bluuebunny/crossref_metadata_2025_split huggingface dataset:
The sustainability of healthcare innovations: a concept analysis
Authors: Fleiszer Andrea R. , Semenic Sonia E. , Ritchie Judith A. , Richer Marie‐Claire , Denis Jean‐Louis 
Published: February 2015

AbstractAimTo report on an analysis of the concept of the sustainability of healthcare innovations.BackgroundWhile there have been significant empirical, theoretical and practical contributions made towards the development and implementation of healthcare innovations, there has been less attention paid to their sustainability. Yet many desired healthcare innovations are not sustained over the long term. There is a need to increase clarity around the concept of innovation sustainability to guide the advancement of knowledge on this topic.DesignConcept analysis.Data sourcesWe included literature reviews, theoretical and empirical articles, books and grey literature obtained through database searching (ABI/INFORM, Academic Search Complete, Business Source Complete, CINAHL, Embase, MEDLINE and Web of Science) from 1996–May 2014, reference harvesting and citation searching.MethodsWe examined sources according to terms and definitions, characteristics, preconditions, outcomes and boundaries to evaluate the maturity of the concept.ResultsThis concept is partially mature. Healthcare innovation sustainability remains a multi‐dimensional, multi‐factorial notion that is used inconsistently or ambiguously and takes on different meanings at different times in different contexts. We propose a broad conceptualization that consists of three characteristics: benefits, routinization or institutionalization, and development. We also suggest that sustained innovations are influenced by a variety of preconditions or factors, which are innovation‐, context‐, leadership‐ and process‐related.ConclusionFurther conceptual development is essential to continue advancing our understanding of the sustainability of healthcare innovations, especially in nursing where this topic remains largely unexplored.
The interplay of spatial and climatic landscapes in the genetic distribution of a South American parrot
Authors: Masello Juan F. , Montano Valeria , Quillfeldt Petra , Nuhlíčková Soňa , Wikelski Martin , Moodley Yoshan 
Published: February 2015

AbstractAimOur aim was to understand the interplay of heterogeneous climatic and spatial landscapes in shaping the distribution of nuclear microsatellite variation in burrowing parrots, Cyanoliseus patagonus. Given the marked phenotypic differences between populations of burrowing parrots we hypothesized an important role of geographical as well climatic heterogeneity in the population structure of this species.LocationSouthern South America.MethodsWe applied a landscape genetics approach to investigate the explicit patterns of genetic spatial autocorrelation based on both geography and climate using spatial principal component analysis (sPCA). This necessitated a novel statistical estimation of the species climatic landscape, considering temperature‐ and precipitation‐based variables separately to evaluate their weight in shaping the distribution of genetic variation in our model system.ResultsGeographical and climatic heterogeneity successfully explained molecular variance in burrowing parrots. sPCA divided the species distribution into two main areas, Patagonia and the pre‐Andes, which were connected by an area of geographical and climatic transition. Moreover, sPCA revealed cryptic and conservation‐relevant genetic structure: the pre‐Andean populations and the transition localities were each divided into two groups, each management units for conservation.Main conclusionssPCA, a method originally developed for spatial genetics, allowed us to unravel the genetic structure related to spatial and climatic landscapes and to visualize these patterns in landscape space. These novel climatic inferences underscore the importance of our modified sPCA approach in revealing how climatic variables can drive cryptic patterns of genetic structure, making the approach potentially useful in the study of any species distributed over a climatically heterogeneous landscape.
Surface ECG f Wave Analysis of Dofetilide Drug Effect in the Atrium
Authors: RAYGOR VIRAJ P. , NG JASON , GOLDBERGER JEFFREY J. 
Published: February 2015

Dofetilide Effect on f Waves in AFIntroductionThe electrocardiogram (ECG) fibrillatory (f) wave characteristics in atrial fibrillation (AF) could provide important information regarding the efficacy of antiarrhythmic drug therapy.Methods and ResultsTo measure the effects of dofetilide on the surface ECG f wave characteristics in patients with persistent AF, baseline and post‐drug (2 hours after first dose and after multiple doses) ECGs in 31 patients with persistent AF admitted for dofetilide loading were evaluated. A QRST template subtraction algorithm was used to yield an atrial ECG. Fast Fourier transform analysis was performed to evaluate the maximum organizational index (OI), the dominant frequency (DF) in the lead with max OI, the median DF for all leads, and the vector magnitude f wave amplitude. Dofetilide reduced DF in the lead with the max OI (6.32 ± 0.98 Hz at baseline vs. 4.83 ± 0.63 Hz after final dose, P < 0.0001) and median DF (6.46 ± 0.87 Hz vs. 4.92 ± 0.62 Hz, P < 0.0001). Dofetilide also increased the maximum OI from 0.52 ± 0.11 at baseline to 0.59 ± 0.11 after final dose (P = 0.02). Of the 29 patients with long‐term follow‐up, the 22 (76%) with recurrent AF on dofetilide had a lower baseline DF in the lead with the max OI (6.01 ± 1.08 vs. 6.89 ± 0.46; P = 0.05). The change in DF after dofetilide did not correlate with the change in QTc interval.ConclusionsThe standard ECG can be used to assess atrial rate in AF. This may be useful to assess antiarrhythmic drug effects for treatment of AF.
Adherence to self‐care behavior and glycemic effects using structured education
Authors: Yang Yi‐Sun , Wu Yueh‐Chu , Lu Ying‐Li , Kornelius Edy , Lin Yu‐Tze , Chen Yu‐Ju , Li Ching‐Lu , Hsiao Hui‐Wen , Peng Chiung‐Huei , Huang Chien‐Ning 
Published: February 2015

AbstractAims/IntroductionThe purpose of the present study was to examine glycemic control in suboptimally controlled type 2 diabetes provided by a structured education group using the Diabetes Conversation Map™ (CM™) vs usual care in a university‐based hospital primary care clinic.Materials and MethodsThis was a randomized, pragmatic clinical trial. Patients with type 2 diabetes were randomly assigned to structured education or usual care groups. The primary outcome was the difference in the mean change of glycated hemoglobin (HbA1c) from baseline to 12 months. Secondary outcomes included the percentage achieving therapeutic HbA1c goal and self‐behavioral changes.ResultsA total of 245 patients were randomly assigned to two groups (CM™ group n = 121; usual care group, n = 116). The absolute reduction of HbA1c was significantly greater in the CM™ group at 3 and 6 months (Δ = −0.59% and Δ = −1.13%, P < 0.01), but the difference was no longer statistically significant at 9 and 12 months (Δ = −0.43% and Δ = −0.49%), based on an intention‐to‐treat analysis. A per‐protocol analysis showed the significant change was maintained at 12 months (Δ = −0.67%). In the intervention group, greater percentages of patients achieved their American Association of Diabetes Educators Self‐Care Behaviours™ framework (AADE7) behavioral goals at 3 months, in particular being active, problem‐solving, reducing risk and health coping.ConclusionsIn type 2 diabetic patients with suboptimally controlled glucose, there were greater improvements in glucose control and self‐care behavioral goals in those who underwent the CM™ education program compared with outcomes achieved in patients receiving usual care.
Stent under‐expansion on the procedure day, a predictive factor for poor oral intake after metallic stenting for gastric outlet obstruction
Authors: Hori Yasuki , Naitoh Itaru , Ban Tesshin , Narita Kei , Nakazawa Takahiro , Hayashi Kazuki , Miyabe Katsuyuki , Shimizu Shuya , Kondo Hiromu , Nishi Yuji , Yoshida Michihiro , Umemura Shuichiro , Kato Akihisa , Yamada Tomonori , Ando Tomoaki , Joh Takashi 
Published: February 2015

AbstractBackground and AimSelf‐expandable metallic stents (SEMS) have been widely accepted as palliation therapy for malignant gastric outlet obstruction (GOO). However, the factors predictive of poor oral intake after SEMS placement have not been elucidated sufficiently. We aimed to clarify both the patient and stent‐related predictive factors.MethodsWe retrospectively reviewed 126 consecutive patients who underwent uncovered SEMS placement for malignant GOO between April 2010 and March 2013 at a university hospital and two tertiary care referral centers.ResultsTechnical success of SEMS placement was achieved in all 126 (100%) patients. Improved oral intake was observed in 111 (88.1%) patients. A Karnofsky performance status ≤ 40 (odds ratio [OR], 1.19; 95% confidence interval [CI], 1.02–1.28; P = 0.041), peritoneal dissemination (OR, 1.20; 95% CI, 1.01–1.26; P = 0.038), and under‐expansion of the SEMS on the procedure day (OR, 1.55; 95% CI, 1.26–1.62; P < 0.001) were independent predictive factors for poor improvement on the GOO scoring system, according to multivariate analysis.ConclusionsSEMS under‐expansion was a stent related, while poor performance status and peritoneal dissemination were patient related, predictive factors for poor oral intake after SEMS placement for malignant GOO.
Association of colonic regulatory T cells with hepatitis C virus pathogenesis and liver pathology
Authors: Hetta Helal F , Mekky Mohamed A , Khalil Nasr K , Mohamed Wegdan A , El‐Feky Mohamed A , Ahmed Shabaan H , Daef Enas A , Nassar Mahmoud I , Medhat Ahmed , Sherman Kenneth E , Shata Mohamed Tarek M 
Published: February 2015

AbstractBackground and AimForkhead box protein P3 (FoxP3)+ regulatory T (Treg) cells play a fundamental role in maintaining the balance between the tissue‐damaging and protective immune response to chronic hepatitis C (CHC) infection. Herein, we investigated the frequency of Treg cells in the colon and their potential relationship to the various CHC outcomes and hepatic histopathology.MethodsColonic biopsies were collected from three groups with CHC: treatment naïve (TN; n = 20), non‐responders (NR; n = 20), sustained virologic response (SVR; n = 20), and a fourth healthy control group (n = 10). The plasma viral loads and cytokines levels were determined by quantitative real‐time polymerase chain reaction, and ELISA, respectively. Liver biopsies were examined to assess inflammatory score and fibrosis stage. Colonic Treg frequency was estimated by immunohistochemistry using confocal microscopy.ResultsA significant increase in the frequency of colonic Treg was found in TN, and NR groups compared with the control and SVR group. The frequency of colonic Treg, plasma interleukin (IL)‐10 and IL‐4 levels were significantly positively correlated with viral load and negatively correlated with METAVIR inflammatory score, and fibrosis stages.ConclusionColonic Treg cells are negatively correlated with liver inflammation and hepatitis C virus (HCV) viral load, which suggests a strong linkage between gut‐derived Treg cell populations and HCV infection.
An observational study of older patients’ participation in hospital admission and discharge – exploring patient and next of kin perspectives
Authors: Dyrstad Dagrunn N , Laugaland Kristin A , Storm Marianne 
Published: February 2015

Aims and objectivesTo explore older patients’ participation during hospital admission and discharge.BackgroundPatient participation is suggested as a means to improve the quality of transitional healthcare. Older people with chronic diseases, physical disabilities and cognitive impairments often need to transfer from primary to hospital healthcare and vice versa.DesignThis study adopts a participant observational research design.MethodsParticipant observations of 41 older patients (over 75 years of age) during hospital admission and discharge were conducted in two hospitals in Norway (in 2012). The observations included short conversations with the patient and their next of kin to capture their participation experiences. Systematic text condensation was used to analyse the data material from the field notes.ResultsVarying degrees of information exchange between healthcare professionals and patients, and a lack of involvement of the patient in decision‐making (in admission and discharge) were observed and experienced by patients and their next of kin. The next of kin appeared to be important advocates for the patients in admission and provided practical support both during admission and discharge. Data suggest that patient participation in admission and discharge is influenced by time constraints and the heavy workloads of healthcare professionals. Patients’ health conditions and preferences also influence participation.ConclusionsSeveral issues influence the participation of the older patients during hospital admission and discharge. Participation of the older patients needs continuous support from healthcare professionals that acknowledges both the individual patient's preferences and their capacity to participate.Relevance to clinical practiceStudy findings report discrepancies in the involvement of older people and their next of kin. There is a need to increase and support older patients’ participation in hospital admission and discharge.
The Effect of Providing Peer Information on Retirement Savings Decisions
Authors: BESHEARS JOHN , CHOI JAMES J. , LAIBSON DAVID , MADRIAN BRIGITTE C. , MILKMAN KATHERINE L. 
Published: February 2015

ABSTRACTUsing a field experiment in a 401(k) plan, we measure the effect of disseminating information about peer behavior on savings. Low‐saving employees received simplified plan enrollment or contribution increase forms. A randomized subset of forms stated the fraction of age‐matched coworkers participating in the plan or age‐matched participants contributing at least 6% of pay to the plan. We document an oppositional reaction: the presence of peer information decreased the savings of nonparticipants who were ineligible for 401(k) automatic enrollment, and higher observed peer savings rates also decreased savings. Discouragement from upward social comparisons seems to drive this reaction.
Pricing in the Primary Market for Cat Bonds: New Empirical Evidence
Authors: Braun Alexander 
Published: February 2015

We present empirical evidence from the primary market for cat bonds, which provides new insights concerning the prevailing pricing practice of these instruments. For this purpose, transactional information from a multitude of sources has been collected and cross‐checked in order to compile a data set comprising virtually all cat bond tranches that were launched between June 1997 and December 2012. In order to identify the main determinants of the cat bond spread at issuance, a series of OLS regressions with heteroskedasticity‐ and autocorrelation‐consistent standard errors is run. Our results confirm the expected loss as the most important factor. Apart from that, covered territory, sponsor, reinsurance cycle, and the spreads on comparably rated corporate bonds exhibit a major impact. Based on these findings, we then propose an econometric cat bond pricing model that is applicable for all territories, perils, and trigger types. It exhibits a robust fit across different calibration subsamples and achieves a higher in‐sample and out‐of‐sample accuracy than several competing specifications that have been introduced in earlier work.
Portfolio Choice in Retirement—What is The Optimal Home Equity Release Product?
Authors: Hanewald Katja , Post Thomas , Sherris Michael 
Published: February 2015

AbstractWe study the decision problem of the optimal choice between home equity release products from a retired homeowner's perspective in the presence of longevity, long‐term care, house price, and interest rate risk. The individual can choose to release home equity using reverse mortgages or home reversion plans, to buy annuities, and long‐term care insurance. The individual enjoys utility gains from having access to either one of the two equity release products. Higher utility gains are found for the reverse mortgage, as its product features allow for higher lump‐sum payouts and provide downside protection for house prices.
Net Contribution, Liquidity, and Optimal Pension Management
Authors: Choi Changhui , Jang Bong‐Gyu , Kim Changki , Roh Sang‐youn 
Published: February 2015

AbstractThis article presents an optimal portfolio balancing strategy for a pension fund manager in the presence of fixed and proportional transaction costs with respect to stock trades and changes in net contribution. An analytic solution to the one‐period problem is presented and a heuristic method for a multiperiod problem is developed. For reasonably calibrated parameters, we find that our numerical results explain the actual asset allocation schemes of some internationally renowned pension funds. Moreover, we show that net contribution and liquidity have significant impacts on the optimal asset allocation of a pension fund.
THE URBAN–RURAL GAP IN UNIVERSITY ATTENDANCE: DETERMINANTS OF UNIVERSITY PARTICIPATION AMONG CANADIAN YOUTH
Authors: Newbold K. Bruce , Brown W. Mark 
Published: February 2015

ABSTRACTBased on existing work, there are clear differences in the incidence of degree holders across the urban–rural hierarchy in favor of large urban areas. In large part, this gradient can be traced to the higher probability of obtaining a degree among residents of larger urban centers. Utilizing data from the Youth in Transition Survey (YITS), this paper explores factors that may account for university participation among Canadian youth. It asks whether this difference is due to local access to universities, family characteristics (e.g., parental income, education, and immigrant status), and local labor market characteristics that may increase the incentive for urban youth to attend university.
Improving T cell-induced response to subunit vaccines: opportunities for a proteomic systems approach
Authors: Dunston Christopher R , Herbert Rebecca , Griffiths Helen R 
Published: February 2015

Abstract

Prophylactic vaccines are an effective strategy to prevent development of many infectious diseases. With new and re-emerging infections posing increasing risks to food stocks and the health of the population in general, there is a need to improve the rationale of vaccine development. One key challenge lies in development of an effective T cell-induced response to subunit vaccines at specific sites and in different populations.

Objectives
In this review, we consider how a proteomic systems-based approach can be used to identify putative novel vaccine targets, may be adopted to characterise subunit vaccines and adjuvants fully.

Key findings
Despite the extensive potential for proteomics to aid our understanding of subunit vaccine nature, little work has been reported on identifying MHC 1-binding peptides for subunit vaccines generating T cell responses in the literature to date.

Summary
In combination with predictive and structural biology approaches to mapping antigen presentation, proteomics offers a powerful and as yet un-tapped addition to the armoury of vaccine discovery to predict T-cell subset responses and improve vaccine design strategies.
Non‐parametric methods reveal non‐linear functional trait variation of lichens along environmental and fire age gradients
Authors: Nelson Peter R. , McCune Bruce , Roland Carl , Stehn Sarah 
Published: February 2015

AbstractQuestionsPopular methods to analyse community–trait–environment relationships constrain community patterns by trait and environment relationships. What if some traits are strongly associated with community composition but unrelated to environmental variables and vice versa? We take a different approach, unconstrained by this assumption using non‐parametric methods. We applied this technique to lichen (fungal/algal and/or cyanobacterial symbioses) communities across environmental and fire age gradients by measuring richness and cover of four important functional traits: energy generation (type of photosynthetic symbiont), water relations (inferred from growth form), dispersal capability (from vegetative propagules) and microsite specificity (measured by substrate affinity).LocationDenali National Park and Preserve, Alaska, USA.MethodsWe ordinated plots in species space and regressed trait and environmental variables against ordination axes, resulting in one‐ or two‐dimensional trait and environment surfaces. We then superimposed these surfaces on the ordination to create a new visual display, the ‘hilltop plot’, which enabled simultaneous measurement and display of one‐ and two‐dimensional, non‐linear community–trait–environment associations.ResultsMost traits examined show non‐linear relationships with community structure. Fire favoured simple cladoniiform lichens, species with higher vegetative dispersal capacity and specificity to grow on wood, but excluded the ‘reindeer’ lichens, which had lower cover even more than 20 yrs after fire. Forests had more sorediate lichens than non‐forested habitats, whereas high elevation, rocky areas had more green algal and fruticose lichens. Cyanobacterial lichen richness was positively related to shrub cover, while tripartite (cyanobacteria and green algae in a single lichen) and foliose lichen richness was highest in areas with higher moss cover.ConclusionsDifferent combinations of lichen functional traits peaked along environmental and disturbance gradients, which we interpreted as balancing energy generation, water relations, vegetative dispersal and habitat specificity. Our method of trait–environment–community analysis revealed numerous one‐ and two‐dimensional, non‐linear relationships between community composition and functional traits, environmental variables and fire age gradients, which informed mechanisms behind community assembly. Our results indicate non‐parametric and non‐linear methods of trait–environment–community analysis have the potential to detect patterns that would have been missed using current popular techniques.