bluuebunny/crossref_metadata_2025_split huggingface dataset:
Decreased Stress Levels in Nurses: A Benefit of Quiet Time
Authors: Riemer Heather C. , Mates Joanna , Ryan Linda , Schleder Bonnie J. 
Published: September 2015

Background
The benefits of quiet time, a therapeutic method of improving the health care environment, have been evaluated in patients, but only a few studies have examined the effects of quiet time on intensive care nurses.

Objective
To evaluate the effects of implementing quiet time in a medical-surgical intensive care unit on levels of light, noise, and nurses’ stress.

Methods
Quiet time consisted of turning down the unit lights for a designated time. Levels of light, noise, and nurses’ stress were measured. Nurses’ stress levels were measured by using a 100-point visual analog scale; unit noise, by using a digital sound level meter (model 407736, Extech Instruments); and unit light, by using an illumination light meter (model 615, Huygen Corporation). Measurements were obtained 30 minutes before and 30 minutes, 1 hour, and 2 hours after implementation of quiet time.

Results
Analysis of variance and comparisons of means indicated that both light levels and nurses’ stress levels were significantly decreased after quiet time (both P &lt; .001). Noise levels were also decreased after quiet time, but the decrease was not significant (P = .08).

Conclusions
Use of quiet time resulted in decreased light levels and decreased stress levels among nurses. Quiet time is an easily performed energy-saving intervention to promote a healthy work environment.
IL-12p40 Homodimer Ameliorates Experimental Autoimmune Arthritis
Authors: Lee Seon-Yeong , Jung Young Ok , Kim Doo-Jin , Kang Chang-Min , Moon Young-Mee , Heo Yu-Jung , Oh Hye-Jwa , Park Seong-Jeong , Yang Se-Hwan , Kwok Seung Ki , Ju Ji-Hyeon , Park Sung-Hwan , Sung Young Chul , Kim Ho-Youn , Cho Mi-La 
Published: September 2015

Abstract
IL-23 is the key cytokine that induces the expansion of Th17 cells. It is composed of p19 and p40 subunits of IL-12. The p40 subunit binds competitively to the receptor of IL-23 and blocks its activity. Our aim was to assess the preventive and therapeutic effect of the IL-12p40 homodimer (p40)2 subunit in autoimmune arthritis animal models. In the current study, using IL-1R antagonist–knockout mice and a collagen-induced arthritis model, we investigated the suppressive effect of (p40)2 on inflammatory arthritis. We demonstrated that the recombinant adenovirus-expressing mouse (p40)2 model prevented the development of arthritis when given before the onset of arthritis. It also decreased the arthritis index and joint erosions in the mouse model if transferred after arthritis was established. (p40)2 inhibited the production of inflammatory cytokines and Ag-specific T cell proliferation. It also induced CD4+CD25+Foxp3 regulatory T (Treg) cells in vitro and in vivo, whereas the generation of retinoic acid receptor–related organ receptor γt and Th17 cells was suppressed. The induction of Treg cells and the suppression of Th17 cells were mediated via activated STAT5 and suppressed STAT3. Our data suggest that (p40)2 suppressed inflammatory arthritis successfully. This could be a useful therapeutic approach in autoimmune arthritis to regulate the Th17/Treg balance and IL-23 signaling.
Hof van Justitie oordeelt over mandaat van ECB inzake monetair beleid
Authors: Louisse M.L. 
Published: September 2015

Hof van Justitie oordeelt over mandaat van ECB inzake monetair beleid
Op 16 juni 2015 heeft het Hof van Justitie van de Europese Unie prejudiciële vragen beantwoord van het Bundesverfassungsgericht over de verenigbaarheid van het Outright Monetary Transactions-programma (OMT-programma) met het Europese recht, en meer in het bijzonder met het mandaat van de Europese Centrale Bank (ECB). Dit OMT-programma is vergelijkbaar met het programma van kwantitatieve verruiming (QE), waarmee de ECB in maart 2015 is gestart. Dit artikel gaat in op het arrest van het Hof van Justitie, de mogelijke aanknopingspunten die dit arrest biedt voor de beantwoording van de vraag of de ECB met het QE-programma binnen haar mandaat blijft, en de mogelijke gevolgen die dit arrest heeft voor de onafhankelijkheid van de ECB.
De reikwijdte van de zorgplicht binnen concernverhoudingen
Authors: van Liere F. 
Published: September 2015

De reikwijdte van de zorgplicht binnen concernverhoudingen
In deze bijdrage wordt ingegaan op de aansprakelijkheid van de moedermaatschappij jegens crediteuren van haar dochter(s) vanwege schending van de zorgplicht om de crediteurenbelangen in acht te nemen. De term zorgplicht is in lagere rechtspraak en literatuur ontwikkeld, maar de Hoge Raad heeft deze term nog niet aanvaard, waardoor nog altijd onduidelijkheid bestaat over de exacte invulling van de zorgplicht. In dat kader worden drie vragen behandeld: naar de inhoud van de zorgplicht, naar de omstandigheden waaronder zij zich manifesteert en naar het moment van inwerkingtreding van de zorgplicht. Aan de hand van de kernarresten en de economische werkelijkheid worden deze vragen beantwoord en wordt geconcludeerd dat sprake is van een immer aanwezige zorgplicht om de belangen van de crediteuren in acht te nemen als uitwerking van de concernleidingsplicht van de moedermaatschappij binnen concernverhoudingen.
Potentials, Experiences and Outcomes of a Comprehensive Community Based Programme to Address Malnutrition in Tribal India
Authors: Prasad Vandana , Sinha Dipa 
Published: September 2015

This paper demonstrates the effect of an innovative community-based management programme on acute malnutrition among children under three years of age, through an observational longitudinal cohort study in tribal blocks in central-eastern India.
The key components of the programme include child care through crèches, community mobilisation and systems strengthening to ensure better child feeding and caring practices and delivery of public health and nutrition services.
For a cohort of 587 children, the increase in children in the non-wasting category is from 72% to 80% (p<0.001) and the reduction in Severe Acute Malnutrition (SAM) from 8% to 4% (p<0.005), a reduction of 46.6%. Normalcy is fairly well maintained at 89%. Among the severely wasted, 16% show no improvement, 49% moved into a moderate wasting category and 36% to normalcy over 4-6 months. Among the moderately wasted, 26% showed no improvement and 7% declined to a severely wasted category, and 67% moved to normalcy. The average Weight for Height Z-score (WHZ) for the cohort improved from -1.41 in the initial period to -1.13 in November (p<0.0001).
This study suggests that this medium term strategy using a rights-based participatory approach for community based management of malnutrition may be comparatively effective by current WHO guidelines and other known community based interventions in terms of mortality, cost, degree and pace of improvements.
Immediate Effect of Therapeutic Massage on Pain Sensation and Unpleasantness: A Consecutive Case Series
Authors: Menard Martha Brown 
Published: September 2015

Background: Musculoskeletal pain is a common condition that poses a significant burden to its sufferers and costs the US economy billions of dollars each year in lost productivity. Individuals complaining of musculoskeletal pain make up a large proportion of clients treated by massage therapists in community practices, yet few studies have examined the immediate effect of therapeutic massage on this type of pain in the practice setting. Purpose: To assess the immediate effect of therapeutic massage on musculoskeletal pain sensation and unpleasantness in a community setting. Setting: Solo private practice in central Virginia, United States. Participants: One hundred sixteen first-time clients who complained of musculoskeletal pain as a presenting symptom. Research design: Prospective, consecutive practice-based case series. Intervention: A single 60-minute session of individualized therapeutic massage; techniques used included Swedish massage employing effleurage, petrissage, and friction,;deep tissue; myofascial; positional release; passive and resisted joint mobilization; and biofield modalities. Main Outcome Measures: Visual Analog Scales for pain sensation and unpleasantness. Results: Both pain sensation and unpleasantness were significantly reduced by a single session of therapeutic massage. Mean pain sensation decreased from 3.76 (SD=1.87) prior to massage to .89 (SD=1.35) following massage, with t=18.87, P<.001. Mean pain unpleasantness decreased from 5.21 (SD=2.48) prior to massage to .64 (SD=1.23) following massage, with t=20.45, P<.001. Effect sizes were 1.76 and 1.90, respectively. Conclusions: In this case series, therapeutic massage appeared to be an effective intervention for common musculoskeletal pain that influenced both the physical and affective dimension of the pain experience. Although care was taken to reduce potential bias through limiting eligibility to first time clients and use of a standardized script, practice-based case series have inherent limitations. Issues in conducting practice-based research by massage therapists and recommendations for future research are discussed.
Streptozotocin‐Induced Diabetic Models in Mice and Rats
Authors: Furman Brian L. 
Published: September 2015

AbstractStreptozotocin (STZ) is an antibiotic that produces pancreatic islet β‐cell destruction and is widely used experimentally to produce a model of type 1 diabetes mellitus (T1DM). Detailed in this unit are protocols for producing STZ‐induced insulin deficiency and hyperglycemia in mice and rats. Also described are protocols for creating animal models for type 2 diabetes using STZ. These animals are employed for assessing the pathological consequences of diabetes and for screening potential therapies for the treatment of this condition. © 2015 by John Wiley & Sons, Inc.
Isolation of Endoplasmic Reticulum, Mitochondria, and Mitochondria‐Associated Membrane and Detergent Resistant Membrane Fractions from Transfected Cells and from Human Cytomegalovirus‐Infected Primary Fibroblasts
Authors: Williamson Chad D. , Wong Daniel S. , Bozidis Petros , Zhang Aiping , Colberg‐Poley Anamaris M. 
Published: September 2015

AbstractIncreasingly mechanistic virology studies require dependable and sensitive methods for isolating purified organelles containing functional cellular sub‐domains. The mitochondrial network is, in part, closely apposed to the endoplasmic reticulum (ER). The mitochondria‐associated membrane (MAM) fraction provides direct physical contact between the ER and mitochondria. Characterization of the dual localization and trafficking of human cytomegalovirus (HCMV) UL37 proteins required establishing protocols in which the ER and mitochondria could be reliably separated. Because of its documented role in lipid and ceramide transfer from the ER to mitochondria, a method to purify MAM from infected cells was also developed. Two robust procedures were developed to efficiently isolate mitochondria, ER, and MAM fractions while providing substantial protein yields from HCMV‐infected primary fibroblasts and from transfected HeLa cells. Furthermore, this unit includes protocols for isolation of detergent resistant membranes from subcellular fractions as well as techniques that allow visualization of the mitochondrial network disruption that occurs in permissively infected cells by their optimal resolution in Percoll gradients. © 2015 by John Wiley & Sons, Inc.
Handling Data Quality Information of Survey Data in GIS: A Case of Using the American Community Survey Data
Authors: Wong David W. , Sun Min 
Published: September 2015

Abstract
Many survey datasets have relatively high levels of error. The American Community Survey (ACS) data disseminated by the U.S. Census Bureau offer critical socio-demographic data of the U.S. and include a margin of error to indicate the reliability of an estimate for each census unit. Such feature-based reliability data should be incorporated when using ACS data in GIS such that users are informed of the data quality. This paper provides a brief review of the ACS data. Challenges to the use of ACS data quality information in GIS are discussed. The paper briefly reviews a set of mapping tools packaged as an ArcGIS extension to tackle some challenges in incorporating the data quality information in ACS data. These mapping functions can also be used to handle other survey spatial datasets with reliability information. The extension provides a foundation to build additional GIS tools to handle and analyze survey data.
Public Use Microdata Area Fragmentation: Research and Policy Implications of Polygon Discontiguity
Authors: Siordia Carlos , Fox Amber 
Published: September 2015

Abstract
The American Community Survey (ACS) is created by the Unites States Census Bureau and contains the most recent and detailed information on the population. The U.S. Census Bureau releases Public Use Microdata Sample (PUMS) ACS files to allow public entities the ability to examine detailed individual-level data. In order to protect the confidentiality of survey participants, the Census only allows individual-level observations to be geographically referenced with Public Use Microdata Areas (PUMAs)—polygons that contain at least 100,000 people. Microdata files offer the unique advantage of creating custom tabulations on the population that are not made available elsewhere. The advantages from using PUMS files are limited by the typology of PUMAs. Our project fills a gap by introducing the reader to how PUMA typology is produced and how it affects research. The specific aim of this project is to highlight the fact that PUMAs can be fragmented—made up of physically non-adjacent/multi-part polygons. This is important because the treatment of fragmented/multi-part polygons as contiguous spatial entities erroneously imposes a false structure of contiguity that challenges theoretical and statistical assumptions in geographically aware research. By providing evidence from three metropolitan areas in Texas (USA) and displaying the degree of polygon discontiguity concentration by state, we outline some of the implications of polygon discontiguity for research and policy. We compliment our descriptive investigation by discussing solutions in closing and by identifying and discussing the three general elements in polygon fragmentation: quantity, distance, and size.
Assessing the Spatial Concentration and Temporal Persistence of Poverty: Industrial Structure, Racial/Ethnic Composition, and the Complex Links to Poverty
Authors: Curtis Katherine J. , Reyes Perla E. , O’Connell Heather A. , Zhu Jun 
Published: September 2015

AbstractThis study assesses the social-structural, spatial, and temporal dimensions of aggregate-level poverty in the US Upper Midwest between 1960 and 2000. Central focus is on the links between local-area poverty, industrial structure and racial/ethnic composition, and the spatial and temporal dimensions of the linkages. During the study period, the region underwent significant industrial restructuring and dramatic change in racial/ethnic concentration. Using newly developed statistical methods for spatial-temporal regression, we explore hypotheses related to the spatial and temporal dimensions of the complex relationship between poverty, industrial structure, and race/ethnicity. Our approach yields reliable and interpretable estimates for structural factors of interest as well as the spatial-temporal autocorrelation structure underlying the data. Results inform theory about the implications of industrial structure and racial/ethnic composition for the concentration and persistence of poverty with clear direction for future research, and contribute to our understanding of the methodological approaches to investigating data that varies by and is dependent on space and time.
Spatial Sufficiency of 5% Medicare Standard Analytic Files
Authors: Mobley Lee R. 
Published: September 2015

Abstract
The 5% Medicare Standard Analytic Files (SAF) are random samples used to analyze national trends in medical treatments, expenditures, and outcomes. Their utility in small-area or multilevel analyses is unknown. To demonstrate possible limitations of the 5% SAF for analysis of health behaviors in small areas. We use descriptive Chi-square goodness-of-fit tests and mapping to explore consistency in the 5% representation of the 100% population in states and counties. We conduct multilevel modeling of individual utilization of mammography or endoscopy services for cancer screening and contrast findings across the 5% and 100% files. Subjects are enrolled in both parts A and B Medicare coverage and ages 65–104, alive and residing in the same state, with no gaps in coverage during the study period. Identically defined groups are drawn from the 5% SAF and 100% population claims and denominator files. The Chi-square tests of homogeneous population subgroups in 5% and 100% files exhibit significant differences in 7 of 8 states. Maps confirm this among states’ counties and find that one state is generally under-represented by the 5% SAF, while others show areas with variable representation. Multilevel modeling results are largely consistent across the partitions of the data, but 5% sample models have much lower statistical power. Area-level covariate effect estimates show some differences across the two datasets. Multilevel modeling with contextual variables may be misleading in small area analyses conducted using 5% Medicare SAFs. Provider supply and market characteristics show inconsistent results. Disparities research may benefit from 100% files to provide statistical power needed to detect meaningful differences. This is significant because the Centers for Medicare and Medicaid Services have recently curtailed permissions to use the 100% files. These 100% files are one of few sources of population data available in the U.S. that are representative of small areas in the U.S.. In times of constrained budgets, using population data files is essential so that resources can be targeted to areas robustly identified as having greatest need or gaps in outcomes.
Spatial Variation in the Relationship between Hispanic Concentration and County Poverty: A Migration Perspective
Authors: O’Connell Heather A. , Shoff Carla 
Published: September 2015

AbstractRacial/ethnic minority concentration is generally positively related to county poverty. Yet, spatial variation in this relationship may call into question the meaning attached to racial/ethnic concentration. We argue that racial/ethnic concentration reflects more than just the concentration of individuals from a disadvantaged group. In addition, we extend previous work by taking a migration perspective to explain spatial non-stationarity in racial/ethnic concentration’s relationship with county poverty. Factors related to the migration process, including migrant selectivity and spatial differentiation in place characteristics, could alter the relationship between a minority group’s concentration and poverty. We employ spatially informed methods and 2006–2010 American Community Survey data to examine the relationship between Hispanic concentration and county poverty. The GWR results indicate significant spatial variation in the percent Hispanic-county poverty relationship. Hispanic migration regimes capture some of the observed relationship non-stationarity, suggesting migration-related processes partially drive Hispanic-county poverty relationship non-stationarity. However, we discuss other explanations that should be considered in future research. This work advances research on spatial inequality by examining the social implications of migration and by investigating the role of place in shaping the meaning of minority concentration.
Liver Resection for Primary Intrahepatic Stones: Focus on Postoperative Infectious Complications
Authors: Clemente Gennaro , De Rose Agostino M. , Murri Rita , Ardito Francesco , Nuzzo Gennaro , Giuliante Felice 
Published: September 2015

AbstractBackground
Primary intrahepatic lithiasis is defined by the presence of gallstones at the level of cystic dilatations of the intrahepatic biliary tree. Liver resection is considered the treatment of choice, with the purpose of removing stones and atrophic parenchyma, also reducing the risk of cholangiocarcinoma. However, in consequence of the considerable incidence of infectious complications, postoperative morbidity remains high. The current study was designed to evaluate the impact of preoperative bacterial colonization of the bile ducts on postoperative outcome.MethodsThe clinical records of 73 patients treated with liver resection were reviewed and clinical data, operative procedures, results of bile cultures, and postoperative outcomes were examined.ResultsLeft hepatectomy (38 patients) and left lateral sectionectomy (19 patients) were the most frequently performed procedures. Overall morbidity was 38.3 %. A total of 133 microorganisms were isolated from bile. Multivariate analysis identified previous endoscopic or percutaneous cholangiography (p = 0.043) and preoperative cholangitis (p = 0.003) as the only two independent risk factors for postoperative infectious complications.ConclusionsPostoperative morbidity was strictly related to the preoperative biliary infection. An effective control of infections should be always pursued before liver resection for intrahepatic stones and an aggressive treatment of early signs of sepsis should be strongly emphasized.
Universal Use of Intraoperative Nerve Monitoring by Recently Fellowship‐Trained Thyroid Surgeons is Common, Associated with Higher Surgical Volume, and Impacts Intraoperative Decision‐Making
Authors: Marti Jennifer L. , Holm Tammy , Randolph Gregory 
Published: September 2015

AbstractIntroductionThe value of routine use of intraoperative recurrent laryngeal nerve monitoring (IONM) in thyroid surgery is controversial. We analyzed the practices of recently fellowship‐trained thyroid surgeons from two diverging surgical backgrounds with respect to IONM. We hypothesized that the majority of recently trained surgeons would use IONM, and that it would potentially influence their operative procedure.MethodsA 21‐question survey was sent to 56 fellowship‐trained endocrine and head and neck surgeons who completed fellowships accredited by the American Association of Endocrine Surgeons or American Head and Neck Society within the past 10 years, examining the demographics of respondents, and details of IONM practice. Groups were compared using the Fisher exact and χ2 tests.ResultsThe response rate for the survey was 76 % (42/56). Overall, 95 % use IONM for some or all of their cases. Sixty percent (n = 25) of respondents always use IONM during thyroid surgery, 36 % (n = 15) use it selectively, and 5 % (n = 2) never use it. We compared respondents who always use IONM (n = 25), to those who selectively or never use it (n = 17). Exposure to IONM during residency or fellowship did not influence use (p = 0.99). However, higher‐volume surgeons were more likely to always use IONM (p = 0.036). Among users of IONM, the most common reason given for use was increased surgeon confidence (55 %) and improved safety (54 %). Over 90 % of respondents found reoperative cases and preoperative vocal cord paralysis to be indications for IONM. Among those who always used IONM, 64 % would alter extent of surgery based on IONM findings, compared to only 27 % of selective users.ConclusionsA survey of recently trained endocrine and head and neck surgeons reveals that the vast majority (95 %) of these surgeons commonly use IONM during thyroid surgery. IONM was more commonly used by higher‐volume surgeons. Routine users were more likely to modify surgery based on nerve integrity (i.e., not complete a total thyroidectomy if the nerve loses conduction signal).