bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency neurosurgery in Darwin: still the generalist surgeons' responsibility
Authors: Luck Tara , Treacy Peter John , Mathieson Matthew , Sandilands Jessica , Weidlich Stephanie , Read David 
Published: April 2015

AbstractBackgroundRoyal Darwin Hospital (RDH) is the only major hospital for the ‘Top End’ of Northern Territory and Western Australia. As retrieval distances exceed 2600 km, resident generalist surgeons undertake all emergency neurosurgery.MethodsRetrospective clinical study from RDH records and review of prospectively collected datasets from RDH Intensive Care Unit and National Critical Care Trauma Response Centre for all emergency neurosurgery patients between 2008 and 2013.ResultsData were obtained from 161 patients with 167 admissions (73% male, 39% indigenous) who underwent 195 procedures (33 per year), including burr hole, craniotomy, cerebral and posterior fossa craniectomy, elevation fracture and ventricular drain. Trauma accounted for 68%, with alcohol as a known factor in 57%. Subdural haematoma (SDH) accounted for 53%. Severity of head injury at presentation correlated with outcome (R2 = 0.12, P < 0.001). Factors associated with death included injury at remote location (P = 0.022), time injury to operation >24 h (P = 0.023) and specific diagnoses of acute SDH (P = 0.006), acute‐on‐chronic SDH (P = 0.053) and infection (P = 0.052). Indigenous patients were younger (40 versus 55 years, P < 0.001) and more likely to have alcohol as a factor in trauma cases (71% versus 49%, P = 0.027). Time from injury to hospital was high for accidents at a remote location (12.9 versus 1.3 h, P < 0.001); however, Glasgow Outcome Scales (P = 0.13) were no different to accident at metropolitan Darwin.ConclusionGeneral surgeons at RDH perform a wide range of emergency neurosurgical procedures primarily for trauma. Factors contributing to poor outcomes included remote location of trauma and delay in reaching the hospital. Outcomes at 3 months appear acceptable.
Imprinting, latchment and displacement: a mini review of early instinctual behaviour in newborn infants influencing breastfeeding success
Authors: Mobbs Elsie J. , Mobbs George A. , Mobbs Anthony E. D. 
Published: April 2015

AbstractInstinctive behaviours have evolved favouring the mother–infant dyad based on fundamental processes of neurological development, including oral tactile imprinting and latchment. Latchment is the first stage of emotional development based on the successful achievement of biological imprinting. The mechanisms underpinning imprinting are identified and the evolutionary benefits discussed.ConclusionIt is proposed that the oral tactile imprint to the breast is a keystone for optimal latchment and breastfeeding, promoting evolutionary success.
Effect of carboxylesterase 1 c.428G > A single nucleotide variation on the pharmacokinetics of quinapril and enalapril
Authors: Tarkiainen E. Katriina , Tornio Aleksi , Holmberg Mikko T. , Launiainen Terhi , Neuvonen Pertti J. , Backman Janne T. , Niemi Mikko 
Published: April 2015

AimThe aim of the present study was to investigate the effects of the carboxylesterase 1 (CES1) c.428G > A (p.G143E, rs71647871) single nucleotide variation (SNV) on the pharmacokinetics of quinapril and enalapril in a prospective genotype panel study in healthy volunteers.MethodsIn a fixed‐order crossover study, 10 healthy volunteers with the CES1 c.428G/A genotype and 12 with the c.428G/G genotype ingested a single 10 mg dose of quinapril and enalapril with a washout period of at least 1 week. Plasma concentrations of quinapril and quinaprilat were measured for up to 24 h and those of enalapril and enalaprilat for up to 48 h. Their excretion into the urine was measured from 0 h to 12 h.ResultsThe area under the plasma concentration–time curve from 0 h to infinity (AUC0–∞) of active enalaprilat was 20% lower in subjects with the CES1 c.428G/A genotype than in those with the c.428G/G genotype (95% confidence interval of geometric mean ratio 0.64, 1.00; P = 0.049). The amount of enalaprilat excreted into the urine was 35% smaller in subjects with the CES1 c.428G/A genotype than in those with the c.428G/G genotype (P = 0.044). The CES1 genotype had no significant effect on the enalaprilat to enalapril AUC0–∞ ratio or on any other pharmacokinetic or pharmacodynamic parameters of enalapril or enalaprilat. The CES1 genotype had no significant effect on the pharmacokinetic or pharmacodynamic parameters of quinapril.ConclusionsThe CES1 c.428G > A SNV decreased enalaprilat concentrations, probably by reducing the hydrolysis of enalapril, but had no observable effect on the pharmacokinetics of quinapril.
Measuring anticholinergic drug exposure in older community‐dwelling Australian men: a comparison of four different measures
Authors: Pont Lisa G. , Nielen Johannes T. H. , McLachlan Andrew J. , Gnjidic Danijela , Chan Lewis , Cumming Robert G. , Taxis Katja 
Published: April 2015

AimsAnticholinergic drug exposure is associated with adverse outcomes in older people. While a number of tools have been developed to measure anticholinergic drug exposure, there is limited information about the agreement and overlap between the various scales. The aim of this study was to investigate the agreement and overlap between different measures of anticholinergic drug exposure in a cohort of community‐dwelling older men.MethodsA cross‐sectional study was used to compare anticholinergic drug exposure calculated using the Anticholinergic Risk Scale (ARS), the Anticholinergic Drug Scale (ADS), the Anticholinergic Cognitive Burden (ACB) and the Drug Burden Index anticholinergic subscale (DBI‐ACH) in a cohort of community‐dwelling men aged 70 years and older (n = 1696). Statistical agreement, expressed as Cohen's kappa (κ), between these measurements was calculated.ResultsDifferences were found between the tools regarding the classification of anticholinergic drug exposure for individual participants. Thirteen percent of the population used a drug listed as anticholinergic on the ARS, 39% used a drug listed on the ADS and the ACB, and 18% of the population used one or more anticholinergic drugs listed on the DBI‐ACH. While agreement was good between the ACB and ADS (κ = 0.628, 95% CI 0.593, 0.664), little agreement was found between remaining tools (κ = 0.091–0.264).ConclusionsWith the exception of the ACB and ADS, there was poor agreement regarding anticholinergic drug exposure among the four tools compared in this study. Great care should be taken when interpreting anticholinergic drug exposure using existing scales due to the wide variability between the different scales.
Clobazam: A Safe, Efficacious, and Newly Rediscovered Therapeutic for Epilepsy
Authors: Gauthier Angela C. , Mattson Richard H. 
Published: April 2015

SummaryClobazam is an oral 1,5‐benzodiazepine used worldwide for the treatment of many types of epilepsies, although it is currently only approved for Lennox–Gastaut syndrome in the USA. This anticonvulsant and anxiolytic therapeutic has repeatedly demonstrated great efficacy and a high safety profile in refractory epilepsy as well as in a few monotherapy trials in both children and adults. Clobazam allosterically activates the GABAA receptor, and it binds less to subunits that mediate sedative effects than other benzodiazepines. It acts quickly, maintaining a therapeutic effect for a long duration due to its active metabolite, N‐desmethylclobazam. Dosage is between 5 mg and 40 mg a day, depending on patient weight, efficacy, and tolerability. Efficacy tolerance has not been a problem in the best studies. Clobazam has provided many benefits to epileptic patients. It should be used by clinicians early as an adjuvant therapy in the treatment of refractory epilepsy and even considered as monotherapy in a broad spectrum of epilepsy syndromes.
Young Children's Help‐Seeking as Active Information Gathering
Authors: Vredenburgh Christopher , Kushnir Tamar 
Published: April 2015

AbstractYoung children's social learning is a topic of great interest. Here, we examined preschoolers’ (M = 52.44 months,SD = 9.7 months) help‐seeking as a social information gathering activity that may optimize and support children's opportunities for learning. In a toy assembly task, we assessed each child's competency at assembling toys and the difficulty of each step of the task. We hypothesized that children's help‐seeking would be a function of both initial competency and task difficulty. The results confirmed this prediction; all children were more likely to seek assistance on difficult steps and less competent children sought assistance more often. Moreover, the magnitude of the help‐seeking requests (from asking for verbal confirmation to asking the adult to take over the task) similarly related to both competency and difficulty. The results provide support for viewing children's help‐seeking as an information gathering activity, indicating that preschoolers flexibly adjust the level and amount of assistance to optimize their opportunities for learning.
Consequences of a restrictive syringe exchange policy on utilisation patterns of a syringe exchange program in Baltimore, Maryland: Implications for HIV risk
Authors: Sherman Susan G. , Patel Shivani A. , Ramachandran Daesha V. , Galai Noya , Chaulk Patrick , Serio‐Chapman Chris , Gindi Renee M. 
Published: April 2015

AbstractIntroduction and AimsSyringe distribution policies continue to be debated in many jurisdictions throughout the USA. The Baltimore Needle and Syringe Exchange Program (NSP) operated under a 1‐for‐1 syringe exchange policy from its inception in 1994 through 1999, when it implemented a restrictive policy (2000–2004) that dictated less than 1‐for‐1 exchange for non‐program syringes.Design and MethodsData were derived from the Baltimore NSP, which prospectively collected data on all client visits. We examined the impact of this restrictive policy on program‐level output measures (i.e. distributed : returned syringe ratio, client volume) before, during and after the restrictive exchange policy. Through multiple logistic regression, we examined correlates of less than 1‐for‐1 exchange ratios at the client level before and during the restrictive exchange policy periods.ResultsDuring the restrictive policy period, the average annual program‐level ratio of total syringes distributed : returned dropped from 0.99 to 0.88, with a low point of 0.85 in 2000. There were substantial decreases in the average number of syringes distributed, syringes returned, the total number of clients and new clients enrolling during the restrictive compared to the preceding period. During the restrictive period, 33 508 more syringes were returned to the needle exchange than were distributed. In the presence of other variables, correlates of less than 1‐for‐1 exchange ratio were being white, female and less than 30 years old.Discussion and ConclusionsWith fewer clean syringes in circulation, restrictive policies could increase the risk of exposure to HIV among Injection Drug Users (IDUs) and the broader community. The study provides evidence to the potentially harmful effects of such policies. [Sherman SG, Patel SA, Ramachandran DV, Galai N, Chaulk P, Serio‐Chapman C, Gindi RM. Consequences of a restrictive syringe exchange policy on utilisation patterns of a syringe exchange program in Baltimore, Maryland: Implications for HIV risk. Drug Alcohol Rev 2015;34:637–644]
Translocated to the fringe: genetic and niche variation in bighorn sheep of the Great Basin and northern Mojave deserts
Authors: Malaney Jason L. , Feldman Chris R. , Cox Michael , Wolff Peregrine , Wehausen John D. , Matocq Marjorie D. 
Published: April 2015

AbstractAimConservation biologists use various approaches to augment imperilled populations in order to supplement genetic variation and restore ecological function. However, understanding genotypic, phenotypic and ecotypic variation is critical in determining the most suitable sources to conserve historical and functional variation. Bighorn sheep (Ovis canadensis) provide a classic example of restoration biology, where management programmes have re‐established extirpated populations via translocations. Through this process, translocated individuals may now face novel environments, including new bioclimatic conditions and an opportunity to interbreed with historically isolated and distinct genetic units. Our goal was to integrate genetic and ecological analyses to assess some of the evolutionary ramifications of this important management practice.LocationWestern North America, but focused on the Great Basin and northern Mojave deserts.MethodsWe quantified genetic variation across 55 Herds of bighorn sheep using 16 microsatellite loci (N = 347) and a mitochondrial gene (N = 110). We used ordination, Bayesian clustering and phylogenetic analyses to delineate evolutionary units. We used multivariate ordination for 26 ecologically relevant variables to characterize niche‐based differences among genetic clusters and then tested whether repatriated populations occupy conditions similar to source areas.ResultsWe document genetic differentiation among three traditional management units of bighorn sheep that now occupy the Great Basin and northern Mojave deserts, but also identify limited hybridization among these groups. Niche‐based analyses revealed that translocated populations now occur in conditions incongruent with source ranges.Main conclusionsThis study highlights the importance of considering both genetic variation and ecological differences when implementing translocations. Early consideration of these variables may help minimize the potential for hybridization among distinct groups and mitigate challenges of managing populations experiencing novel environments. More broadly, results from this study have implications for future restoration efforts in this iconic system, but also for similar translocation‐based conservation programmes.
Impact of climate change on cold hardiness of Douglas‐fir (Pseudotsuga menziesii): environmental and genetic considerations
Authors: Bansal Sheel , St. Clair J. Bradley , Harrington Constance A. , Gould Peter J. 
Published: April 2015

AbstractThe success of conifers over much of the world's terrestrial surface is largely attributable to their tolerance to cold stress (i.e., cold hardiness). Due to an increase in climate variability, climate change mayreduceconifer cold hardiness, which in turn could impact ecosystem functioning and productivity in conifer‐dominated forests. The expression of cold hardiness is a product of environmental cues (E), genetic differentiation (G), and their interaction (G × E), although few studies have considered all components together. To better understand and manage for the impacts of climate change on conifer cold hardiness, we conducted a common garden experiment replicated in three test environments (cool, moderate, and warm) using 35 populations of coast Douglas‐fir (Pseudotsuga menziesiivar. menziesii) to test the hypotheses: (i) cool‐temperature cues in fall are necessary to trigger cold hardening, (ii) there is large genetic variation among populations in cold hardiness that can be predicted from seed‐source climate variables, (iii) observed differences among populations in cold hardinessin situare dependent on effective environmental cues, and (iv) movement of seed sources from warmer to cooler climates will increase risk to cold injury. During fall 2012, we visually assessed cold damage of bud, needle, and stem tissues following artificial freeze tests. Cool‐temperature cues (e.g., degree hours below 2 °C) at the test sites were associated with cold hardening, which were minimal at the moderate test site owing to mild fall temperatures. Populations differed 3‐fold in cold hardiness, with winter minimum temperatures and fall frost dates as strong seed‐source climate predictors of cold hardiness, and with summer temperatures and aridity as secondary predictors. Seed‐source movement resulted in only modest increases in cold damage. Our findings indicate that increased fall temperatures delay cold hardening, warmer/drier summers confer a degree of cold hardiness, and seed‐source movement from warmer to cooler climates may be a viable option for adapting coniferous forest to future climate.
Awareness and preference for functional foods: the perspective of older Italian consumers
Authors: Annunziata Azzurra , Vecchio Riccardo , Kraus Artur 
Published: April 2015

AbstractThe literature has identified several factors that specifically influence how older consumers view and consume functional foods (FFs), including the perceived need for the product and perceived health benefit. Health claims (HCs), symbols and logos on FF labels can thus play a central role in enhancing product attractiveness and perception of health benefits. Nevertheless, few studies have examined how elderly consumers perceive non‐verbal communication (such as symbols) associated with health‐related information on FFs. Research undertaken on 400 Italian consumers aged over 60 revealed that HCs on FF influence older consumers' perceptions of the healthiness of products. However, respondents also stated that they had difficulties reading and interpreting HCs and nutritional information on food labels. The findings highlight the existence of significant barriers to FF acceptance and use by older consumers, namely price sensitivity, availability and general scepticism on the reliability of the information provided by food manufacturers.
Factors Associated with Six-Month Outcome of Pediatric Stroke
Authors: Gordon Anne L. , Anderson Vicki , Ditchfield Michael , Coleman Lee , Mackay Mark T. , Greenham Mardee , Hunt Rod W. , Monagle Paul 
Published: April 2015

Background Pediatric stroke outcome studies are often cross sectional in design. Prospective information regarding the clinical course following diagnosis is lacking, but may inform clinical management beyond the acute period. Aims To describe the outcome of arterial ischemic stroke in infants, children and adolescents at one-month and six-months post-stroke across health domains, and explore the relationship between lesion characteristics and early outcome with six-month adaptive behavior. Methods A single center prospective longitudinal study at a tertiary level children's hospital. Recruitment was undertaken from December 2007 to January 2012. Participants were children aged birth to 18 years presenting acutely with first diagnosed arterial ischemic stroke. Lesion characteristics on brain imaging were classified. Children were grouped according to age at diagnosis for analysis (neonates vs. those aged >30 days). Results In 50 children with a median age of 47 months at diagnosis, sensorimotor impairments were most evident upon neurological examination acutely, especially in the older children. At both one-month and six-months motor functioning was significantly impaired in the older age group but no significant cognitive or language sequelae were identified. Lesion characteristics alone were not associated with six-month adaptive behavior outcomes. Conclusions For patients surviving arterial ischemic stroke, the most significant clinical consequences both acutely and at six-months, are sensorimotor impairments, particularly evident in the older children. In contrast cognitive or language sequelae were not identified. Long-term surveillance is required to describe clinical course and rehabilitation needs, particularly for neonates and infants.
Measurement of oxyhemoglobin concentration changes in interstitial cystitis female patients: A near‐infrared spectroscopy study
Authors: Matsumoto Shinya , Matsumoto Shinichi , Homma Yukio 
Published: April 2015

ObjectivesTo investigate brain activity related to bladder sensation in interstitial cystitis patients.MethodsA total of 10 interstitial cystitis patients (all women; mean age 68 years) and 10 healthy controls (all women; mean age 64 years) participated in the present study. Frontal lobe blood flow was measured non‐invasively by using multichannel near‐infrared spectroscopy with large and small bladder volumes (created by infusing water) up to the first desire to void.ResultsThe frontal cortex of the right and left hemisphere was activated, and the activation was detected as an increase in oxyhemoglobin concentration. The increase during the first desire to void in the interstitial cystitis group was greater than that in the control group. In addition, this difference was particularly observed in Brodmann's areas 9, 44, 45 and 46, reportedly associated with micturition and sensory modulation.ConclusionsThe present study shows that the frontal area is largely activated during bladder filling in interstitial cystitis patients. Our findings suggest that the major change in cerebral blood flow is related to the characteristic urinary symptoms of interstitial cystitis patients.
Declining Cholesterol and Mortality in a Sample of Older Nursing Home Residents
Authors: Grant Mark D. , Piotrowski Zdzislaw H. , Miles Toni P. 
Published: April 2015

OBJECTIVE: To examine the association between declining serum cholesterol and mortality in a sample of older nursing home residents.DESIGN: A retrospective cohort study.SETTING: A 203‐bed nursing home.PARTICIPANTS: Persons aged 65 and older, resident in the nursing home on January 1, 1988, or admitted through December 31, 1989, were eligible (n = 185) for the study. Follow‐up for mortality was conducted until June 30, 1991. Fifty‐five survivors with two or more cholesterol levels recorded before January 1, 1990, and the 76 decedents with two or more recorded cholesterol levels constituted the analytic sample (71% of eligible subjects).OUTCOME MEASURE: Mortality of the nursing home residents.RESULTS: Cholesterol declined 31.1 mg/dL/yr (95% confidence interval [CI], 19.7 to 42.6) among decedents, versus 4.2 mg/dL/yr (95% CI, −4.9 to 13.2) among survivors. The association between cholesterol decline (absolute or relative rates) and mortality was examined using logistic regression controlling for age, sex, and tube feeding. Compared with a referrent group with no change or increase, declining cholesterol greater than 45 mg/dL/yr was accompanied by an adjusted relative odds for death of 6.2 (95% CI, 2.1 to 18.4); declining cholesterol greater than 20% per year was accompanied by an adjusted relative odds for death of 7.3 (95% CI, 2.4 to 22.2). Extreme declines greater than 20% per year occurred in 47% of decedents but in only 15% of survivors.CONCLUSION: Precipitously declining cholesterol appeared to be a marker for mortality in the sample and may help explain the low cholesterol‐mortality association in older nursing home residents. J Am Geriatr Soc 44:31–36, 1996.