bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationships among Puberty, Muscle and Fat, and Liveweight Gain during Mating in Young Female Sheep
Authors: Rosales Nieto CA , Ferguson MB , Thompson H , Briegel JR , Macleay CA , Martin GB , Thompson AN 
Published: May 2015

ContentsGreater depths of muscle are associated with better reproductive performance in ewe lambs, but, in adult ewes, reproductive performance also seems to vary with liveweight gain during the mating period. Therefore, in a large field study with Merino ewe lambs, we tested whether the relationships among eye muscle depth (EMD), fat depth (FAT) and reproductive performance depend on liveweight gain during the mating period. We selected lambs with a wide range in phenotypic values for depths of eye muscle (EMD) and fat (FAT) and assigned them to dietary treatments designed to achieve low (LOW, n = 244) or high (HIGH, n = 237) rates of liveweight gain during a 28‐day mating period. The LOW treatment maintained live weight, whereas the HIGH treatment gained 179 ± 3.8 g/day (p < 0.001). From those ewe lambs that attained puberty, first oestrus was detected at live weight 37.8 ± 0.2 kg and age 232 days. The proportion of ewes that attained puberty increased with EMD (p < 0.01). Ewes from the HIGH treatment were more fertile (pregnant ewes per 100 ewes exposed to rams) and had a higher reproductive rate (foetuses in utero per 100 ewes exposed to rams; p < 0.001) than those from the LOW treatment. Fertility and reproductive rate were positively correlated with weight gain during mating as well as live weight at the start of mating, FAT and EMD (p < 0.05 to <0.001). We conclude that faster growth, due to either extra nutrition during mating or higher phenotypic potential for fat and muscle, will increase reproductive performance in ewe lambs mated at 8 months of age.
GmWRKY27 interacts with GmMYB174 to reduce expression of GmNAC29 for stress tolerance in soybean plants
Authors: Wang Fang , Chen Hao‐Wei , Li Qing‐Tian , Wei Wei , Li Wei , Zhang Wan‐Ke , Ma Biao , Bi Ying‐Dong , Lai Yong‐Cai , Liu Xin‐Lei , Man Wei‐Qun , Zhang Jin‐Song , Chen Shou‐Yi 
Published: May 2015

SummarySoybean (Glycine max) is an important crop for oil and protein resources worldwide. The molecular mechanism of the abiotic stress response in soybean is largely unclear. We previously identified multiple stress‐responsive WRKY genes from soybean. Here, we further characterized the roles of one of these genes, GmWRKY27, in abiotic stress tolerance using a transgenic hairy root assay. GmWRKY27 expression was increased by various abiotic stresses. Over‐expression and RNAi analysis demonstrated that GmWRKY27 improves salt and drought tolerance in transgenic soybean hairy roots. Measurement of physiological parameters, including reactive oxygen species and proline contents, supported this conclusion. GmWRKY27 inhibits expression of a downstream gene GmNAC29 by binding to the W–boxes in its promoter region. The GmNAC29 is a negative factor of stress tolerance as indicated by the performance of transgenic hairy roots under stress. GmWRKY27 interacts with GmMYB174, which also suppresses GmNAC29 expression and enhances drought stress tolerance. The GmWRKY27 and GmMYB174 may have evolved to bind to neighbouring cis elements in the GmNAC29 promoter to co‐reduce promoter activity and gene expression. Our study discloses a valuable mechanism in soybean for regulation of the stress response by two associated transcription factors. Manipulation of these genes should facilitate improvements in stress tolerance in soybean and other crops.
A search strategy to identify studies on the prognosis of work disability: a diagnostic test framework
Authors: Kok Rob , Verbeek Jos A H M , Faber Babs , van Dijk Frank J H , Hoving Jan L 
Published: May 2015

ObjectiveSearching the medical literature for evidence on prognosis is an important aspect of evidence-based disability evaluation. To facilitate this, we aimed to develop and evaluate a comprehensive and efficient search strategy in PubMed, to be used by either researchers or practitioners and that will identify articles on the prognosis of work disability.MethodsWe used a diagnostic test analytic framework. First, we created a reference set of 225 articles on the prognosis of work disability by screening a total of 65 692 titles and abstracts from10 journals in the period 2000–2009. Included studies had a minimum follow-up of 6 months, participants in the age of 18–64 with a minimum sick leave of 4 weeks or longer or having serious activity limitations in 50% of the cases and outcome measures that reflect impairments, activity limitations or participation restrictions. Using text mining methods, we extracted search terms from the reference set and, according to sensitivity and relative frequency, we combined these into search strings.ResultsBoth the research and the practice search filter outperformed existing filters in occupational health, all combined with the Yale-prognostic filter. The Work Disability Prognosis filter for Research showed a comprehensiveness of 90% (95% CI 86 to 94) and efficiency expressed more user-friendly as Number Needed to Read=20 (95% CI 17 to 34).ConclusionsThe Work Disability Prognosis filter will help practitioners and researchers who want to find prognostic evidence in the area of work disability evaluation. However, further refining of this filter is possible and needed, especially for the practitioner for whom efficiency is especially important.
Assessment of the feasibility of an ultra-low power, wireless digital patch for the continuous ambulatory monitoring of vital signs
Authors: Hernandez-Silveira Miguel , Ahmed Kamran , Ang Su-Shin , Zandari Fahriya , Mehta Tinaz , Weir Rebecca , Burdett Alison , Toumazou Chris , Brett Stephen J 
Published: May 2015

Background and objectivesVital signs are usually recorded at 4–8 h intervals in hospital patients, and deterioration between measurements can have serious consequences. The primary study objective was to assess agreement between a new ultra-low power, wireless and wearable surveillance system for continuous ambulatory monitoring of vital signs and a widely used clinical vital signs monitor. The secondary objective was to examine the system's ability to automatically identify and reject invalid physiological data.SettingSingle hospital centre.ParticipantsHeart and respiratory rate were recorded over 2 h in 20 patients undergoing elective surgery and a second group of 41 patients with comorbid conditions, in the general ward.Outcome measuresPrimary outcome measures were limits of agreement and bias. The secondary outcome measure was proportion of data rejected.ResultsThe digital patch provided reliable heart rate values in the majority of patients (about 80%) with normal sinus rhythm, and in the presence of abnormal ECG recordings (excluding aperiodic arrhythmias such as atrial fibrillation). The mean difference between systems was less than ±1 bpm in all patient groups studied. Although respiratory data were more frequently rejected as invalid because of the high sensitivity of impedance pneumography to motion artefacts, valid rates were reported for 50% of recordings with a mean difference of less than ±1 brpm compared with the bedside monitor. Correlation between systems was statistically significant (p<0.0001) for heart and respiratory rate, apart from respiratory rate in patients with atrial fibrillation (p=0.02).ConclusionsOverall agreement between digital patch and clinical monitor was satisfactory, as was the efficacy of the system for automatic rejection of invalid data. Wireless monitoring technologies, such as the one tested, may offer clinical value when implemented as part of wider hospital systems that integrate and support existing clinical protocols and workflows.
Cost-effectiveness and public health benefit of secondary cardiovascular disease prevention from improved adherence using a polypill in the UK
Authors: Becerra Virginia , Gracia Alfredo , Desai Kamal , Abogunrin Seye , Brand Sarah , Chapman Ruth , García Alonso Fernando , Fuster Valentín , Sanz Ginés 
Published: May 2015

ObjectiveTo evaluate the public health and economic benefits of adherence to a fixed-dose combination polypill for the secondary prevention of cardiovascular (CV) events in adults with a history of myocardial infarction (MI) in the UK.DesignMarkov-model-based cost-effectiveness analysis, informed by systematic reviews, which identified efficacy, utilities and adherence data inputs.SettingGeneral practice in the UK.ParticipantsPatients with a mean age of 64.7 years, most of whom are men with a recent or non-recent diagnosis of MI and for whom secondary preventive medication is indicated and well tolerated.InterventionFixed-dose combination polypill (100 mg aspirin, 20 mg atorvastatin and 2.5, 5, or 10 mg ramipril) compared with multiple monotherapy.Primary and secondary outcome measuresCV events prevented per 1000 patients; cost per life-year gained; and cost per quality-adjusted life-year (QALY) gained.ResultsThe model estimates that for each 10% increase in adherence, an additional 6.7% fatal and non-fatal CV events can be prevented. In the base case, over 10 years, the polypill would improve adherence by ∼20% and thereby prevent 47 of 323 (15%) fatal and non-fatal CV events per 1000 patients compared with multiple monotherapy, with an incremental cost-effectiveness ratio (ICER) of £8200 per QALY gained. Probabilistic sensitivity analyses for the base-case assumptions showed an 81.5% chance of the polypill being cost-effective at a willingness-to-pay threshold of £20 000 per QALY gained compared with multiple monotherapy. In scenario analyses that varied structural assumptions, ICERs ranged between cost saving and £21 430 per QALY gained.ConclusionsAssuming that some 450 000 adults are at risk of MI, a 10 percentage point uptake of the polypill could prevent 3260 CV events and 590 CV deaths over a decade.The polypill appears to be a cost-effective strategy to prevent fatal and non-fatal CV events in the UK.
Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study
Authors: Chia Yook Chin , Gray Sarah Yu Weng , Ching Siew Mooi , Lim Hooi Min , Chinna Karuthan 
Published: May 2015

ObjectiveThis study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting.DesignThis is a 10-year retrospective cohort study.SettingA primary care clinic in a teaching hospital in Malaysia.Participants967 patients’ records were randomly selected from patients who were attending follow-up in the clinic.Main outcome measuresBaseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted.ResultsIn 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2–30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63. It also discriminates well for Malay (AUC 0.65, p=0.01), Chinese (AUC 0.60, p=0.03), and Indians (AUC 0.65, p=0.001). There was good calibration with Hosmer-Lemeshow test χ2=3.25, p=0.78.ConclusionsTaking into account that this cohort of patients were already on treatment, the Framingham General CVD Risk Prediction Score predicts fairly accurately for men and overestimates somewhat for women. In the absence of local risk prediction charts, the Framingham general CVD risk prediction chart is a reasonable alternative for use in a multiethnic group in a primary care setting.
What do you think overdiagnosis means? A qualitative analysis of responses from a national community survey of Australians
Authors: Moynihan Ray , Nickel Brooke , Hersch Jolyn , Doust Jenny , Barratt Alexandra , Beller Elaine , McCaffery Kirsten 
Published: May 2015

ObjectiveOverdiagnosis occurs when someone is diagnosed with a disease that will not harm them. Against a backdrop of growing evidence and concern about the risk of overdiagnosis associated with certain screening activities, and recognition of the need to better inform the public about it, we aimed to ask what the Australian community understood overdiagnosis to mean.Design, setting and participantsContent analysis of verbatim responses from a randomly sampled community telephone survey of 500 Australian adults, between January and February 2014. Data were analysed independently by two researchers.Main outcome measuresAnalysis of themes arising from community responses to open-ended questions about the meaning of overdiagnosis.ResultsThe sample was broadly representative of the Australian population. Forty per cent of respondents thought overdiagnosis meant exaggerating a condition that was there, diagnosing something that was not there or too much diagnosis. Twenty-four per cent described overdiagnosis as overprescribing, overtesting or overtreatment. Only 3% considered overdiagnosis meant doctors gained financially. No respondents mentioned screening in conjunction with overdiagnosis, and over 10% of participants were unable to give an answer.ConclusionsAround half the community surveyed had an approximate understanding of overdiagnosis, although no one identified it as a screening risk and a quarter equated it with overuse. Strategies to inform people about the risk of overdiagnosis associated with screening and diagnostic tests, in clinical and public health settings, could build on a nascent understanding of the nature of the problem.
Work-related allergies to storage mites in Parma (Italy) ham workers
Authors: Tafuro Federica , Ridolo Erminia , Goldoni Matteo , Montagni Marcello , Mutti Antonio , Corradi Massimo 
Published: May 2015

ObjectivesTo investigate the role of storage mites in the development of allergic diseases among ham production workers, and to search for early alterations in lung function tests and early inflammation markers in exhaled air. Respiratory allergies due to storage mites have been reported in people with various occupations but, although such mites are unavoidable when curing ham, there are no published data concerning ham production workers.SettingSecondary care.DesignExperimental cross-sectional study.Participants220 participants (110 ham production workers and 110 controls) were recruited.Primary and secondary outcome measuresWorkersanswered a medical questionnaire, and underwent spirometry and fraction of exhaled nitric oxide at 50 mL/s (FeNO50) measurements. Those with allergic symptoms also underwent skin prick tests to determine their sensitisation to airborne allergens. A methacholine test was performed in symptomatic participants when spirometry was normal to assess airways hyper-responsiveness.ResultsSymptomatic storage mite sensitisation was observed in 16 workers (14.5%) (rhinoconjunctivitis in 15 (63%) and asthma in (4%)) and 2 controls (1.8%; p=0.001). Higher FeNO50values in exposed symptomatic workers compared with healthy control participants (34.65±7.49 vs 13.29±4.29 ppb; p<0.001) suggested bronchial and nasal involvement, although their lung function parameters were normal. Regardless of exposure, a FeNO50value of 22.5 ppb seems to be 100% sensitive and 99.4% specific in distinguishing allergic and non-allergic participants. Multivariate analysis of FeNO50values in the symptomatic participants showed that they were positively influenced by IgE-mediated allergy (p=0.001) and reported symptom severity (p=0.041), and negatively by smoking status (p=0.049).ConclusionsHam processing workers, as well as workers involved in any meat processing work that includes curing, should be informed about the occupational risk of sensitisation to mites.
Professionalism dilemmas, moral distress and the healthcare student: insights from two online UK-wide questionnaire studies
Authors: Monrouxe Lynn V , Rees Charlotte E , Dennis Ian , Wells Stephanie E 
Published: May 2015

ObjectiveTo understand the prevalence of healthcare students’ witnessing or participating in something that they think unethical (professionalism dilemmas) during workplace learning and examine whether differences exist in moral distress intensity resulting from these experiences according to gender and the frequency of occurrence.DesignTwo cross-sectional online questionnaires of UK medical (study 1) and nursing, dentistry, physiotherapy and pharmacy students (study 2) concerning professionalism dilemmas and subsequent distress for (1) Patient dignity and safety breaches; (2) Valid consent for students’ learning on patients; and (3) Negative workplace behaviours (eg, student abuse).Participants and setting2397 medical (67.4% female) and 1399 other healthcare students (81.1% female) responded.Main resultsThe most commonly encountered professionalism dilemmas were: student abuse and patient dignity and safety dilemmas. Multinomial and logistic regression identified significant effects for gender and frequency of occurrence. In both studies, men were more likely to classify themselves as experiencing no distress; women were more likely to classify themselves as distressed. Two distinct patterns concerning frequency were apparent: (1)Habituation(study 1): less distress with increased exposure to dilemmas ‘justified’ for learning; (2)Disturbance(studies 1 and 2): more distress with increased exposure to dilemmas that could not be justified.ConclusionsTomorrow's healthcare practitioners learn within a workplace in which they frequently encounter dilemmas resulting in distress. Gender differences could be respondents acting according to gendered expectations (eg, males downplaying distress because they are expected to appear tough).Habituationto dilemmas suggests students might balance patient autonomy and right to dignity with their own needs to learn for future patient benefit.Disturbancecontests the ‘accepted’ notion that students become less empathic over time. Future research might examine the strategies that students use to manage their distress, to understand how this impacts of issues such as burnout and/or leaving the profession.
Predictors of skilled attendance at delivery among antenatal clinic attendants in Ghana: a cross-sectional study of population data
Authors: Amoakoh-Coleman Mary , Ansah Evelyn K , Agyepong Irene Akua , Grobbee Diederick E , Kayode Gbenga A , Klipstein-Grobusch Kerstin 
Published: May 2015

ObjectiveTo identify demographic, maternal and community predictors of skilled attendance at delivery among women who attend antenatal clinic at least once during their pregnancy in Ghana.DesignA cross-sectional study using the 2008 Ghana Demographic and Health Survey (DHS) data. We used frequencies for descriptive analysis, χ2test for associations and logistic regression to identify significant predictors. Predictive models were built with estimation of area under the receiver operating characteristic curves (AUC).SettingGhana.ParticipantsA total of 2041 women who had a live birth in the 5 years preceding the survey, and attended an antenatal clinic having a skilled provider, at least once, during the pregnancy.OutcomeSkilled attendance at delivery.ResultsOverall, 60.5% (1235/2041) of women in our study sample reported skilled attendance at delivery. Significant positive associations existed between skilled attendance at delivery and the variables such as maternal educational level, wealth status class, ever use of contraception, previous pregnancy complications and health insurance coverage (p<0.001). Significant predictors of skilled attendance were wealth status class, residency, previous delivery complication, health insurance coverage and religion in a model with AUC (95% CI) of 0.85 (0.83 to 0.88).ConclusionsWomen less likely to have skilled attendance at delivery can be identified during antenatal care by using data on wealth status class, health insurance coverage, residence, history of previous birth complications and religion, and targeted with interventions to improve skilled attendance at delivery.
Are we recording postoperative complications correctly? Comparison of NHS Hospital Episode Statistics with the American College of Surgeons National Surgical Quality Improvement Program
Authors: Parthasarathy Muralidharan , Reid Vicki , Pyne Laura , Groot-Wassink Thomas 
Published: May 2015

BackgroundHospital Episode Statistics (HES) data are used to measure surgical outcomes, but its quality has been considered inferior to that of clinical databases. We compare the recording accuracy of HES, an administrative database used in the National Health Service (NHS), with that of ACS NSQIP (American College of Surgeons National Surgical Quality Improvement Program), a well-established clinical database.Methods1323 patient records from our hospital, common to both databases were compared for ten surgical procedures (amputation, appendicectomy, cholecystectomy, femoral hernia repair, Hartmann's procedure, incisional hernia repair, inguinal hernia repair, long saphenous vein surgery, parathyroidectomy and umbilical hernia repair) and nine postoperative complications (acute renal failure, myocardial infarction, pneumonia, pulmonary embolism, urinary tract infection, blood transfusion, septic shock, surgical site infection and wound disruption) using text strings or ICD-10 (International Classification of Diseases) codes. κ coefficient was calculated as a measure of concordance between HES and ACS NSQIP databases.ResultsThe databases showed perfect or very good agreement in recording a majority of surgical procedures (κ coefficient range 0.82–1.0), but there was discordance in recording postoperative complications. When HES was investigated using text string or ICD-10 code, the κ coefficient range for nine postoperative complications was 0.00–0.56, indicating poor to moderate inter-rater agreement. Concordance was even less when searched by HES coder's recommended way to record postoperative complications.ConclusionsHES poorly registers postoperative complications. Suggested improvements include addition of dates when a condition is diagnosed, agreed criteria to identify postoperative complications, specifically trained coding staff for surgery and consistent use of the coding guidance.
How members of the public interpret the wordaccident
Authors: Girasek D C 
Published: May 2015

ObjectiveTo explore what the wordaccidentmeans to the lay public. This interpretation is of interest because it has been raised by injury control professionals as one justification for discouraging use of that word.MethodsA national telephone survey of 943 adults in the United States was conducted. Respondents were selected at random from households whose phone numbers were generated using random digit dialing techniques. Bivariate and multivariate analyses were performed to determine if respondent characteristics predicted their interpretations of the wordaccident.ResultsEighty three per cent of respondents associated preventability with the wordaccident, and only 26% felt that accidents were controlled by fate. However, 71% thought that accidents could not be predicted, and 4% felt that accidents were done on purpose. Age, education, income, and race emerged as independent predictors of variousaccidentinterpretations.ConclusionsOnly in the case of “unpredictability” does the public's interpretation of the wordaccidentmatch many experts' expectations. The concept of “unintentionality” is what seems to be communicated most strongly by use of the wordaccident. Persistent attempts on the part of injury control professionals to eliminate this word from social discourse may result in unintended consequences, which are discussed.