bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heredity of acne in Korean patients
Authors: Cho Eun Byul , Ha Ji Min , Park Eun Joo , Kim Kwang Ho , Kim Kwang Joong 
Published: September 2014

AbstractAcne is a chronic inflammatory disease of the pilocebaceous unit that presents with various spectrum and severity. Genetic backgrounds and environmental factors are also considered to be relevant, but few studies have focused on Korean patients. A cross‐sectional epidemiologic study on family history of Korean acne patients was performed to analyze family history of acne, and to compare the severity and characteristics of acne in association with family history. A total of 221 patients were enrolled, 98 male (44.3%) and 123 female (55.7%). Patients were grouped as patients with (A+) or without (A‐) family history of acne. In a second analysis, patients with any experience of acne treatment were evaluated. Severity of acne was measured with Burton's grading system and Korean Acne Grading System (KAGS). Female patients had a higher tendency to have family history than males (P = 0.002). Group A+ had statistically significant earlier onset of acne (P = 0.002). In inexperienced patients, patients with family history showed a relatively earlier onset (P = 0.084). This study confirmed the role of heredity in acne. Family history of acne is associated with earlier onset of the disease, and more non‐inflammatory lesions.
Using multivariate statistics to explore trade‐offs among spatial planning scenarios
Authors: Harris Linda R. , Watts Matthew E. , Nel Ronel , Schoeman David S. , Possingham Hugh P. 
Published: September 2014

SummaryScenario planning can be useful to guide decision‐making under uncertainty. While systematic conservation planning can create protected‐area networks for multiple and complex reserve–design scenarios, planners rarely compare different reserve networks explicitly, or quantify trade‐offs among scenarios.We demonstrate the use of multivariate statistics traditionally applied in community ecology to compare reserves designed under different scenarios, using conservation planning for beaches in South Africa as an example. Twelve reserve–design scenarios were run in Marxan in a hierarchical experimental design with three levels: including/excluding the probability of site destruction; two different cost types; and three different configurations of existing terrestrial and marine reserves.Multivariate statistics proved to be useful tools in the conservation planning context. In our case study, they showed that the trade‐off associated with including the probability of site destruction during coastal reserve design depended on the cost type: if the cost is related to the site‐destruction probability then reserves are significantly larger; if not, then reserves are significantly more costly. In both cases, the configuration of existing reserves lockeda prioriinto the solutions was more important and resulted in significantly larger and more costly reserves.Synthesis and applications. This study demonstrates a novel application of multivariate statistical tools to robustly quantify potential trade‐offs among diverse sets of reserve–design scenarios. These statistics can be applied: to support negotiations with stakeholders and decision‐makers regarding reserve configurations in the face of uncertainty; in reserve–design sensitivity analyses; and in priority setting for future research and data collection to improve conservation plans.
Further validation of the Health Promoting Activities Scale with mothers of typically developing children
Authors: Bourke‐Taylor Helen , Lalor Aislinn , Farnworth Louise , Pallant Julie F. 
Published: September 2014

Background/aimThe Health Promoting Activities Scale (HPAS) measures the frequency that mothers participate in self‐selected leisure activities that promote health and wellbeing. The scale was originally validated on mothers of school‐aged children with disabilities, and the current article extends this research using a comparative sample of mothers of typically developing school‐aged children.MethodAustralian mothers (N = 263) completed a questionnaire containing the HPAS, a measure of depression, anxiety and stress (DASS‐21) and questions concerning their weight, height, sleep quality and demographics. Statistical analysis assessed the underlying structure, internal consistency and construct validity of the HPAS. Inferential statistics were utilised to investigate the construct validity.ResultsExploratory factor analysis supported the unidimensionality of the HPAS. It showed good internal consistency (Cronbach's alpha = 0.78). Significantly lower HPAS scores were recorded for women who were obese; had elevated levels of depression, anxiety and stress; had poor quality sleep or had heavy caring commitments. The mean HPAS score in this sample (M = 32.2) was significantly higher than was previously reported for women of children with a disability (M = 21.6: P < 0.001).ConclusionsFurther psychometric evaluation of the HPAS continues to support the HPAS as a sound instrument that measures the frequency that women participate in meaningful occupation that is associated with differences in mental health and wellbeing and other health indicators.
The Dynamics of Community Health Care Consolidation: Acquisition of Physician Practices
Authors: CHRISTIANSON JON B. , CARLIN CAROLINE S. , WARRICK LOUISE H. 
Published: September 2014

Policy Points:

In order to develop effective policies on the consolidation of community health systems, policymakers must understand both the motivations and processes for consolidation.
We found that physician practice consolidation is often a strategic response by providers to public and private cost containment efforts; therefore, it will be difficult to reverse using traditional policy options.
Many current health care cost containment policies incentivize continued provider consolidation, which presents a direct challenge to health care reform models that rely on competition among providers to accomplish cost control and quality improvement.
ContextHealth care delivery systems are becoming increasingly consolidated in urban areas of the United States. While this consolidation could increase efficiency and improve quality, it also could raise the cost of health care for payers. This article traces the consolidation trajectory in a single community, focusing on factors influencing recent acquisitions of physician practices by integrated delivery systems.MethodsWe used key informant interviews, supplemented by document analysis.FindingsThe acquisition of physician practices is a process that will be difficult to reverse in the current health care environment. Provider revenue uncertainty is a key factor driving consolidation, with public and private attempts to control health care costs contributing to that uncertainty. As these efforts will likely continue, and possibly intensify, community health care systems now are less consolidated than they will be in the future. Acquisitions of multispecialty and primary care practices by integrated delivery systems follow a common process, with relatively predictable issues relating to purchase agreements, employment contracts, and compensation. Acquisitions of single‐specialty practices are less common, with motivations for acquisitions likely to vary by specialty type, group size, and market structure. Total cost of care contracting could be an important catalyst for practice acquisitions in the future.ConclusionsIn the past, market and regulatory forces aimed at controlling costs have both encouraged and rewarded the consolidation of providers, with important new developments likely to create momentum for further consolidation, including acquisitions of physician practices.
Habitat fragmentation and genetic variability of tetrapod populations
Authors: Rivera‐Ortíz F. A. , Aguilar R. , Arizmendi M. D. C. , Quesada M. , Oyama K. 
Published: September 2014

AbstractIn the last two centuries, the development of human civilization has transformed large natural areas into anthropogenic landscapes, making habitat fragmentation a pervasive feature of modern landscapes. In animal populations, habitat fragmentation may alter their genetic diversity and structure due to limited gene flow and dispersion and reduced effective population sizes, potentially leading to genetic drift in small habitat patches. We tested the hypothesis that habitat fragmentation affects genetic diversity of tetrapod populations through a meta‐analysis. We also examined certain life history traits of species and particular external landscape factors that may determine the magnitude of genetic erosion observed in fragmented habitats. Our results showed that habitat fragmentation reduces overall genetic diversity of tetrapod populations. Stronger negative fragmentation effects were detected for amphibians, birds and mammals. Within each taxonomic group, species with large body size were more strongly affected by fragmentation. Particularly within mammals, we found that less vagile species with short generation times represent the most susceptible tetrapod group to lose genetic diversity in fragmented habitats. As external drivers, we found a nonsignificant trend of lower fragmentation effects in study systems of less than 50 years and stronger effects in older (>100 years) fragmented systems. As expected, the extent of habitat loss was also important in determining the magnitude of genetic erosion in tetrapods. Extreme habitat loss showed stronger negative effects on genetic diversity irrespective of taxonomic groups. The information gathered in this review also highlights research bias and gaps in the literature.
Ongoing impact of HIV infection on mortality among people who inject drugs despite free antiretroviral therapy
Authors: Lappalainen Leslie , Hayashi Kanna , Dong Huiru , Milloy M. J. , Kerr Thomas , Wood Evan 
Published: September 2014

AbstractAimsTo determine the impact of HIV infection on mortality over time among people who inject drugs (PWID) in settings with free HIV/AIDS care.Design and SettingProspective cohort study of PWID in Vancouver, Canada, recruited between May 1996 and December 2011. We ascertained morality rates and causes of death through a confidential linkage with the provincial vital statistics registry.ParticipantsA total of 2283 individuals were followed for a median of 60.9 months (interquartile range: 34.4–113.1), among whom 622 (27.2%) individuals were HIV‐positive at baseline, and 179 (7.8%) seroconverted during follow‐up.MeasurementsThe primary and secondary outcomes of interests were all‐cause mortality and cause of death, respectively. The main independent variable of interest was HIV serostatus (positive versus negative). We used Cox proportional hazards regression to determine factors associated with mortality, including socio‐demographic variables, drug use behaviors and other risk behaviors.FindingsDuring the study period, 491 (21.5%) individuals died. In multivariate analyses, HIV infection remained associated independently with all‐cause mortality (adjusted hazard ratio = 3.15; 95% CI: 2.59–3.82). While all‐cause mortality rates declined markedly during the study period (P < 0.001), the independent effect of HIV infection on mortality remained unchanged over time (P = 0.640). Among HIV‐positive individuals, significant changes in causes of death from infectious and AIDS‐related causes to non‐AIDS‐related etiologies were observed.ConclusionsHIV infection continues to have a persistent impact on mortality rates among people who inject drugs in settings with free HIV/AIDS care, although causes of death have shifted markedly from infectious and AIDS‐related causes to non‐AIDS‐related etiologies.
Foundations for the future: A long‐term plan for Australian ecosystem science
Authors: Andersen Alan , Beringer Jason , Bull C. Michael , Byrne Margaret , Cleugh Helen , Christensen Rebekah , French Kris , Harch Bronwyn , Hoffmann Ary , Lowe Andrew J. , Moltmann Tim , Nicotra Adrienne , Pitman Andy , Phinn Stuart , Wardle Glenda , Westoby Mark 
Published: September 2014

AbstractAustralia's ecosystems are the basis of our current and future prosperity, and our national well‐being. A strong and sustainable Australian ecosystem science enterprise is vital for understanding and securing these ecosystems in the face of current and future challenges. This Plan defines the vision and key directions for a national ecosystem science capability that will enable Australia to understand and effectively manage its ecosystems for decades to come. The Plan's underlying theme is that excellent science supports a range of activities, including public engagement, that enable us to understand and maintain healthy ecosystems. Those healthy ecosystems are the cornerstone of our social and economic well‐being. The vision guiding the development of this Plan is that in 20 years' time the status of Australian ecosystems and how they change will be widely reported and understood, and the prosperity and well‐being they provide will be secure. To enable this, Australia's national ecosystem science capability will be coordinated, collaborative and connected. The Plan is based on an extensive set of collaboratively generated proposals from national town hall meetings that also form the basis for its implementation. Some directions within the Plan are for the Australian ecosystem science community itself to implement, others will involve the users of ecosystem science and the groups that fund ecosystem science. We identify six equal priority areas for action to achieve our vision: (i) delivering maximum impact for Australia: enhancing relationships between scientists and end‐users; (ii) supporting long‐term research; (iii) enabling ecosystem surveillance; (iv) making the most of data resources; (v) inspiring a generation: empowering the public with knowledge and opportunities; (vi) facilitating coordination, collaboration and leadership. This shared vision will enable us to consolidate our current successes, overcome remaining barriers and establish the foundations to ensure Australian ecosystem science delivers for the future needs of Australia.
The 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: protocol, methods and analysis of data
Authors: Pandit J. J. , Andrade J. , Bogod D. G. , Hitchman J. M. , Jonker W. R. , Lucas N. , Mackay J. H. , Nimmo A. F. , O'Connor K. , O'Sullivan E. P. , Paul R. G. , Palmer J. H. MacG. , Plaat F. , Radcliffe J. J. , Sury M. R. J. , Torevell H. E. , Wang M. , Cook T. M. ,   the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland
Published: September 2014

SummaryAccidental awareness during general anaesthesia with recall is a potentially distressing complication of general anaesthesia that can lead to psychological harm. The 5th National Audit Project was designed to investigate the reported incidence, predisposing factors, causality and impact of accidental awareness. A nationwide network of local co‐ordinators across all UK and Irish public hospitals reported all new patient reports of accidental awareness to a central database, using a system of monthly anonymised reporting over a calendar year. The database collected the details of the reported event, anaesthetic and surgical technique, and any sequelae. These reports were categorised into main types by a multidisciplinary panel, using a formalised process of analysis. The main categories of accidental awareness were: certain or probable; possible; during sedation; on or from the intensive care unit; could not be determined; unlikely; drug errors; and statement only. The degree of evidence to support the categorisation was also defined for each report. Patient experience and sequelae were categorised using current tools or modifications of such. The 5th National Audit Project methodology may be used to assess new reports of accidental awareness during general anaesthesia in a standardised manner, especially for the development of an ongoing database of case reporting. This paper is a shortened version describing the protocols, methods and data analysis from 5th National Audit Project – the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home#pt.
QT Correction Methods in Infants and Children: Effects of Age and Gender
Authors: Benatar Abraham , Feenstra Arjen 
Published: September 2014

BackgroundAccurate determination of the QTc interval in children is important especially when using drugs which can prolong cardiac repolarization. Previous work suggests the most appropriate correction formula to be QTc = QT/RR0.38. We set out to compute the best population‐derived age and gender‐related QT correction formula factor in normal children.MethodsWe evaluated a cohort of 1400 healthy children. From a resting 12‐lead electrocardiogram, QT and RR intervals were measured. Subjects were divided into four age and gender groups: 0–1 years (n = 540); 1–5 years (n = 281); 5–10 years (n = 277), and > 10 years (n = 302). QT/RR intervals were plotted and fitted with two regression analyses, linear regression obtaining constant α (QTc = QT + α x (1‐RR)), and log‐linear analysis deriving constant β (QTc = QT/RRβ). Furthermore, regression analysis of QTc/RR for the two formulas was performed obtaining slope and R2.ResultsCorrection constant α decreased steadily with increasing age, genders remained on par until 10 years of age followed by more pronounced decrease in females (range 0.24–0.18). The β constant showed a similar trend however with more pronounced decline (range 0.45–0.31). Regression slopes of QTc/RR plots (all ages and both genders) were close to zero (both formulas).ConclusionFor the full range of pediatric subjects, the optimum population‐based correction factors α and β decreased with increasing age and gender, digressing more so in adolescent girls. More specific correction factors, based on age and gender, are necessary in QT correction.
Use of ECG Restitution (Beat‐to‐Beat QT‐TQ Interval Analysis) to Assess Arrhythmogenic Risk of QTc Prolongation with Guanfacine
Authors: Fossa Anthony A. , Zhou Meijian , Robinson Antoine , Purkayastha Jaideep , Martin Patrick 
Published: September 2014

BackgroundGuanfacine (Intuniv) is a centrally active alpha‐2A adrenergic agonist for the new indication of attention‐deficit/hyperactivity disorder. QTc (QTcF and QTcNi) was prolonged at both therapeutic (4 mg) and supratherapeutic (8 mg) doses of a thorough QT study even though guanfacine has had a safe clinical history of over 3 million prescriptions for the treatment of hypertension. In an attempt to understand this disparity, retrospective evaluation of the continuous ECG data utilized dynamic beat‐to‐beat and ECG restitution analyses was performed.MethodsSixty healthy subjects using 24‐hour Holters were examined in a 3‐arm, placebo‐ and positive‐controlled, double‐blind crossover study for effects on beat‐to‐beat QT, TQ, and RR intervals.ResultsECG restitution analyses indicated that, at all time points, a disproportionate effect to increase the TQ interval (rest) occurred more in relationship to each QT interval lengthening resulting in a placebo‐adjusted reduced QT/TQ ratio of 21% after 4 mg and 31% after 8 mg (both antiarrhythmic responses). Additionally, the percentage of time and magnitude of stress on the heart, as measured by the upper limits of the QT/TQ ratio, were reduced with guanfacine by 22% to 24%. In contrast to guanfacine, moxifloxacin did not show a significant improvement in any restitution parameters but reflected a trend toward proarrhythmia with an increase in the QT/TQ ratio of up to 11%.ConclusionThese results indicate that guanfacine causes a stabilizing effect on cardiac restitution that helps reconcile the clinical evidence for a lack of arrhythmia liability despite apparent increases in typical QT/QTc prolongation measures.
The Effect of Hemodialysis on Electrocardiographic Parameters
Authors: Astan Ramazan , Akpinar Ibrahim , Karan Adnan , Kacmaz Fehmi , Sokmen Erdogan , Baysal Erkan , Ozeke Ozcan , Selçuk Mehmet Timur 
Published: September 2014

BackgroundCardiovascular complications are the leading causes of premature deaths in hemodialysis patients. Due to rapid changes in volume and electrolyte concentration following dialysis, the some electrocardiographic (ECG) changes or arrhythmias might be seen.ObjectiveTo investigate the acute effects of hemodialysis on the ECG parameters in patients with chronic end‐stage renal disease (ESRD).MethodWe included the consecutive ESRD patients who underwent a hemodialysis. Before and after hemodialysis, some 12 lead ECG parameters were analyzed by two different cardiologists by using electronic digital caliper device.ResultsA total of 62 patients (mean 52 ± 15 years; 65% male) with ESRD undergoing hemodialysis were recruited to the study. P‐wave amplitude, QRS amplitude, QRS duration, QTc dispersion, the sum of amplitudes in V1S + V5R derivations, total QRS amplitude, and duration were significantly greater in posthemodialysis patients compared to the prehemodialysis ones. However, T‐wave amplitude and QTc duration were significantly lower in posthemodialysis patients.ConclusionThe ECG changes including prolangated QRS and increased QTc interval after hemodialysis should be kept in mind and assessed carefully in ESRD patients. Prolongation of these parameters may prove to be a further noninvasive marker of susceptibility to ventricular arrhythmias.
Clostridium colitis: challenges in diagnosis and treatment
Authors: Buxey Kenneth N. , Sia Chris , Bell Stephen , Wale Roger , Wein Daniel , Warrier Satish K. 
Published: September 2014

AbstractBackgroundClostridium difficile infection (CDI) has been reported to occur with increasing frequency and with more severe presentations being encountered. This article presents data from The Alfred Hospital highlighting the increased incidence, the increased severity and the broader clinical presentations observed. A case series highlights a variety of clinical scenarios that provided diagnostic and management challenges. We additionally describe a novel form of treatment for fulminant colitis.MethodsA retrospective review of C. difficile toxin (CDT)‐positive and culture‐positive cases was performed at The Alfred Hospital (2010–2012). Six cases are then presented as a case series to highlight the broad and atypical types of presentations one may encounter. Finally, a novel method for managing fulminant colitis operatively is presented.ResultsA fourfold increase in cases of toxin‐positive and culture‐positive cases was noted over the initial 14 months of the period of analysis, the rate of cases detected then plateaued. This increase could not be explained by increased testing being undertaken. It is also not associated with increased usage of antibiotics nor with increased patient numbers being treated.ConclusionCDI can present in various clinical forms. In our hospital, the number of cases of toxin‐positive and culture‐positive detection is increasing. A low threshold is required to identify and adequately treat patients with CDI. Fulminant colitis can be managed successfully with the creation of a diverting loop ileostomy, colonic washout and subsequent antegrade colonic vancomycin enemas.