bluuebunny/crossref_metadata_2025_split huggingface dataset:
Robotic versus non‐robotic instruments in spatially constrained operating workspaces: a pre‐clinical randomized crossover study
Authors: Cundy Thomas P. , Marcus Hani J. , Hughes‐Hallett Archie , MacKinnon Thomas , Najmaldin Azad S. , Yang Guang‐Zhong , Darzi Ara 
Published: November 2014

ObjectiveTo compare the effectiveness of robotic and non‐robotic laparoscopic instruments in spatially constrained workspaces.Materials and MethodsSurgeons performed intracorporeal sutures with various instruments within three different cylindrical workspace sizes. Three pairs of instruments were compared: 3‐mm non‐robotic mini‐laparoscopy instruments; 5‐mm robotic instruments; and 8‐mm robotic instruments. Workspace diameters were 4, 6 and 8 cm, with volumes of 50, 113 and 201 cm3 respectively. Primary outcomes were validated objective task performance scores and instrument workspace breach counts.ResultsA total of 23 participants performed 276 suture task repetitions. The overall median task performance scores for the 3‐, 5‐ and 8‐mm instruments were 421, 398 and 402, respectively (P = 0.12). Task scores were highest (best) for the 3‐mm non‐robotic instruments in all workspace sizes. Scores were significantly lower when spatial constraints were imposed, with median task scores for the 4‐, 6‐ and 8‐cm diameter workspaces being 388, 415 and 420, respectively (P = 0.026). Significant indirect relationships were seen between boundary breaches and workspace size (P < 0.001). Higher breach counts occurred with the robotic instruments.ConclusionsSmaller workspaces limit the performance of both robotic and non‐robotic instruments. In operating workspaces <200 cm3, 3‐mm non‐robotic instruments are better suited for advanced bimanual operative tasks such as suturing. Future robotic instruments need further optimization if this technology is to be uniquely advantageous for clinical roles that involve endoscopic access to workspace‐restricted anatomical areas.
Challenging Gender Stereotypes: Resistance and Exclusion
Authors: Mulvey Kelly Lynn , Killen Melanie 
Published: November 2014

The likelihood of resisting gender‐stereotypic peer group norms, along with expectations about personal resistance, was investigated in 9‐ to 10‐year‐olds and 13‐ to 14‐year‐olds (N = 292). Participants were told about a stereotype conforming group (boys playing football; girls doing ballet) and a stereotype nonconforming group (boys doing ballet; girls playing football). Contrary to expectations from gender‐stereotyping research, participants stated that they would personally resist gender‐stereotypic norms, and more so than they would expect their peers to resist. However, expecting peers to resist declined with age. Participants expected that exclusion from the group was a consequence for challenging the peer group, and understood the asymmetrical status of gender stereotypes with an expectation that it would be more difficult for boys to challenge stereotypes than for girls.
Irisin: ‘fat’ or artefact
Authors: Crujeiras A.B. , Pardo M. , Casanueva F.F. 
Published: November 2014

SummarySoon after the discovery of the muscle‐derived factor irisin, a great controversy arose in the literature regarding certain inconsistencies in the regulation of the fibronectin type III domain containing 5 protein (FNDC5/irisin) after exercise, as well as the unpredicted association of circulating irisin levels with parameters of adiposity in humans. Due to these questionable findings, doubts as to the identity of the soluble portion of FNDC5 as well as the real role of irisin and its possible therapeutic applications in the treatment of obesity and diabetes have proliferated. We recently postulated that FNDC5/irisin is an adipokine expressed and secreted by white adipose tissue in rats and humans. Its circulating concentration correlates with adiposity in humans among independent cohorts of patients. Further analysis, focused on obesity‐related metabolic disorders, has shown that irisin could play a role in promoting insulin resistance or act as an adaptive response to counteract disturbances in glucose and lipid homoeostasis in obesity. Overall, this leads us to raise the question whether the new factor, increased in circulation of obese patients, is really irisin‐reflecting fat mass or it is an artefact. Therefore, the current review is focused on the potential participation of adipose tissue in irisin circulating levels, and the role of irisin in metabolic pathologies associated with obesity in an attempt to clarify the controversy generated by these recently published reports.
Patients’ expectations, satisfaction, and quality of life with immediate loading protocol
Authors: Menassa Melanie , de Grandmont Pierre , Audy Nicholas , Durand Robert , Rompré Pierre , Emami Elham 
Published: November 2014

AbstractObjectivesTo examine patients’ expectations, the level of satisfaction, and the oral health‐related quality of life (OHRQoL) with regard to the implants’ immediate loading protocol (ILP) in edentate individuals.MethodsThis pilot trial used a pre–post design to assess patient‐centered outcomes in 18 edentate individuals (mean age 62.4 ± 7.7 years) who have received a 2‐implant (unsplinted) mandibular overdenture through an ILP. Visual analog scales, the McGill denture satisfaction questionnaire, and the oral health impact profile (OHIP‐20) questionnaire were used to evaluate patients’ expectations, satisfaction, and OHRQoL at baseline, 2 weeks, 1 month, and 4 months after surgery. Personality trait and socio‐demographic information were obtained using the revised NEO personality inventory and a self‐administered questionnaire, respectively. Non‐parametric methods and Brunner–Langer approach were used to analyze the data.ResultsThe participants had a wide range of expectations regarding the ILP. Expectations included short‐term positive impact on aesthetics (83.3%) and social life (55.7%), as well as negative effects on comfort (5.6%), the ability to chew (11.1%), and the ability to clean the lower denture (11.1%). The ILP satisfied 94.4% of the participants, regardless of socio‐demographic and personality profiles. There was a statistically significant improvement in overall satisfaction, comfort, perceived aesthetics, stability of the overdenture, and ability to chew from baseline to 2‐week, 1‐, and 4‐month follow‐up (P < 0.001). There was 100% agreement among patients on recommending this procedure to others.There was a statistically significant decrease in the total OHIP scores and all its domains (P < 0.001) from baseline to 2 weeks. These differences remained statistically significant at 4‐month follow‐up. The ILP improved patients’ OHRQoL, regardless of the implant loss, the socio‐demographic characteristics, and personality traits.ConclusionsThe ILP of two unsplinted implants with a mandibular overdenture significantly improved satisfaction and short‐term OHRQoL, and appears to meet expectations in edentulous elders. There was 100% agreement among patients on recommending this procedure to others.
The Value of Using Feasibility Models in Systematic Conservation Planning to Predict Landholder Management Uptake
Authors: TULLOCH AYESHA I. T. , TULLOCH VIVITSKAIA J. D. , EVANS MEGAN C. , MILLS MORENA 
Published: November 2014

AbstractUnderstanding the social dimensions of conservation opportunity is crucial for conservation planning in multiple‐use landscapes. However, factors that influence the feasibility of implementing conservation actions, such as the history of landscape management, and landholders’ willingness to engage are often difficult or time consuming to quantify and rarely incorporated into planning. We examined how conservation agencies could reduce costs of acquiring such data by developing predictive models of management feasibility parameterized with social and biophysical factors likely to influence landholders’ decisions to engage in management. To test the utility of our best‐supported model, we developed 4 alternative investment scenarios based on different input data for conservation planning: social data only; biological data only; potential conservation opportunity derived from modeled feasibility that incurs no social data collection costs; and existing conservation opportunity derived from feasibility data that incurred collection costs. Using spatially explicit information on biodiversity values, feasibility, and management costs, we prioritized locations in southwest Australia to control an invasive predator that is detrimental to both agriculture and natural ecosystems: the red fox (Vulpes vulpes). When social data collection costs were moderate to high, the most cost‐effective investment scenario resulted from a predictive model of feasibility. Combining empirical feasibility data with biological data was more cost‐effective for prioritizing management when social data collection costs were low (<4% of the total budget). Calls for more data to inform conservation planning should take into account the costs and benefits of collecting and using social data to ensure that limited funding for conservation is spent in the most cost‐efficient and effective manner.
Training Intervention Study Participants to Disseminate Health Messages to the Community: A New Model for Translation of Clinical Research to the Community
Authors: Zimmermann Kristine , Khare Manorama M. , Koch Abigail R. , Wright Cherie , Geller Stacie 
Published: November 2014

AbstractPeer education offers a novel strategy for the translation of health promotion interventions in hard‐to‐reach communities. We describe the development, implementation, and evaluation of a program where research participants from a cardiovascular risk reduction intervention were invited to be trained as peer educators. The goal of the “Heart‐to‐Heart” intervention was to promote healthy behaviors among peers to reduce cardiovascular disease risk. We recruited and trained 32 peer educators from a rural, Midwestern community to implement the program, and 18 educators reached 175 women and men. A mixed‐method analysis revealed that those who opted to become peer educators were more likely to be African American than participants of the study population from which they were recruited. Peer educators reported positive assessments of their encounters with respect to preparation and confidence, as well as reinforced personal health behaviors. Peer educators' success was evident in reports from the individuals they reached, who reported learning new concepts and intention to change behavior. Interviews with peer educators revealed their motivations, peer education barriers, and recommendations. The Heart‐to‐Heart model for training research participants to serve as peer educators to disseminate behavior change messages warrants further investigation as a strategy for the translation of research to communities.
A Data‐Rich Recruitment Core to Support Translational Clinical Research
Authors: Kost Rhonda G. , Corregano Lauren M. , Rainer Tyler‐Lauren , Melendez Caroline , Coller Barry S. 
Published: November 2014

AbstractBackgroundUnderenrollment of clinical studies wastes resources and delays assessment of research discoveries. We describe the organization and impact of a centralized recruitment core delivering comprehensive recruitment support to investigators.MethodsThe Rockefeller University Center for Clinical and Translational Science supports a centralized recruitment core, call center, Research Volunteer Repository, data infrastructure, and staff who provide expert recruitment services to investigators. During protocol development, consultations aim to optimize enrollment feasibility, develop recruitment strategy, budget, and advertising. Services during study conduct include advertising placement, repository queries, call management, prescreening, referral, and visit scheduling. Utilization and recruitment outcomes are tracked using dedicated software.ResultsFor protocols receiving recruitment services during 2009–2013: median time from initiation of recruitment to the first enrolled participant was 10 days; of 4,047 first‐time callers to the call center, 92% (n = 3,722) enrolled in the Research Volunteer Repository, with 99% retention; 23% of Repository enrollees subsequently enrolled in ≥1 research studies, with 89% retention. Of volunteers referred by repository queries, 49% (280/537) enrolled into the study, with 92% retained.ConclusionsProvision of robust recruitment infrastructure including expertise, a volunteer repository, data capture and real‐time analysis accelerates protocol accrual. Application of recruitment science improves the quality of clinical investigation.
Urtikaria
Authors: Wedi Bettina , Wieczorek Dorothea , Raap Ulrike , Kapp Alexander 
Published: November 2014

ZusammenfassungDie Urtikaria ist häufig und als Krankheitsbild bereits in der Antike beschrieben worden. Trotzdem sind zum Pathomechanismus und Management viele Fragen offen. Die publizierte Evidenz ist im Vergleich zu anderen häufigen Hauterkrankungen gering. Die klinische Symptomatik mit juckenden, flüchtigen Urticae und/oder Angioödemen wird durch eine Mediatorausschüttung (insbesondere von Histamin) aus aktivierten Mastzellen und basophilen Granulozyten vermittelt. Der Mechanismus der Mastzellaktivierung ist für die meisten Urtikariaformen im Detail bislang nicht geklärt. Bei der Urtikaria müssen unterschiedliche Subtypen abgegrenzt werden. Spontane Formen sind häufiger als induzierbare Formen. Im Management sind besonders die chronischen Urtikariaformen und besondere Lebensalter und ‐umstände (Kinder, Schwangere) problematisch. Daher ist die internationale Konsensbildung mit der Entwicklung einer aktualisierten Leitlinie, die neben Empfehlungen zur Diagnostik auch einen dreistufigen Behandlungsalgorithmus beinhaltet, hilfreich. Neben den in Standarddosierung zugelassenen H1‐Antihistaminika steht seit kurzem mit Omalizumab für die chronische spontane Urtikaria, die nicht auf H1‐Antihistaminika anspricht, eine weitere zugelassene Therapieoption zur Verfügung. Der Wirkmechanismus von Omalizumab bei der chronischen Urtikaria ist nicht im Detail geklärt, seine Aufdeckung könnte wesentlich zum Verständnis der Pathogenese der Urtikaria und zur Entwicklung weiterer therapeutischer Strategien beitragen.
Hypsarrhythmia assessment exhibits poor interrater reliability: A threat to clinical trial validity
Authors: Hussain Shaun A. , Kwong Grace , Millichap John J. , Mytinger John R. , Ryan Nicole , Matsumoto Joyce H. , Wu Joyce Y. , Lerner Jason T. , Sankar Raman 
Published: November 2014

SummaryObjectiveHypsarrhythmia is the classic interictal electroencephalographic pattern associated with infantile spasms, and characterized by high voltage, disorganization, and multifocal independent epileptiform discharges. Given this seemingly simple definition, one might expect excellent interrater reliability (IRR) in the identification of this pattern. Alternatively, it may be argued that assessments of voltage and disorganization are fairly subjective, and thus quite challenging in borderline cases. We sought to test the IRR of hypsarrhythmia assessment in a systematic fashion.MethodsSix blinded pediatric electroencephalographers from four centers reviewed 22 electroencephalography (EEG) samples from patients with infantile spasms. Each sample was 5 min in duration and included only wakefulness. Raters determined if each EEG was abnormal and if hypsarrhythmia was present/absent, and characterized relevant features: voltage, organization, epileptiform discharges, slowing, interictal attenuations, symmetry, and synchrony. In addition, raters indicated their level of confidence for each assessment. Multirater kappa statistics (κ) were calculated for the assessment of hypsarrhythmia and each feature.ResultsAlthough IRR was favorable in determining whether a study was normal or abnormal (κ = 0.89), reliability was unfavorable for assessment of hypsarrhythmia (κ = 0.40), modified hypsarrhythmia (κ = 0.47), high voltage (κ = 0.37), disorganization (κ = 0.22), multifocal epileptiform discharges (κ = 0.68), interictal voltage attenuations (κ = 0.21), slowing (κ = 0.20), asymmetry (κ = 0.26), and asynchrony (κ = 0.08). Despite generally unsatisfactory interrater agreement, raters consistently reported high confidence in assessments.SignificanceThis study contradicts the view that hypsarrhythmia assessment is straightforward. Even small variability in the identification of hypsarrhythmia has potentially deleterious consequences for clinical care, as its presence or absence impacts decisions to pursue high‐risk and high‐cost therapies. These inconsistencies may similarly confound studies in which abolition of hypsarrhythmia is an outcome measure. There is a great need for practical, reliable, and unbiased measures of hypsarrhythmia.
High vapor pressure deficit drives salt‐stress‐induced rice yield losses in India
Authors: Tack Jesse , Singh Rakesh K. , Nalley Lawton L. , Viraktamath Basavaraj C. , Krishnamurthy Saraswathipura L. , Lyman Nate , Jagadish Krishna S. V. 
Published: November 2014

AbstractFlooded rice is grown across wide geographic boundaries from as far north as Manchuria and as far south as Uruguay and New South Wales, primarily because of its adaptability across diverse agronomic and climatic conditions. Salt‐stress damage, a common occurrence in delta and coastal rice production zones, could be heightened by the interactions between high temperature and relative humidity (vapor pressure deficit – VPD). Using temporal and spatial observations spanning 107 seasons and 19 rice‐growing locations throughout India with varying electrical conductivity (EC), including coastal saline, inland saline, and alkaline soils, we quantified the proportion of VPD inducing salinity damage in rice. While controlling for time‐invariant factors such as trial locations, rice cultivars, and soil types, our regression analysis indicates that EC has a nonlinear detrimental effect on paddy rice yield. Our estimates suggest these yield reductions become larger at higher VPD. A one standard deviation (SD) increase in EC from its mean value is associated with 1.68% and 4.13% yield reductions at median and maximum observed VPD levels, respectively. Yield reductions increase roughly sixfold when the one SD increase is taken from the 75th percentile of EC. In combination, high EC and VPD generate near catastrophic crop loss as predicted yield approaches zero. If higher VPD levels driven by global warming materialize in conjunction with rising sea levels or salinity incursion in groundwater, this interaction becomes an important and necessary predictor of expected yield losses and global food security.
Does the extracorporeal blood flow affect survival of the arteriovenous vascular access?
Authors: Ponce Pedro , Marcelli Daniele , Scholz Caecilia , Wehmeyer Wolfgang , Gonçalves Pedro , Grassmann Aileen , Brand Katharina , Canaud Bernard 
Published: November 2014

AbstractHemodiafiltration with high‐convective volumes is associated with improved patient survival, whereby practical realization is contingent on high extracorporeal blood flow (Qb) and dialysis treatment time. However, Qb is restricted by vascular access (VA) quality and/or concerns that high Qb could damage the VA. Taking VA quality into consideration, one can investigate the relationship between Qb and VA survival. We analyzed data from 1039 patients treated by hemodiafiltration over a 21‐month period where access blood flow (Qa) measurements were also available at baseline. VA failure was defined as a surgical intervention resulting in the generation of a new VA. Qa was included as a stratification variable within a Cox regression model. A second Cox proportional hazard model with a penalized spline was used to describe the association between Qb and VA survival. Compared with Qb in the 350–357 mL/min range, a significantly higher hazard ratio (HR) for VA failure was detected for fistula only, and then only for Qb < 312 mL/min (HR: 2.361, 95% confidence interval [CI]: 1.251–4.453), Qb = 387–397 mL/min (HR: 1.920, 95% CI: 1.007–3.660) and Qb >414 mL/min (HR: 2.207, 95% CI: 1.101–4.424). Age, gender, diabetes, VA vintage, position of the VA, and arterial pressure were not significantly associated with outcome. The form of the penalized spline confirmed higher risk for VA failure for the lowest and the highest values of Qb. Taking Qa into consideration, no association was found between VA failure and Qb up to flows as high as approximately 390 mL/min.
Men's preferences and trade‐offs for prostate cancer screening: a discrete choice experiment
Authors: Howard Kirsten , Salkeld Glenn P. , Patel Manish I. , Mann Graham J. , Pignone Michael P. 
Published: November 2014

AbstractObjectivesProstate cancer screening using prostate‐specific antigen (PSA) remains controversial. In deciding about screening, men must weigh the benefits and harms: little is known about benefit: harm trade‐offs men are willing to accept. The objective of this study was to assess men's preferences forPSAscreening, and the trade‐offs between benefits and harms men are willing to accept when deciding about screening.MethodsPreferences of 662 men aged 40–69 were assessed using a discrete choice experiment.PSAscreening was described by six attributes: prostate cancer deaths, prostate cancer diagnoses, unnecessary biopsies from false‐positivePSAtests, impotence, urinary incontinence/bowel problems and cost. A mixed logit model was used to examine the influence of attributes on men's preferences forPSAtesting; benefit: harm trade‐offs were also calculated.ResultsMen's preferences were significantly influenced by test characteristics, particularly potential mortality benefit, unnecessary biopsies and likelihood of urinary incontinence or bowel problems; preferences were also influenced by age, priorPSAtesting experience and perceived risk of prostate cancer. Men were willing to accept between 65 and 233 of 10 000 extra men with unnecessary biopsies, and between 31 and 72 of 10 000 extra men with incontinence/bowel problems to avoid one prostate cancer death.ConclusionsDifferences in valuations of attributes and trade‐offs acceptable to men of different ages suggest a one size fits all approach toPSAtesting, regardless of age, may not reflect men's preferences. Our results can be used by policymakers to ensure screening programmes are in line with men's preferences and by clinicians and patients to facilitate informed discussions of the most relevant benefits and downsides ofPSAscreening for an individual man.
Couples with diabetes and health‐care providers: a grounded theory of preferential relating
Authors: Falke Stephanie I. , Lawson Lindsey 
Published: November 2014

AbstractBackgroundA collaborative health‐care relationship is considered critical in managing chronic illness like diabetes. Poorly controlled diabetes can greatly diminish one's quality of life and lead to severe complications or even death.RationaleUnderstanding how to improve the relationship between patients and their providers supports improved diabetes health outcomes.ObjectiveWe conducted a grounded theory study to examine the types of relationships that diabetic patients and their spouses prefer to form with their health‐care providers.ResultsThe analysis of in‐depth interviews with 18 diabetic couples reveals four major relationship preferences that differ by the nature of caregiving and decision‐making power demonstrated by the physician.ConclusionUsing illustrative examples, we show how the type of health‐care relationship couples prefer is explained by their connection with one another and suggest implications for practitioners that expand current collaborative models of care.