bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interobserver Agreement in the Clinical Assessment of Children With Blunt Abdominal Trauma
Authors: Yen Kenneth , Kuppermann Nathan , Lillis Kathleen , Monroe David , Borgialli Dominic , Kerrey Benjamin T. , Sokolove Peter E. , Ellison Angela M. , Cook Lawrence J. , Holmes James F. ,   The Intra‐abdominal Injury Study Group for the Pediatric Emergency Care Applied Research Network (PECARN)
Published: May 2013

AbstractObjectivesThe objective was to determine the interobserver agreement of historical and physical examination findings assessed during the emergency department (ED) evaluation of children with blunt abdominal trauma.MethodsThis was a planned substudy of a multicenter, prospective cohort study of children younger than 18 years of age evaluated for blunt abdominal trauma. Patients were excluded if injury occurred more than 24 hours prior to evaluation or if computed tomography (CT) imaging was obtained at another hospital prior to transfer to a study site. Two clinicians independently recorded their clinical assessments of a convenience sample of patients onto data collection forms within 60 minutes of each other and prior to CT imaging (if obtained) or knowledge of laboratory results. The authors categorized variables as either subjective symptoms (i.e., patient history) or objective findings (i.e., physical examination). For each variable recorded by the two observers, the agreement beyond that expected by chance was estimated, using the kappa (κ) statistic for categorical variables and weighted κ for ordinal variables. Variables with 95% lower confidence limits (LCLs) κ ≥ 0.4 (moderate agreement or better) were considered to have acceptable agreement.ResultsA total of 632 pairs of physician observations were obtained on 23 candidate variables. Acceptable agreement was achieved in 16 (70%) of the 23 variables tested. For six subjective symptoms, κ ranged from 0.48 (complaint of shortness of breath) to 0.90 (mechanism of injury), and only the complaint of shortness of breath had a 95% LCL κ < 0.4. For the 17 objective findings, κ ranged from –0.01 (pelvis instability) to 0.82 (seat belt sign present). The 95% LCL for κ was <0.4 for flank tenderness, abnormal chest auscultation, suspicion of alcohol or drug intoxication, pelvis instability, absence of bowel sounds, and peritoneal irritation.ConclusionsObservers can achieve at least acceptable agreement on the majority of historical and physical examination variables in children with blunt abdominal trauma evaluated in the ED. Those variables are candidates for consideration for development of a clinical prediction rule for intra‐abdominal injury in children with blunt trauma.
Cravings as a mediator and moderator of drinking outcomes in the COMBINE study
Authors: Subbaraman Meenakshi Sabina , Lendle Samuel , van der Laan Mark , Kaskutas Lee Ann , Ahern Jennifer 
Published: May 2013

AbstractAimsInvestigators of the COMBINE (Combining Medications and Behavioral Interventions for Alcoholism) study examined whether combining medications with a behavioral intervention would improve outcomes over monotherapies. Unexpectedly, the combination did not offer any advantage over either treatment alone. This study aimed to explain the lack of incremental benefit offered by the combination over either monotherapy by assessing the role of cravings as a treatment mediator and moderator.DesignSecondary mediation and moderation analyses of COMBINE study data.SettingEleven United States academic sites.ParticipantsA total of 863 patients randomized to one of four treatment groups: naltrexone (100 mg/day; n = 209), the combined behavioral intervention (CBI, n = 236), naltrexone and CBI combined (n = 213) and placebo naltrexone (n = 205).MeasurementsPercentage of days abstinent (PDA) measured between 13 and 16 weeks post‐baseline. Cravings, the potential mediator/moderator, were measured at baseline, weeks 4 and 12 using the Obsessive‐Compulsive Drinking Scale.FindingsCompared with placebo, naltrexone, CBI and the combination all increased PDA by an additional 6–10 percentage points for those with high cravings (P < 0.05 for all three treatment groups). None had significant effects on PDA for those with low cravings. The effects of all three treatments were mediated at least partially by cravings; craving reduction explained 48–53% of treatment effects (P < 0.05 for all three treatment groups). Furthermore, naltrexone appeared to reduce cravings at 4 weeks, while CBI did not reduce cravings until 12 weeks.ConclusionsThe Combining Medications and Behavioral Interventions for Alcoholism (COMBINE) naltrexone + CBI combination may not be more beneficial than either monotherapy because craving reduction is a common mechanism of both.
Single nucleotide polymorphism discovery in albacore and Atlantic bluefin tuna provides insights into worldwide population structure
Authors: Albaina A. , Iriondo M. , Velado I. , Laconcha U. , Zarraonaindia I. , Arrizabalaga H. , Pardo M. A. , Lutcavage M. , Grant W. S. , Estonba A. 
Published: May 2013

SummaryThe optimal management of the commercially important, but mostly over‐exploited, pelagic tunas, albacore (Thunnus alalunga Bonn., 1788) and Atlantic bluefin tuna (BFT; Thunnus thynnus L., 1758), requires a better understanding of population structure than has been provided by previous molecular methods. Despite numerous studies of both species, their population structures remain controversial. This study reports the development of single nucleotide polymorphisms (SNPs) in albacore and BFT and the application of these SNPs to survey genetic variability across the geographic ranges of these tunas. A total of 616 SNPs were discovered in 35 albacore tuna by comparing sequences of 54 nuclear DNA fragments. A panel of 53 SNPs yielded FST values ranging from 0.0 to 0.050 between samples after genotyping 460 albacore collected throughout the distribution of this species. No significant heterogeneity was detected within oceans, but between‐ocean comparisons (Atlantic, Pacific and Indian oceans along with Mediterranean Sea) were significant. Additionally, a 17‐SNP panel was developed in Atlantic BFT by cross‐species amplification in 107 fish. This limited number of SNPs discriminated between samples from the two major spawning areas of Atlantic BFT (FST = 0.116). The SNP markers developed in this study can be used to genotype large numbers of fish without the need for standardizing alleles among laboratories.
Is home‐based pelvic floor muscle training effective in treatment of urinary incontinence after birth in primiparous women? A randomized controlled trial
Authors: Åhlund Susanne , Nordgren Birgitta , Wilander Eva‐Lotta , Wiklund Ingela , Fridén Cecilia 
Published: May 2013

AbstractObjectiveTo assess the effect of pelvic floor muscle training (PFMT) on pelvic floor muscle strength and urinary incontinence (UI) in primiparous women who underwent a home training program between three and 9 months after delivery.DesignRandomized controlled trial.PopulationOne hundred primiparous women were consecutively recruited from four different antenatal clinics in the urban area of Stockholm, Sweden. Women with UI who had undergone normal term singleton vaginal delivery, 10–16 weeks postpartum were randomly allocated to either intervention or control group.MethodsMaximally voluntary contraction (MVC) and endurance were measured with a perionometer. The Oxford grading scale was used to manually estimate the strength of the pelvic floor muscle and self‐reported symptoms of UI was registered through the Bristol Female Lower Urinary Tract Symptoms Module (ICIQ FLUTS) questionnaire.Main outcome measuresMaximally voluntary contraction of the pelvic floor muscle measured with a perionometer.ResultsMaximally voluntary contraction increased significantly in both groups between baseline and follow up (p < 0.05). The median MVC in cmHg for the intervention and control group was 16.2 and 12.1 at baseline and 26.0 and 18.2 at follow up, respectively. The median endurance, in seconds, for the intervention and control group was 9.6 and 12.0 at baseline and 26.7 and 23.4 at follow up, respectively. Pelvic floor muscle strength measured with the Oxford Scale increased significantly in both groups between baseline and follow up (p < 0.05).ConclusionThe results indicate that home‐based PFMT is effective. However, written training instructions were as efficient as home‐based training with follow up visits every sixth week.
Symptoms of irritable bowel syndrome in patients with inflammatory bowel disease: examining the role of sub‐clinical inflammation and the impact on clinical assessment of disease activity
Authors: Berrill J. W. , Green J. T. , Hood K. , Campbell A. K. 
Published: May 2013

SummaryBackgroundSymptoms compatible with irritable bowel syndrome (IBS) are frequently present in patients with inflammatory bowel disease (IBD); however, the cause of this phenomenon is unclear.AimTo determine the different contributions of ‘true IBS’ and sub‐clinical inflammation in producing IBS‐type symptoms in IBD patients, and to ascertain the impact these symptoms have on the clinical assessment of IBD activity.MethodsIn this cross‐sectional study, 169 IBD patients completed questionnaires to assess disease activity, presence of IBS‐type symptoms, and levels of anxiety and depression. Stool samples were collected for analysis of faecal calprotectin (FC).ResultsIBS‐type symptoms were significantly more common in female patients (OR = 4.64, 1.55–13.88) and were associated with higher levels of anxiety (OR = 1.11, 1.01–1.21). There was no statistical difference between the FC levels of patients in clinical remission with IBS‐type symptoms compared with those without (median values = 111 μg/g vs. 45.5 μg/g respectively, P = 0.171). The prevalence of IBS‐type symptoms in patients with a normal FC level was 31%.ConclusionsA substantial number of IBD patients with normal faecal calprotectin level experience IBS‐type symptoms. These patients exhibit similar features to people diagnosed with IBS in the general community, suggesting that the conditions are not mutually exclusive and may coexist in a considerable number of IBD patients. A systematic diagnostic approach is required to assess IBD patients with IBS‐type symptoms as sub‐clinical inflammation may play a role in a proportion of cases.
A Model of Climate Belief Profiles: How Much Does It Matter If People Question Human Causation?
Authors: Sibley Chris G. , Kurz Tim 
Published: May 2013

Despite the weight of scientific evidence presented in recent assessment reports of the IPCC, there remains some skepticism among the public that the climate is changing and whether such change is caused by human activity. We modeled climate change belief profiles using Latent Class Analysis in a New Zealand national probability sample (N = 6,072). Roughly 50% of New Zealanders believed that climate change was real and caused by humans, with 30% undecided. The majority of New Zealanders believe that climate change is real and likely caused by humans, with one in six remaining skeptical. We identified two types of climate skeptics, those who did not believe in climate change (7%), and those who believed climate change was real but not caused by humans (10%). Beliefs about the reality of climate change were more predictive than beliefs about human cause of support for carbon emissions policy and self‐reported proenvironmental behavior. Our model indicates that persuading people about the reality of climate change will predict greater incremental variance in behavior and policy attitudes than persuading people of its human cause; although persuading people of both will be still more effective due to the synergistic interaction of these dual beliefs.
The Discourse of Balance: Balance as Metaphor and Ideology
Authors: Vair Hester 
Published: May 2013

La combination du travail payé et la maternité est difficile parce que les institutions sociales sont basées sur la supposition que les deux sont toujous mutuellement exclusifs. Les mères qui travaillent gèrent la tension entre le travail et la maternité chaque jour, et quand elles le font, elles établissent des nouveaux modèles sociaux. Cette recherche présente les résultats d'une étude de 21 mères qui travaillent de la classe moyenne et soutient qu'elles ont été incapables de challenger l'organisation punitive du travail et de la maternité. Ces mères utilisent la métaphore de l’“équilibre” pour décrire comment elles gèrent la tension. Cependant, leurs récits des difficultés de gérer la maternité lorsque les méres travaillent décrit une autre histoire. En fait, l’“équilibre” est une idéologie qui fonctionne afin d'obscurcir la contradiction entre le travail et la maternité.Combining paid work and motherhood is difficult because social institutions are still based on the assumption that these are mutually exclusive. Working mothers manage the tension between work and motherhood daily, and as they do, they establish new social patterns. This paper reports on the findings of a study of 21 middle‐class working mothers and argues that they have been unable to challenge the punitive organization of work and motherhood. These mothers use the metaphor of “balance” to describe how they manage the tension. However, their narratives of the difficulties of managing working motherhood tell a different story. In fact, “balance” is an ideology, which functions to obscure the contradiction between work and motherhood.
Is Industrial Unrest Reviving in Canada? Strike Duration in the Early Twenty‐First Century
Authors: Brym Robert , Bauer Louise Birdsell , McIvor Mitch 
Published: May 2013

Les données canadiennes à long terme sur la fréquence, la durée et l'ampleur des grèves laissent entendre que la grève est un acte en voie de disparition. Cependant, le début du 21e siècle va à l'encontre du point de vue de ces prévisions. Depuis 2001, la durée moyenne d'une grève est plus longue, et n'est pas anticyclique. Ce document explique cette anomalie en utilisant l'argument que les employeurs tentent de réduire les gains salariaux des décennies précédentes en raison de la hausse de la dette publique et de la menace d'un marché de moins en moins entravé. Ces conditions motivent apparemment certains travailleurs à subir de très longs arrêts de travail, sans tenir compte de l'étape du cycle économique, dans le but de protéger leurs droits.Canadian data on strike frequency, duration, and volume imply that the strike is withering away. Some research also suggests that strike duration is countercyclical. However, the early twenty‐first century was anomalous from the viewpoint of these expectations. After 2001, mean strike duration increased and was not countercyclical. This paper explains the anomaly by arguing that employers are seeking to scale back the wage gains of previous decades in the face of mounting public debt and the whip of an increasingly unfettered market. These conditions apparently motivate some workers to endure protracted work stoppages, irrespective of the phase of the business cycle, in an effort to protect their rights.
In vitro drug causality assessment in Stevens–Johnson syndrome – alternatives for lymphocyte transformation test
Authors: Porebski G. , Pecaric‐Petkovic T. , Groux‐Keller M. , Bosak M. , Kawabata T. T. , Pichler W. J. 
Published: May 2013

SummaryBackgroundPatients with Stevens–Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) are often exposed simultaneously to a few potentially culprit drugs. However, both the standard lymphocyte transformation tests (LTT) with proliferation as the assay end‐point as well as skin tests, if done, are often negative.ObjectiveAs provocation tests are considered too dangerous, there is an urgent need to identify the relevant drug in SJS/TEN and to improve sensitivity of tests able to identify the causative drug.MethodsFifteen patients with SJS/TEN with the ALDEN score ≥ 6 and 18 drug‐exposed controls were included. Peripheral blood mononuclear cells (PBMC) were isolated and cultured under defined conditions with drugs. LTT was compared to the following end‐points: cytokine levels in cell culture supernatant, number of granzyme B secreting cells by ELISpot and intracellular staining for granulysin and IFNγ in CD3+ CD4+, CD3+ CD8+ and NKp46+ cells. To further enhance sensitivity, the effect of IL‐7/IL‐15 pre‐incubation of PBMC was evaluated.ResultsLymphocyte transformation tests was positive in only 4/15 patients (sensitivity 27%, CI: 8–55%). Similarly, with granzyme B‐ELISpot culprit drugs were positive in 5/15 patients (sensitivity 33%, CI: 12–62%). The expression of granulysin was significantly induced in NKp46+ and CD3+ CD4+ cells (sensitivity 40%, CI: 16–68% and 53%, CI: 27–79% respectively). Cytokine production could be demonstrated in 38%, CI: 14–68% and 43%, CI: 18–71% of patients for IL‐2 and IL‐5, respectively, and in 55%, CI: 23–83% for IFNγ. Pre‐incubation with IL‐7/IL‐15 enhanced drug‐specific response only in a few patients. Specificities of tested assays were in the range of 95 (CI: 80–99%)–100% (CI: 90–100%).Conclusions and Clinical RelevanceGranulysin expression in CD3+ CD4+, Granzyme B‐ELISpot and IFNγ production considered together provided a sensitivity of 80% (CI: 52–96%) and specificity of 95% (80–99%). Thus, this study demonstrated that combining different assays may be a feasible approach to identify the causative drug of SJS/TEN reactions; however, confirmation on another group of patients is necessary.
Early‐pregnancy maternal vitamin D status and maternal hyperglycaemia
Authors: Tomedi L. E. , Simhan H. N. , Bodnar L. M. 
Published: May 2013

AbstractAimsTo estimate the association between serum 25‐hydroxyvitamin D concentrations and maternal hyperglycaemia (post‐load glucose concentration ≥ 7.5 mmol/l).MethodsPregnant women (n = 429; 61% black, 36% obese, 45% smokers) enrolled in a cohort study at <16 weeks gestation. Non‐fasting blood samples were assayed for serum 25‐hydroxyvitamin D at enrolment. At 24–28 weeks gestation, maternal hyperglycaemia was determined using a 50‐g 1‐h oral glucose challenge test.ResultsA total of 67% of women had 25‐hydroxyvitamin D concentrations < 50 nmol/l and 11% had maternal hyperglycaemia. Among smokers, each 23‐nmol/l increase in serum 25‐hydroxyvitamin D was associated with a reduction in the odds of maternal hyperglycaemia [odds ratio: 0.30 (95% CI: 0.13, 0.68)] after adjustment for parity, race/ethnicity, age, pre‐pregnancy BMI, marital status, income, family history of diabetes, and gestational age of gestational diabetes mellitus screening. Among non‐smokers, we found no association between early pregnancy vitamin D status and maternal hyperglycaemia.ConclusionsSmoking status may modify the relationship between poor maternal vitamin D status and maternal hyperglycaemia.
Distal‐less and dachshund pattern both plesiomorphic and apomorphic structures in chelicerates: RNA interference in the harvestman Phalangium opilio (Opiliones)
Authors: Sharma Prashant P. , Schwager Evelyn E. , Giribet Gonzalo , Jockusch Elizabeth L. , Extavour Cassandra G. 
Published: May 2013

SUMMARYThe discovery of genetic mechanisms that can transform a morphological structure from a plesiomorphic (=primitive) state to an apomorphic (=derived) one is a cardinal objective of evolutionary developmental biology. However, this objective is often impeded for many lineages of interest by limitations in taxonomic sampling, genomic resources, or functional genetic methods. In order to investigate the evolution of appendage morphology within Chelicerata, the putative sister group of the remaining arthropods, we developed an RNA interference (RNAi) protocol for the harvestman Phalangium opilio. We silenced the leg gap genes Distal‐less (Dll) and dachshund (dac) in the harvestman via zygotic injections of double‐stranded RNA (dsRNA), and used in situ hybridization to confirm RNAi efficacy. Consistent with the conserved roles of these genes in patterning the proximo‐distal axis of arthropod appendages, we observed that embryos injected with Dll dsRNA lacked distal parts of appendages and appendage‐like structures, such as the labrum, the chelicerae, the pedipalps, and the walking legs, whereas embryos injected with dac dsRNA lacked the medial podomeres femur and patella in the pedipalps and walking legs. In addition, we detected a role for these genes in patterning structures that do not occur in well‐established chelicerate models (spiders and mites). Dll RNAi additionally results in loss of the preoral chamber, which is formed from pedipalpal and leg coxapophyses, and the ocularium, a dorsal outgrowth bearing the eyes. In one case, we observed that an embryo injected with dac dsRNA lacked the proximal segment of the chelicera, a plesiomorphic podomere that expresses dac in wild‐type embryos. This may support the hypothesis that loss of the cheliceral dac domain underlies the transition to the two‐segmented chelicera of derived arachnids.
Differences in diet and feeding ecology of similar‐sized spotted (Lepisosteus oculatus) and shortnose (Lepisosteus platostomus) gars during flooding of a south‐eastern US river
Authors: Walker Richard H. , Kluender Edward R. , Inebnit Tommy E. , Reid Adams S. 
Published: May 2013

AbstractConnection events between rivers and their adjacent floodplains can alter availability of resources. Riverine fishes opportunistically exploit seasonally available resources during periods of high water. Gars are known to utilize floodplain habitats throughout different life stages for spawning and feeding. Food habits of gars have been the focus of many studies; however, less is known regarding the partitioning of food resources between syntopic species overlapping in body size. Further, little information exists on food resources of shortnose gar, Lepisosteus platostomus. We report results of diet analysis of spotted, Lepisosteus oculatus, and shortnose gar from the Fourche LaFave River in central Arkansas. Stomachs were examined from 74 adult spotted gar (46–81 cm TL) and 91 adult shortnose gar (49–76 cm TL) collected between May and July 2007 during flooding. Forty‐seven (64%) spotted and 54 (59%) shortnose gar contained identifiable prey items. Spotted and shortnose gars had low diet overlap (33.0%), indicating these two species partition food resources. Considering percent composition by weight (%Cw), spotted and shortnose gar appear to partition available food resources during summer flooding. Percent composition by weight of fishes and crustaceans was significantly greater in the diet of spotted gar than shortnose gar (Table 2). Shortnose gar had significantly greater %Cw of amphibians and terrestrial invertebrates compared to spotted gar. It is likely that the seasonal and consistent annual availability of terrestrial subsidies to the system holds a unique importance for the shortnose gar population.