bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helping mothers survive bleeding after birth: an evaluation of simulation‐based training in a low‐resource setting
Authors: Nelissen Ellen , Ersdal Hege , Østergaard Doris , Mduma Estomih , Broerse Jacqueline , Evjen‐Olsen Bjørg , van Roosmalen Jos , Stekelenburg Jelle 
Published: December 2013

AbstractObjectiveTo evaluate “Helping Mothers Survive Bleeding After Birth” (HMS BAB) simulation‐based training in a low‐resource setting.DesignEducational intervention study.SettingRural referral hospital in Northern Tanzania.PopulationClinicians, nurse‐midwives, medical attendants, and ambulance drivers involved in maternity care.MethodsIn March 2012, health care workers were trained in HMS BAB, a half‐day simulation‐based training, using a train‐the‐trainer model. The training focused on basic delivery care, active management of third stage of labor, and treatment of postpartum hemorrhage, including bimanual uterine compression.Main outcome measuresEvaluation questionnaires provided information on course perception. Knowledge, skills, and confidence of facilitators and learners were tested before and after training.ResultsFour master trainers trained eight local facilitators, who subsequently trained 89 learners. After training, all facilitators passed the knowledge test, but pass rates for the skills test were low (29% pass rate for basic delivery and 0% pass rate for management of postpartum hemorrhage). Evaluation revealed that HMS BAB training was considered acceptable and feasible, although more time should be allocated for training, and teaching materials should be translated into the local language. Knowledge, skills, and confidence of learners increased significantly immediately after training. However, overall pass rates for skills tests of learners after training were low (3% pass rate for basic delivery and management of postpartum hemorrhage).ConclusionsThe HMS BAB simulation‐based training has potential to contribute to education of health care providers. We recommend a full day of training and validation of the facilitators to improve the training.
Lymphadenectomy in surgical stage I epithelial ovarian cancer
Authors: Svolgaard Olivia , Lidegaard Øjvind , Nielsen Marie Louise S. , Nedergaard Lotte , Mosgaard Berit J. , Lidang Marianne , Mogensen Ole , Kock Kirsten , Blaakær Jan , Stæhr Estrid , Andersen Erik S. , Grove Anni , Høgdall Claus 
Published: December 2013

AbstractObjectiveTo identify the extent of lymphadenectomy performed in women presenting with epithelial ovarian cancer macroscopically confined to the ovary. Furthermore, the effect of lymphadenectomy on overall survival is evaluated.DesignA prospective nationwide case‐only study.SettingDenmark 2005–2011.SampleAll women registered in the nationwide Danish Gynecologic Cancer Database from 1 January 2005 to 1 May 2011, presenting with a tumor macroscopically confined to the ovary without visible evidence of abdominal spread at the time of the initial exploration (surgical stage I).MethodDescriptive and survival analyses of data from Danish Gynecologic Cancer Database.Main outcome measuresThe annual proportion of women with surgical stage I disease who received lymphadenectomy and the survival in the two groups.ResultsOf 2361 women with epithelial ovarian cancer, 627 were identified with surgical stage I. Lymphadenectomy was performed in 216 women (34%) of whom 13 (6%) had lymph node metastases. At 5‐year follow up 85% remained alive in the lymphadenectomy group compared with 80% in the control group (p = 0.064). The lymphadenectomy fraction increased from 24% in 2005 to 55% in 2011. When univariate and multivariate analyses were conducted only an insignificant difference in the survival probability was found between lymphadenectomy and no lymphadenectomy in women presenting with tumor macroscopically confined to the ovary.ConclusionAlthough increasing, the number of women with surgical stage I disease in Denmark who receive lymphadenectomy remains low, but this did not seem to make a difference to survival.
Fast forward selection for generalized estimating equations with a large number of predictor variables
Authors: Stoklosa Jakub , Gibb Heloise , Warton David I. 
Published: December 2013

SummaryWe propose a new variable selection criterion designed for use with forward selection algorithms; the score information criterion (SIC). The proposed criterion is based on score statistics which incorporate correlated response data. The main advantage of the SIC is that it is much faster to compute than existing model selection criteria when the number of predictor variables added to a model is large, this is because SIC can be computed for all candidate models without actually fitting them. A second advantage is that it incorporates the correlation between variables into its quasi‐likelihood, leading to more desirable properties than competing selection criteria. Consistency and prediction properties are shown for the SIC. We conduct simulation studies to evaluate the selection and prediction performances, and compare these, as well as computational times, with some well‐known variable selection criteria. We apply the SIC on a real data set collected on arthropods by considering variable selection on a large number of interactions terms consisting of species traits and environmental covariates.
Coupled exposure to ingredients of cosmetic products: II. Preservatives
Authors: Uter Wolfgang , Yazar Kerem , Kratz Eva‐Maria , Mildau Gerd , Lidén Carola 
Published: December 2013

SummaryBackgroundThe use of cosmetics exposes consumers to mixtures of ingredients, many of which are potential allergens. Many cosmetics contain one or several preservatives, some being important contact allergens.ObjectiveTo examine the pattern of co‐exposure to preservatives in different categories of cosmetics.MethodsA survey of products marketed in Germany, conducted in 2006–2009 by the Chemical and Veterinary Investigation Office in Karlsruhe, identified 4680 products categorizable according to Annex I to the Cosmetics Directive with information on the presence of preservatives. The occurrence and co‐occurrence of preservatives were analysed and presented in tabular and graphical format.ResultsThirty per cent of all products were not declared to contain any preservatives; for 8%, no INCI labelling was present. For the remainder, the number of preservatives used tended to be higher in leave‐on than in rinse‐off products. Most often, combinations of (up to all five) parabens were used (39% of all products). Combinations with phenoxyethanol were also frequent. Formaldehyde releasers were found in 8% of products overall.ConclusionsThe pattern of co‐exposure to preservatives in important categories of cosmetic products illustrates the ‘cocktail’ of allergens that may facilitate sensitization, although, conversely, the combination of preservatives allows individual use levels to be kept lower, thereby possibly reducing sensitization risk.
Correlations between colonic crypt mucin chemotype, inflammatory grade and Desulfovibrio species in ulcerative colitis
Authors: Lennon G. , Balfe Á. , Bambury N. , Lavelle A. , Maguire A. , Docherty N. G. , Coffey J. C. , Winter D. C. , Sheahan K. , O'Connell P. R. 
Published: December 2013

AbstractAimThe colonic mucus gel layer is composed of mucins that may be sulphated or sialyated. Sulphated mucins predominate in health while in ulcerative colitis (UC) sulphation is reduced. These differences result directly from inflammatory events. It may also be hypothesized that they arise in part from alterations in the colonic microbiota, particularly changes in the burden of sulphated mucin‐metabolizing species, such as Desulfovibrio (DSV) bacteria. The aim of this study was to correlate colonic mucin chemotypes and inflammatory scores in health and UC and relate these changes to changes in the colonization of colonic crypts by DSV.MethodPaired colonic biopsies from 34 healthy controls (HC) and 19 patients with active UC were collected for the purpose of parallel histological and microbiological assessment. High‐iron diamine and Alcian blue staining and haematoxylin and eosin of mucosal biopsy specimens were used to assess histological changes within the clinical spectrum of UC. Quantitative real‐time polymerase chain reaction analysis was employed to determine the total and DSV copy number within the colonic crypts.ResultsCompared with HC, the mucin chemotype in UC was less sulphated and inversely correlated with the degree of mucosal inflammation. A weak but significant negative correlation was found between the abundance of sulphated mucins and DSV burden.ConclusionMucin composition strongly correlates with the degree of mucosal inflammation, and to a lesser extent with DSV burden. These data suggest that mucin chemotype and DSV burden are linked phenomena and highlight the need to consider changes in mucin chemotype in the setting of microbial dysbiosis occurring within the colitic colon.
What does this paper add to the literature?Decreased sulphation of mucins has been associated with inflammation in ulcerative colitis. Currently there are few data describing the relationship between microbial species and changes in mucin chemotype. This study validates previous findings and presents evidence of changes in mucin chemotype occurring in tandem with coherent changes in the microbiota within crypt niches.
Cutaneous collagenous vasculopathy associated with intravascular occlusive fibrin thrombi
Authors: Salama Samih , Chorneyko Kathy , Belovic Brian 
Published: December 2013

AbstractCutaneous collagenous vasculopathy (CCV) is a rare cutaneous microangiopathy that clinically resembles generalized essential telangiectasia with only 12 cases reported to date. The perivascular fibrosis is thought to be due to production of abnormal collagen by veil cells in the outer vessel walls as a result of unknown factors. This report is of an 84‐year‐old male with progressive telangiectasia. Biopsies showed characteristic features of CCV. In addition, there were multiple intravascular fibrin thrombi, some organizing and associated with endothelial cell hyperplasia with recanalization reminiscent of glomeruloid bodies and simulating reactive angioendotheliomatosis (RAE). Histochemically and ultrastructurally fibrin was noted within the vessel walls integrating into the fibrous tissue around the vessels; however, the patient had no evidence of coagulation disorder, cryoglobulinemia or cold agglutinemia. Immunofluorescence showed fibrinogen within the vessel walls but no immunoglobulins or C3. As well, there were minimal inflammatory cells. This suggests pauci‐inflammatory injury to the endothelial cells by unknown angiogenic factors causing local intravascular fibrin thrombi with fibrin leaking and incorporating into the vessel walls, eventually leading to reparative perivascular fibrosis. This case suggests that some cases of CCV are related to a primary local intravascular occlusive thrombotic microangiopathy. However, the primary triggering factor causing the endothelial cell damage has yet to be elucidated.
Versatile strategy for isolating transcription activator‐like effector nuclease‐mediated knockout mutants in Caenorhabditis elegans
Authors: Sugi Takuma , Sakuma Tetsushi , Ohtani Yasuko , Yamamoto Takashi 
Published: December 2013

Targeted genome editing using transcription activator‐like effector nuclease (TALEN) and clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 systems has recently
emerged as a potentially powerful method for creating locus‐specific mutations in Caenorhabditis elegans. Due to the low mutation frequencies, one of the crucial steps in using these technologies is screening animals that harbor a targeted mutation. In previous studies, identifying targeted mutations in C. elegans usually depended on observations of fluorescent markers such as a green fluorescent protein or visible phenotypes such as dumpy and uncoordinated phenotypes. However, this strategy is limited in practice because the phenotypes caused by targeted mutations such as defects in sensory behaviors are often apparently invisible. Here, we describe a versatile strategy for isolating C. elegans knockout mutants by TALEN‐mediated genome editing and a heteroduplex mobility assay. We applied TALENs to engineer the locus of the neural gene glr‐1, which is a C. elegans AMPA‐type receptor orthologue that is known to have crucial roles in various sensory behaviors. Knockout mutations in the glr‐1 locus, which caused defective mechanosensory behaviors, were efficiently identified by the heteroduplex mobility assay. Thus, we demonstrated the utility of a TALEN‐based knockout strategy for creating C. elegans with mutations that cause invisible phenotypes.
Development and reliability of a system to classify the eating and drinking ability of people with cerebral palsy
Authors: Sellers Diane , Mandy Anne , Pennington Lindsay , Hankins Matthew , Morris Christopher 
Published: December 2013

AimThe aim of this study was to develop a valid classification system to describe eating and drinking ability in people with cerebral palsy (CP), and to test its reliability.MethodThe Eating and Drinking Ability Classification System (EDACS) was developed in four stages in consultation with individuals with CP, parents, and health professionals: Stage 1, drafting informed by literature and clinical experience; Stage 2, modification by nominal groups; Stage 3, refinement in an international Delphi survey; and Stage 4, testing of agreement and reliability between classifications made by speech and language therapists (SaLTs), and between SaLTs and parents.ResultsSeven nominal groups involved 56 participants; 95 people participated in two rounds of the Delphi survey. Using the version of EDACS produced from this process, SaLTs in pairs classified 100 children. The rate of absolute agreement was 78% (kappa=0.72; intraclass correlation coefficient [ICC]=0.93; 95% confidence interval [CI] 0.90–0.95). Any disagreement was only by one level, with one exception. SaLTs and parents classified 48 children. The rate of absolute agreement was 58% (kappa=0.45, ICC=0.86; 95% CI 0.76–0.92). Parents either agreed with SaLTs or rated their children as more able by one level.InterpretationThe EDACS provides a valid and reliable system for classifying eating and drinking performance of people with CP, for use in both clinical and research contexts.
Prey switching as a means of enhancing persistence in predators at the trailing southern edge
Authors: Peers Michael J. L. , Wehtje Morgan , Thornton Daniel H. , Murray Dennis L. 
Published: December 2013

AbstractUnderstanding the effects of climate change on species’ persistence is a major research interest; however, most studies have focused on responses at the northern or expanding range edge. There is a pressing need to explain how species can persist at their southern range when changing biotic interactions will influence species occurrence. For predators, variation in distribution of primary prey owing to climate change will lead to mismatched distribution and local extinction, unless their diet is altered to more extensively include alternate prey. We assessed whether addition of prey information in climate projections restricted projected habitat of a specialist predator, Canada lynx (Lynx canadensis), and if switching from their primary prey (snowshoe hare; Lepus americanus) to an alternate prey (red squirrel; Tamiasciurus hudsonicus) mitigates range restriction along the southern range edge. Our models projected distributions of each species to 2050 and 2080 to then refine predictions for southern lynx on the basis of varying combinations of prey availability. We found that models that incorporated information on prey substantially reduced the total predicted southern range of lynx in both 2050 and 2080. However, models that emphasized red squirrel as the primary species had 7–24% lower southern range loss than the corresponding snowshoe hare model. These results illustrate that (i) persistence at the southern range may require species to exploit higher portions of alternate food; (ii) selection may act on marginal populations to accommodate phenotypic changes that will allow increased use of alternate resources; and (iii) climate projections based solely on abiotic data can underestimate the severity of future range restriction. In the case of Canada lynx, our results indicate that the southern range likely will be characterized by locally varying levels of mismatch with prey such that the extent of range recession or local adaptation may appear as a geographical mosaic.
Self‐regulation during e‐learning: using behavioural evidence from navigation log files
Authors: Jeske D. , Backhaus J. , Stamov Roßnagel C. 
Published: December 2013

AbstractThe current paper examined the relationship between perceived characteristics of the learning environment in an e‐module in relation to test performance among a group of e‐learners. Using structural equation modelling, the relationship between these variables is further explored in terms of the proposed double mediation as outlined by Ning and Downing. These authors initially proposed that motivation and self‐regulation strategies are mediators between the perception of the learning environment and performance. In our replication and extension study, we substituted self‐reported self‐regulation with behavioural indicators of self‐regulation using navigation log files and focused on test‐taking rather than general motivation. We proposed that navigational patterns captured using log files can also help deduce self‐regulation in e‐modules and provide information in the absence of self‐reports. Path analyses provide partial support for our navigational hypotheses and the model. Implications of our results for the use of e‐module data and conclusions based on navigation are discussed.
Effects of real‐time visual feedback on pre‐service teachers' singing
Authors: Leong S. , Cheng L. 
Published: December 2013

AbstractThis pilot study focuses on the use real‐time visual feedback technology (VFT) in vocal training. The empirical research has two aims: to ascertain the effectiveness of the real‐time visual feedback software ‘Sing & See’ in the vocal training of pre‐service music teachers and the teachers' perspective on their experience with VFT. Forty participants from an undergraduate music teacher education programme were randomly assigned to three groups. The first two groups were assigned the teacher and student versions of Sing & See, respectively, and the third group served as a control group without access to the software. The experimental groups were given 12 weeks to use the software for vocal training on a self‐regulated basis. The technique of complex selections (TCS) was designed to assess the pitch accuracy and richness of vocal timbre. Pre‐ and post‐test singing tasks showed that the participants from the experimental groups significantly improved their vocal timbre. A questionnaire survey conducted after the training period found that most of the participants in the experimental s were positive about the effectiveness of VFT software in vocal training. As future leaders in the implementation of music education technology, pre‐service music teachers expressed a positive attitude towards the use of VFT as a technology‐enhanced learning (TEL) component in music education.
The role of scaffolding in CSCL in general and in specific environments
Authors: Verdú N. , Sanuy J. 
Published: December 2013

AbstractThis paper aims to analyse if virtual forums set up in an environment specifically designed to improve collaborative learning can effectively influence students' discourse quality and learning when compared with those forums set up in a general environment. Following a coding schema based upon the set of scaffolds offered in the Knowledge Forum environment, we have qualitatively analysed 60 forums and 1370 students from different subjects. The results show that there are very few elaborated and shared deep discussions: the central axis in those superior contributions focuses on bringing new information to already written contributions. There are more new and contrasting opinions in forums set up in a specific virtual environment, whereas there is more reasoning and elaboration in those that were set up in a general one. We propose some explanations for this dissonance and we conclude that collaborative virtual environments are secondary aspects in accounting for deep exchanges of information. Therefore, there are many aspects that need to be taken into account to improve collaborative learning and knowledge building.
Impact of Myocardial Viability and Left Ventricular Lead Location on Clinical Outcome in Cardiac Resynchronization Therapy Recipients with Ischemic Cardiomyopathy
Authors: BOSE ABHISHEK , KANDALA JAGDESH , UPADHYAY GAURAV A. , RIEDL LINDSAY , AHMADO IMAD , PADMANABHAN RAM , GEWIRTZ HENRY , MULLIGAN LAWRENCE J. , SINGH JAGMEET P. 
Published: December 2013

Role of Ischemia and Scar in CRT Patients with CADIntroductionCardiac resynchronization therapy (CRT) recipients with ischemic cardiomyopathy (ICM) have scar segments that may limit ventricular resynchronization and clinical response. The impact of myocardial viability at the left ventricular (LV) pacing site on CRT response is poorly elucidated.Methods and ResultsA retrospective cohort of 160 ICM patients with single photon emission computed tomography‐myocardial perfusion imaging before device implantation were included. Coronary venous angiography and chest radiographs helped classify segmental location of LV lead (LVL). The primary outcome was a composite of heart failure (HF) hospitalization and mortality at 3 years, and secondary outcome was change in systolic function at 6 months. The patients were divided into groups based on the myocardial substrate at the site of LVL: LVL on or adjacent to (1) normal myocardium (LVL‐N, n = 64), (2) segmental scar (LVL‐S, n = 62), and (3) scar and ischemia (LVL‐SI, n = 34). Upon follow‐up, 75 (47%) patients reached primary endpoint with a higher incidence noted in LVL‐S (60%), and LVL‐SI (53%), compared to 31% in LVL‐N (P = 0.004). Kaplan Meier method demonstrated poor event free survival for primary outcome in LVL‐S (P = 0.002), and LVL‐SI (P = 0.03). In Cox proportional hazard model, LVL‐S (HR: 2.26, P = 0.004), and LVL‐SI (1.9, P = 0.047) were independent predictors of primary outcome.ConclusionIn CRT recipients with ICM, scar and reversible ischemia in or adjacent to LV pacing site were independent predictors of HF hospitalization and death.