmidt Heath D. , Kimmey Blake A. , Arreola Adrian C. , Pierce R. Christopher 
Published: February 2014

AbstractEmerging evidence indicates that type I metabotropic glutamate receptors (mGluRs) in the nucleus accumbens play a critical role in cocaine seeking. The present study sought to determine the role of accumbens core mGluR1, mGluR5 and protein kinase C (PKC) in cocaine priming‐induced reinstatement of drug seeking. Here, we show that intra‐accumbens core administration of the mGluR1/5 agonist DHPG (250 μM) promoted cocaine seeking in rats. Consistent with these results, administration of an mGluR1 (50.0 μM YM 298198) or mGluR5 (9.0 μM MPEP) antagonist directly into the accumbens core prior to a priming injection of cocaine (10 mg/kg) attenuated the reinstatement of drug seeking. mGluR1/5 stimulation activates a signaling cascade including PKC. Intracore microinjection of PKC inhibitors (10 μM Ro 31–8220 or 30.0 μM chelerythrine) also blunted cocaine seeking. In addition, cocaine priming‐induced reinstatement of drug seeking was associated with increased phosphorylation of PKCγ, but not PKCα or PKCβII, in the core. There were no effects of pharmacological inhibition of mGluR1, mGluR5 or PKC in the accumbens core on sucrose seeking. Together, these findings indicate that mGluR1 and mGluR5 activation in the accumbens core promotes cocaine seeking and that these effects are reinforcer specific. Furthermore, stimulation of mGluR1 and mGluR5 in the accumbens core may regulate cocaine seeking, in part, through activation of PKCγ.
Genome‐wide association analysis identifies quantitative trait loci for growth in a Landrace purebred population
Authors: Jung E. J. , Park H. B. , Lee J. B. , Yoo C. K. , Kim B. M. , Kim H. I. , Kim B. W. , Lim H. T. 
Published: February 2014

SummaryGrowth‐related traits are complex and economically important in the livestock industry. The aim of this study was to identify quantitative trait loci (QTL) and the associated positional candidate genes affecting growth in pigs. A genome‐wide association study (GWAS) was performed using the porcine single‐nucleotide polymorphism (SNP) 60K bead chip. A mixed‐effects model and linear regression approach were used for the GWAS. The data used in the study included 490 purebred Landrace pigs. All experimental animals were genotyped with 39 438 SNPs located throughout the pig autosomes. We identified a strong association between a SNP marker on chromosome 16 and body weight at 71 days of age (ALGA0092396, P = 5.35 × 10−9, Bonferroni adjusted P < 0.05). The SNP marker was located near the genomic region containing IRX4, which encodes iroquois homeobox 4. This SNP marker could be useful in the selective breeding program after validating its effect on other populations.
Systematic review with network meta‐analysis: the efficacy of anti‐tumour necrosis factor‐alpha agents for the treatment of ulcerative colitis
Authors: Stidham R. W. , Lee T. C. H. , Higgins P. D. R. , Deshpande A. R. , Sussman D. A. , Singal A. G. , Elmunzer B. J. , Saini S. D. , Vijan S. , Waljee A. K. 
Published: February 2014

SummaryBackgroundAntibodies against tumour necrosis factor‐alpha (anti‐TNF) are effective therapies in the treatment of ulcerative colitis (UC), but their comparative efficacy is unknown.AimTo perform a network meta‐analysis comparing the efficacy of anti‐TNF agents in UC.MethodsAfter screening 506 studies, reviewers extracted information on seven studies. Traditional meta‐analysis (TMA) was used to compare each anti‐TNF agent to placebo. Bayesian network meta‐analysis (NMA) was performed to compare the effects of anti‐TNF agents to placebo. In addition, sample sizes for comparative efficacy trials were calculated.ResultsCompared to placebo, TMA revealed that anti‐TNF agents result in a higher likelihood of induction of remission and response (RR: 2.45, 95% CI: 1.72–3.47 and RR: 1.65, 95% CI: 1.37–1.99 respectively) as well as maintenance of remission and response (RR: 2.00, 95% CI: 1.52–2.62 and RR: 1.76, 95% CI: 1.46–2.14 respectively). Individually, infliximab, adalimumab and goliumumab resulted in a higher likelihood of induction and maintenance for both remission and response. NMA found nonsignificant trends in comparisons of the individual agents. The required sample sizes for direct head‐to‐head trials between infliximab and adalimumab for induction and maintenance are 174 and 204 subjects respectively.ConclusionsThis study demonstrates that, compared to placebo, infliximab, adalimumab and golimumab are all effective for the induction and maintenance of remission in ulcerative colitis. However, network meta‐analysis demonstrates that no single agent is clinically superior to the others and therefore, other factors such as cost, safety, route of administration and patient preference should dictate our choice of anti‐TNF agents. A randomised comparative efficacy trial between infliximab and adalimumab in UC is of practical size and should be performed.
Systematic review with meta‐analysis: the declining risk of colorectal cancer in ulcerative colitis
Authors: Castaño‐Milla C. , Chaparro M. , Gisbert J. P. 
Published: February 2014

SummaryBackgroundPatients with ulcerative colitis (UC) have an increased risk of developing colorectal cancer (CRC); however, the magnitude of this effect is open to debate.AimTo assess the risk of CRC in UC patients by systematic review and meta‐analysis.MethodsA systematic literature search was performed up to November 2013. We selected studies describing the incidence and prevalence of CRC in patients with UC. Articles were assessed for quality using the Newcastle‐Ottawa Scale. Cumulative incidence and incidence rates of CRC were combined and analysed using the generic inverse variance method. Sub‐analyses were performed to identify factors associated with an increased risk of developing CRC.ResultsA total of 81 studies (181 923 patients) met the inclusion criteria. The incidence rate of CRC in patients with UC was 1.58 per 1000 patient‐years (py) [95% confidence interval (CI), 1.39–1.76]. Results were heterogeneous (I2 = 81–89%). The incidence rate was 4.02/1000 py (95%CI = 2.74–5.31) in studies that only included patients with extensive colitis, and 1.24/1000 py (95%CI = 1.01–1.47) in population‐based studies. The incidence rate was 0.91/1000 py (95%CI = 0.61–1.2) in the first decade of disease, 4.07/1000 py (95%CI = 2.58–5.56) in the second, and 4.55/1000 py (95%CI = 2.64–6.46) in the third. The incidence rate decreased from 4.29/1000 py in the studies published in the 1950s to 1.21/1000 py in studies published in the last decade.ConclusionsThe risk of patients with ulcerative colitis developing colorectal cancer has decreased steadily over the last six decades, but the extent and duration of the disease increase this risk.
The eye of the caecilian Rhinatrema bivittatum (Amphibia: Gymnophiona: Rhinatrematidae)
Authors: Mohun Samantha M. , Wilkinson Mark 
Published: February 2014

AbstractThe reduction in the visual system of the Gymnophiona has been noted by many authors. Adult caecilian amphibians eyes are small, covered by skin and sometimes bone, with retinal cells that contain only rod opsins and co‐option of structures usually associated with the visual system used for novel sensory structures and functions. Here, we provide a description of the eye of Rhinatrema bivittatum, the first of any rhinatrematid caecilian, and consider its significance for our understanding of the nature of the eye in the last common ancestor of living caecilians. Characters discovered include zonule fibres, an aqueous humour and the remnants of an attachment that could be a protractor lentis muscle.
‘I saw what the future direction would be…’: Experiences of diabetes risk and physical activity after diabetes screening
Authors: Vähäsarja Kati , Kasila Kirsti , Kettunen Tarja , Rintala Pauli , Salmela Sanna , Poskiparta Marita 
Published: February 2014

ObjectivesTo improve understanding of how individuals at high risk of type 2 diabetes experience the risk of diabetes and how these experiences relate to the adoption of physical activity as a protective behaviour.DesignA qualitative study using semi‐structured interview with individuals identified by screening as at high risk of type 2 diabetes.MethodsFourteen individuals, aged 40–64, were interviewed twice, with a 2‐year interval between. Participants' experiences of their risk of diabetes and physical activity were assessed. The transcribed interview data were analysed using inductive qualitative content analysis.ResultsTwo themes emerged from the data: a threatening risk perception and a rejected risk perception. The threatening risk perception occurred when the risk was unexpected by the participant, but became internalized through the screening procedure. The threatening perception also involved a commitment to increase physical activity to prevent diabetes. However, short‐term anxiety and subsequently emerging hopelessness were also part of this perception. The rejected risk perception involved indifference and scepticism regarding the risk. Here, physical activity behaviour and cognitions appeared to remain unchanged. Rejection also involved difficulties in accepting one's high‐risk identity. The rejecting group lacked motivation for increased physical activity, while the other group showed determination regarding increased physical activity, often leading to success.ConclusionPerceptions of the risk of diabetes emerged as threatening or as rejected. Participants' perceptions reflected varying and intertwining emotional, cognitive, and behavioural mechanisms for coping with the risk, all of which should be recognized in promoting physical activity among high‐risk individuals.
Statement of contributionWhat is already known on this subject? Diabetes screening has few adverse psychological effects on screened individuals. Diabetes can be prevented by increased physical activity and modest weight loss among high‐risk individuals. The evidence on the effects of screening on protective behaviour is limited and inconsistent.What does this study add?

High‐risk individuals' threatening perception of risk appears encouraging increased physical activity.

Individuals having problems in adjusting to high‐risk identification may not be motivated to engage in physical activity for prevention.

Failure to achieve the outcomes expected from lifestyle changes may lead people with threatening risk perception to a sense of hopelessness.
Single‐incision laparoscopic ileorectal anastomosis
Authors: Naqi Syed Ali , Smyth James , Mortensen Neil , Hompes Roel , Cahill Ronan 
Published: February 2014

AbstractAimMinimally invasive approaches for stoma closure offer considerable benefits for patients. Single port access via an end ileostomy site after stoma take‐down in patients with prior total colectomy and a rectal stump remnant could allow restoration of ileorectal continuity by anastomosis but has not been detailed previously.MethodsAfter mobilisation of the end ileostomy, the anvil of a circular stapler is secured into the open end of the distal ileum and the intestine returned into the abdominal cavity. A single port access device (in this description, a ‘surgical glove port’) is placed then into the stoma site and full laparoscopy performed. Once the rectal stump is identified and prepared, an intracorporeal anastomosis can be constructed in a tension‐free manner using a Knight‐Griffin technique. Leak‐testing can also be performed and the operation concluded with closure of the solitary incision.ResultsIn selected cases, adhesiolysis and anastomosis can be safely performed in toto. If the peritoneal environment is challenging, access can be escalated to multiport laparoscopy or even laparotomy.ConclusionInitiation of ileorectal anastomosis construction by single port laparoscopy at least allows peritoneal assessment but can provide for the operation's completion. This can confer maximum patient benefit for the most minimally invasive option.
Dynamic cystocolpoproctography is superior to functional pelvic MRI in the diagnosis of posterior pelvic floor disorders: results of a prospective study
Authors: Faucheron J.‐L. , Barot S. , Collomb D. , Hohn N. , Anglade D. , Dubreuil A. 
Published: February 2014

AbstractAimThe accuracy of dynamic cystocolpoproctography (DCP) and dynamic MRI were compared in diagnosing posterior pelvic floor disorders.MethodFifty consecutive female patients (mean age 51 years) complaining of posterior compartment pelvic floor disorder and referred to a tertiary centre entered the prospective study. The Institutional Review Board stated that informed consent from the patients was not necessary for this study. Patients underwent a DCP and a supine functional MRI by two different radiologists. Assessment of radiological examinations was prospective and blind. All patients underwent surgery that led to the final diagnosis. Agreement between the operative diagnosis and the diagnoses following DCP and MRI was assessed using the weighted kappa statistic. A matched‐pairs McNemar's test was applied to demonstrate whether or not one radiological method was superior to the other.ResultsFull‐thickness rectal prolapse was best diagnosed by clinical examination. Internal rectal prolapse and peritoneocele were best diagnosed by DCP. A better agreement with the operative diagnosis, which is not true superiority, was observed for DCP compared with functional pelvic MRI for full‐thickness rectal prolapse, internal rectal prolapse and peritoneocele. There was no significant difference between DCP and functional pelvic MRI in the diagnosis of internal rectal prolapse (P = 0.125) or peritoneocele (P = 0.10).ConclusionAs full‐thickness rectal prolapse, internal rectal prolapse and peritoneocele might be missed by functional pelvic MRI, there should still be a place for DCP in particular cases where the clinical diagnosis is not clear in women with symptomatic posterior pelvic floor disorders.
National Governance Bundles and Corporate Agency Costs: A Cross‐Country Analysis
Authors: Aslan Hadiye , Kumar Praveen 
Published: February 2014

Manuscript TypeConceptual and empiricalResearch Question/IssueComparative corporate governance performance across countries cannot be captured adequately by ranking of single or a few national governance factors (NGFs). But it is also intractable to undertake separate comparative analyses of the large number of NGFs that potentially impact corporate governance mechanisms. How can NGFs be combined into national governance bundles (NGBs) that are informative of the level of agency costs at the firm level and are also convenient to use in comparative analyses?Research Findings/InsightsWe theoretically motivate and empirically identify the components of two NGBs that, at the firm level, have especially significant impact on controlling shareholder agency costs and the agency costs of debt financing, respectively. These NGBs (1) allow consolidation of the effects of various individual NGFs that have been considered separately in the literature, (2) reveal the complementarity and substitutability effects among NGFs and between NGFs and firm governance mechanisms, and (3) are convenient to apply through aggregate bundle scores.Theoretical/Academic ImplicationsForming NGBs by combining NGFs that have especially significant impact on specific agency costs is useful both theoretically and empirically. The theoretical analysis guides the identification of NGFs that may be especially influential on specific agency costs and these predictions can be verified empirically. Examining the effects of NGFs on the relation of firm‐level governance mechanisms and agency costs is useful in understanding the links between national‐ and firm‐level governance variables.Practitioner/Policy ImplicationsThe parsimony and tractability afforded by the NGBs in understanding various aspects of corporate governance performance should prove useful to policymakers, international business managers, and investors. By providing readily available indicators of different agency costs at the firm level, these bundles can guide policymakers in setting the legal and regulatory framework for corporate governance at the national level.
Non‐interactive effects of plant invasion and landscape modification on native communities
Authors: Gooden Ben , French Kris 
Published: February 2014

AbstractAimBiological invasions and anthropogenic habitat modification are considered to be the leading drivers of global environmental change, yet their synergistic impacts on native communities remain poorly understood. We tested the effects of an invasive grass,Stenotaphrum secundatum, on an endangered coastal swamp forest community across an anthropogenic land use gradient. We also investigated the relative importance of landscape versus local community attributes in mediating the effects ofS. secundatuminvasion on the community.LocationFour hundred kilometres of the coastline of south‐eastern Australia.MethodsWe compared the diversity, composition and recruitment of resident vegetation in 32 invaded and 32 non‐invaded forest stands across an anthropogenic land use gradient. Local disturbance and environmental attributes of the forest (e.g. fire severity, litter abundance, canopy openness, vegetation structure) and adjacent landscape matrix (e.g. cover of forest, urban and agricultural land) were measured in detail at each site.ResultsInvasion was associated with substantial local extinctions of native plant species (i.e. 83% fewer species in invaded sites), altered community compositions and an 85% reduction in rates of woody plant recruitment. Local disturbances and environmental attributes of forest stands and adjacent landscape matrix were similar between invaded and native sites. Invasion caused a twofold increase in litter biomass, which we hypothesize is the primary mechanism by which the invader excludes native species. Landscape modification had no effect on the diversity of adjacent swamp forest. There was no interactive effect of landscape modification and invasion on the native community; species losses in response to invasion were high regardless of the condition of the adjacent matrix.Main conclusionsWe show that impacts of non‐native species are not dependent on landscape context and, unexpectedly, that invasion by an alien plant poses a greater threat to diversity of endangered swamp forests than modification of the adjacent matrix.