bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non‐physician cataract surgeons in Sub‐Saharan Africa: situation analysis
Authors: Lewallen Susan , Etya’ale Daniel , Kello Amir Bedri , Courtright Paul 
Published: September 2012

AbstractObjectives  Non‐physician cataract surgeons (NPCS) provide cataract surgical services in some Sub‐Saharan African (SSA) countries. However, their training, placement, legal framework and supervision have not been documented. We sought to do so to inform decision‐making regarding future training.Methods  Standard questionnaires were sent to national eye coordinators and other ophthalmologic leaders in Africa to collect information. Face‐to‐face interviews were conducted at training programmes in Ethiopia, Tanzania and Kenya, and email interviews were conducted with directors at training programmes in the Gambia and Malawi.Results  Responses were provided for 31/39 (79%) countries to which questionnaires were sent. These countries represent about 90% of the population of SSA. Overall, 17 countries have one or more NPCS; two‐thirds of the total 245 NPCS are found in only three countries. Thirty‐six percent of NPCS work alone, but a formal functioning supervision system was reported to be present in only one country. The training centres are similar and face similar challenges.Conclusions  There is considerable variation across SSA in the use and acceptance of NPCS. The placement and support of NPCS after training generally does not follow expectations, and training centres have little role in this. Overall, there was no consensus on whether the cadre, as it is currently viewed, is necessary, desirable or will contribute to addressing cataract surgical needs in SSA.
The economic burden of hypertension in rural south‐west China
Authors: Le Cai , Zhankun Shu , Jun Dong , Keying Zhao 
Published: September 2012

AbstractObjective  To estimate the economic burden of hypertension in a given year in rural Yunnan Province of China, including direct, indirect and intangible costs.Methods  A prevalence‐based cost‐of‐illness method was used to estimate the economic burden of hypertension. Data on participants’ demographic characteristics, inpatient hospitalisation expenditures, outpatient visit expenditures, self‐medication costs and indirect costs related to hypertension were collected from a cross‐sectional health examination and questionnaire survey, involving 9396 consenting individuals aged ≥18 years and 3500 households. Blood pressure (BP) levels were determined from the average of three BP measurements. Years of life lost (YLL) because of hypertension was estimated using medical death certificates.Results  The overall prevalence of and YLL/1000 population because of hypertension was 24.8% and 1.5 years for the survey population, respectively. Mean unit direct medical costs, direct non‐medical costs, morbidity costs, mortality costs, intangible costs and cost of illness were estimated to be $467.2, $20.1, $23.5, $8265.1, $417.4 and $9393.3, respectively. The total cost of hypertension was estimated to be $231.7 million. Direct costs represented the largest component of economic cost of hypertension. On average, males had higher overall direct, indirect and intangible costs of hypertension than females. Both indirect and intangible costs decreased with age, whereas direct costs increased with age. The incidence of household catastrophic health payment and household impoverishment because of hypertension was 8.9% and 4.1%, respectively.Conclusions  Hypertension inflicts a considerable economic burden upon individual households and society as a whole in Yunnan Province, China.
Long‐term stock grazing management in Travelling Stock Reserves and influence on conservation values
Authors: Spooner Peter G. , Morris Mark C. 
Published: September 2012

SummaryWe examined the nature of long‐term grazing management implemented in 51 Travelling Stock Reserves (TSRs) in the Albury region, and investigated potential relationships between grazing intensity and conservation values. In general, grazing intensities in most TSRs decreased over the 22 year study period. Most TSRs were lightly grazed (density = 1.1 DSE/ha/year), and stocked for <2 months per year, but some were much more heavily grazed. Spring grazing intensity was found to be negatively associated with TSR conservation values. Our results suggest that grazing management aims to achieve both production and conservation outcomes are not necessarily exclusive to each other.
Engaged versus Disengaged Ownership: The Case of Pension Funds in the UK
Authors: Tilba Anna , McNulty Terry 
Published: September 2012

AbstractManuscript TypeEmpiricalResearch Question/IssueThis study examines how the practice of pension fund investment management informs the ownership behavior of pension funds vis‐à‐vis investee corporations.Research Findings/InsightsUsing data from: 35 in‐depth semi‐structured interviews with pension fund trustees, executives, investment officers and financial intermediaries; documentary analysis; and observations of four fund investment meetings, we find a variation in pension fund behavior, where a very small number of well‐resourced and internally managed pension funds exhibit engaged ownership behavior. By contrast, the vast majority of pension funds operate at a considerable distance from their investee corporations having delegated pension fund investment management to a chain of external relationships involving actuaries, investment consultants, and fund managers. These relationships are laced with divergent interests and influence dynamics, which explain why these pension funds give primary emphasis to fund investment performance and display little concern for matters of ownership and corporate governance.Theoretical/Academic ImplicationsThe “New Financial Capitalism” is characterized by ownership concentration, yet at the same time liquidity and a lack of institutional investor engagement with corporations. Findings suggest that the principal‐agent view of the relationship between institutional investors and corporate managers is more assumed than demonstrated. This widely assumed theory of investor ownership and control is shown to be contingent upon the meanings and practices that underpin investment fund management by institutions.Practitioner/Policy ImplicationsShareowner engagement is proposed as a solution to problems of corporate governance. Findings about the relationships within the investment chain undermine the notions of pension funds behaving as owners and upholding corporate governance and accountability. This raises skepticism about realizing aspirations for engaged ownership and shareowner stewardship contained in institutional investors' engagement codes such as the Stewardship Code (2010) and contemporary policy debate in the UK and beyond.
Looking into myself: Changes in interoceptive sensitivity during mirror self‐observation
Authors: Ainley Vivien , Tajadura‐Jiménez Ana , Fotopoulou Aikaterini , Tsakiris Manos 
Published: September 2012

AbstractInteroceptive sensitivity is an essential component of recent models of “the self.” Increased focus on the self (e.g., self‐observation in a mirror) can enhance aspects of self‐processing. We examined whether self‐observation also enhances interoceptive sensitivity. Participants performed a heartbeat detection task while looking at their own face in a mirror or at a black screen. There was significant improvement in interoceptive sensitivity in the mirror condition for those participants with lower interoceptive sensitivity at baseline. This effect was independent of the order of conditions, gender, age, body mass index, habitual exercise, and changes in heart rate. Our results suggest that self‐observation may represent a viable way of manipulating individuals' interoceptive sensitivity, in order to directly test causal relations between interoceptive sensitivity and exteroceptive self‐processing.
Rapid Increases and Time‐Lagged Declines in Amphibian Occupancy after Wildfire
Authors: HOSSACK BLAKE R. , LOWE WINSOR H. , CORN PAUL STEPHEN 
Published: September 2012

AbstractClimate change is expected to increase the frequency and severity of drought and wildfire. Aquatic and moisture‐sensitive species, such as amphibians, may be particularly vulnerable to these modified disturbance regimes because large wildfires often occur during extended droughts and thus may compound environmental threats. However, understanding of the effects of wildfires on amphibians in forests with long fire‐return intervals is limited. Numerous stand‐replacing wildfires have occurred since 1988 in Glacier National Park (Montana, U.S.A.), where we have conducted long‐term monitoring of amphibians. We measured responses of 3 amphibian species to fires of different sizes, severity, and age in a small geographic area with uniform management. We used data from wetlands associated with 6 wildfires that burned between 1988 and 2003 to evaluate whether burn extent and severity and interactions between wildfire and wetland isolation affected the distribution of breeding populations. We measured responses with models that accounted for imperfect detection to estimate occupancy during prefire (0–4 years) and different postfire recovery periods. For the long‐toed salamander (Ambystoma macrodactylum) and Columbia spotted frog (Rana luteiventris), occupancy was not affected for 6 years after wildfire. But 7–21 years after wildfire, occupancy for both species decreased ≥25% in areas where >50% of the forest within 500 m of wetlands burned. In contrast, occupancy of the boreal toad (Anaxyrus boreas) tripled in the 3 years after low‐elevation forests burned. This increase in occupancy was followed by a gradual decline. Our results show that accounting for magnitude of change and time lags is critical to understanding population dynamics of amphibians after large disturbances. Our results also inform understanding of the potential threat of increases in wildfire frequency or severity to amphibians in the region.Incrementos Rápidos y Declinaciones Desfasadas en la Ocupación de Anfibios Después de un Incendio
Fetal Brain Function in Response to Maternal Alcohol Consumption: Early Evidence of Damage
Authors: Hepper Peter G. , Dornan James C. , Lynch Catherine 
Published: September 2012

BackgroundStudies of the adverse neurobehavioral effects of maternal alcohol consumption on the fetus have been largely confined to the postnatal period, after exposure to alcohol has finished. This study explored the brain function of the fetus, at the time of exposure to alcohol, to examine its effect on information processing and stability of performance.MethodsFive groups of fetuses, defined by maternal alcohol consumption patterns, were examined: control (no alcohol); moderate (5 to 10 units/wk either drunk evenly across the week or as a binge, in 2 to 3 days); heavy (20+ units/wk drunk evenly or as a binge). Fetal habituation performance was examined on 3 occasions, separated by 7 days, beginning at 35 weeks of gestation. The number of trials required to habituate on each test session and the difference in performance across test sessions were recorded.ResultsFetuses exposed to heavy binge drinking required significantly more trials to habituate and exhibited a greater variability in performance across all test sessions than the other groups. Maternal drinking, either heavily but evenly or moderately as a binge, resulted in poorer habituation, and moderate binge drinking resulted in greater variability compared with no, or even, drinking.ConclusionsDecreased information processing, reflected by poorer habituation, and increased variability in performance may reflect the initial manifestations of structural damage caused by alcohol to the brain. These results will lead to a greater understanding of the effects of alcohol on the fetus's brain, enable the antenatal identification of fetal alcohol spectrum disorders, and lead to the early implementation of better management strategies.
Markers of Bone Resorption and Formation During Abstinence in Male Alcoholic Patients
Authors: Malik Peter , Gasser Rudolf W. , Moncayo Roy , Kemmler Georg , Wolfgang Fleischhacker W. 
Published: September 2012

BackgroundReduced bone mineral density (BMD) is commonly found in alcohol‐dependent patients. Many risk factors have been reported, yet the course of markers of bone formation and resorption in abstinent alcoholic patients have not received much attention.MethodsIn a prospective longitudinal study, we investigated BMD in male abstinent inpatients of an alcohol rehabilitation clinic aged 21 to 50 years at baseline and after 8 weeks of treatment. At baseline and at week 8, all patients had blood drawn for the analysis of liver function tests, calcium, phosphate, parathormone, 25‐hydroxyvitamin D, osteocalcin (OC), serum crosslaps, sex hormones, and prolactin. BMD was determined by dual X‐ray absorptiometry in the lumbar spine and the proximal right femur. We also determined the amount of physical activity prior to inpatient treatment by using the International Physical Activity Questionnaire (IPAQ).ResultsLow BMD was found in 15.1% of the patients for the lumbar spine, in 5.7% for the femoral neck, and in 1.9% for the total hip. BMD differed significantly from normal values, in the lumbar spine and in the femoral neck. At baseline, crosslaps were elevated in 34% of the patients, while OC levels were lowered in 17%. Over the course of the 8 weeks, we found a significant increase in OC plasma levels, indicating a higher rate of bone formation during continuous abstinence. There were also positive correlations between IPAQ scores and BMD as reflected by Z‐scores in all regions, pointing to a protective effect of physical activity.ConclusionsIn summary, this report confirms earlier cross‐sectional studies of lowered BMD in alcoholic noncirrhotic men. We could also demonstrate that the initial imbalance between bone formation and resorption seems to adjust toward a balance between the two during abstinence.
Clinical Indices of Familial Alcohol Use Disorder
Authors: Kendler Kenneth S. , Myers John 
Published: September 2012

BackgroundAlcohol use disorders (AUDs) are clinically heterogeneous and strongly influenced by familial/genetic factors. Can we identify specific clinical features of AUDs that index familial liability to illness?MethodsIn twins from the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders meeting DSM‐IV criteria for lifetime AUDs, we examined whether clinical features of AUDs, including individual DSM‐IV criteria for alcohol dependence (AD) and alcohol abuse (AA), predicted risk for AUDs in cotwins and/or parents. Analyses of individual criterion were repeated controlling for the total number of endorsed criteria.ResultsAcross these analyses, examining narrowly and broadly defined AUDs, risk of AUDs in relatives was more consistently predicted by abuse criteria than by dependence criteria, and by criteria reflecting negative psychosocial consequences rather than pharmacologic/biological criteria. Age at onset (AAO) poorly predicted risk in relatives. AUD associated legal problems, the one criterion slated for removal in DSM‐5, was the most consistent single predictor of familial risk. Associations observed between individual criteria and risks of illness in relatives were generally stronger in monozygotic than dizygotic twin pairs, suggesting that these symptoms reflect a genetic risk for AUDs.ConclusionsIndividual DSM‐IV criteria for AA and AD differ meaningfully in the degree to which they reflect the familial/genetic liability to AUDs. Contrary to expectation, the familial/genetic risk to AUDs was better reflected by symptoms of abuse and negative psychosocial consequences of AUD than by early AAO, or symptoms of tolerance and withdrawal.
Order Imbalance and Daily Momentum Investing: Evidence from Taiwan
Authors: Chang Chiao‐Yi 
Published: September 2012

AbstractWe propose that price‐order‐imbalance momentum strategies will produce outcomes that are more profitable for investors than price momentum strategies in the very short term. Adopting order imbalances information, investors themselves may employ untraded order data or exhibit herding behavior following others’ investing decisions related to order imbalance. Taiwan stock market investors have easy access to order imbalance information. This suggests that, in this emerging market, a strategy considering order imbalance may be more descriptive of investor behavior than a price momentum strategy.
High‐Amplitude Pace Mapping Increases Safety of Radiofrequency Catheter Ablation of Parahisian Ectopic Foci
Authors: MAMCHUR SERGEY E. , KURILIN MIKHAIL Y. 
Published: September 2012

Background:

The objective of the study is to assess the efficacy of high‐amplitude pace mapping in terms of the atrioventricular (AV) block risk after radiofrequency catheter ablation (RCA) of parahisian ectopic foci.
Methods:

Twenty patients aged 38 ± 14 years with no structural heart disease underwent RCA of parahisian ectopic foci. All the patients were randomized into two groups: Group I (n = 11) had RCA performed in the region defined as ectopic focus by electrophysiology study and Group II (n = 9) had high‐amplitude pacing performed in the region of “perfect” mapping. RCA was done only at the sites where high‐amplitude pacing revealed the absence of His bundle capture.
Results:

In group I, the efficacy of RCA was 54.5% and it was 100% in group II (P = 0.0195). Group II had no complications; in group I there were 27% of AV blocks (P = 0.0893). The late recurrence of ectopic activity was comparable in both groups: 3 (27%) and 2 (22%), respectively (P = 0.7953). In all the cases of recurrent ectopic activity and in all the cases of ineffective primary procedure, group I had effective reablation procedures performed using high‐amplitude pace mapping. The overall efficacy in terms of repeated procedures was 90%.
Conclusion:

High‐amplitude pace mapping increases primary and secondary efficacy of parahisian ectopic foci RCA and decreases the risk of AV block development. (PACE 2012;35:1458–1463)
The Mortality Benefit Threshold for Patients with Suspected Pulmonary Embolism
Authors: Pines Jesse M. , Lessler Adam L. , Ward Michael J. , Mark Courtney D. 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1109–1113 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  The mortality benefit for pulmonary embolism (PE) is the difference in mortality between treated and untreated patients. The mortality benefit threshold is the mortality benefit above which testing for a condition should be initiated and below which it should not. To illustrate this concept, the authors developed a decision model to estimate the mortality benefit threshold at several pretest probabilities for low‐risk emergency department (ED) patients with possible PE and compare those thresholds with contemporary management of PE in the United States and what is known and not known about treatment benefits with anticoagulation.Methods:  The authors built a decision model of a 25‐year‐old female with suspected PE. Model inputs were obtained from the literature or clinical judgment when data were unavailable. One‐way sensitivity analysis was used to derive the mortality benefit threshold at several fixed pretest probabilities, and two‐way sensitivity analysis was used to determine drivers of the mortality benefit threshold.Results:  At a 15% pretest probability, the mortality benefit threshold was 3.7%; at 10% it was 5.2%; at 5% it was 9.8%; at 2% it was 23.5%; at 1% it was 46.3%; and at 0.5% it was 92.1%. In two‐way sensitivity analyses, D‐dimer specificity, CT angiography (CTA)/CT venography (CTV) sensitivity, annual cancer risk, probability of death from renal failure, and probability of major bleeding were major model drivers.Conclusions:  The mortality benefit threshold for initiating PE testing is very high at low pretest probabilities of PE, which should be considered by clinicians in their diagnostic approach to PE in the ED. The mortality benefit threshold is a novel way of exploring the benefits and risks of ED‐based testing, particularly in situations like PE where testing (i.e., CT use) carries real risks and the benefits of treatment are uncertain.
Observational Study of Telephone Consults by Stroke Experts Supporting Community Tissue Plasminogen Activator Delivery
Authors: Majersik Jennifer J. , Meurer William J. , Frederiksen Shirley A. , Sandretto Amaria M. , Xu Zhenzhen , Goldman Edward B. , Scott Phillip A. 
Published: September 2012

ACADEMIC EMERGENCY MEDICINE 2012; 19:1027–1034 © 2012 by the Society for Academic Emergency MedicineAbstractObjectives:  Barriers to intravenous (IV) tissue plasminogen activator (tPA) use in ischemic stroke include limited treatment experience of community physicians. Models of acute stroke care have been designed to address these limitations by providing community support. These include support by telephone or televideo, with or without subsequent transport to tertiary care centers. The authors describe the frequency, characteristics, and effect of community phone consultations to a 24/7 stroke “hotline” staffed by stroke physicians at an academic stroke center using such a model.Methods:  Twelve intervention hospitals participating in the INcreasing Stroke Treatment through Interventional behavior Change Tactics (INSTINCT) trial were provided a single‐access number (“hotline”) for expert consultation on tPA use. Experts consisted of stroke‐trained physicians at an academic medical center. Hotline use was not mandated by the study protocol, nor was patient transfer required. Consultants were required to record all treatment questions in a Web‐based log. All patients discussed over the hotline and/or treated with tPA in an INSTINCT hospital underwent multilevel chart review by trained nurse coordinators. Cases were linked to logged hotline calls, based on the time of treatment and the initial treating hospital. Physician adjudicators assessed appropriateness of tPA treatment, presence of deviation from standard guidelines, and treatment complications (intracranial hemorrhage [ICH], systemic hemorrhage, or death).Results:  Over 27 months, there were a total of 204 hotline calls regarding 116 patients. Ninety‐one percent of calls were between 8 a.m. and midnight, and 77% of questions explored issues of eligibility for IV tPA, particularly for minor stroke or improving stroke (26%). A total of 243 patients were treated with IV tPA at the 12 intervention hospitals, 54 of which were following hotline consult. Seventy‐six percent of hotline patients in whom tPA was recommended actually received tPA, while 2% of those in whom tPA was not recommended received the medication. There were no differences in protocol deviations (27.8% hotline group vs. 23.8% nonhotline group), incidence of symptomatic ICH (5.6% vs. 7.3%), or in‐hospital mortality (5.6% vs. 13.2%). No medico–legal issues have been reported for any case in the study.Conclusions:  Providing tPA decision‐making support via telephone consult to community physicians is feasible and safe. Consultants may play a more prominent role in determining tPA ineligibility than acceptance. Future work should include a real‐time survey of physician providers to ascertain such potential qualitative benefits of a stroke hotline.