bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smart nest box: a tool and methodology for monitoring of cavity‐dwelling animals
Authors: Zárybnická Markéta , Kubizňák Petr , Šindelář Jiří , Hlaváč Václav 
Published: November 2015

SummaryCamera recording and video analysis have emerged as a successful non‐invasive method for collecting a wide range of biological data on many different taxa of animals. However, camera monitoring has rarely been applied to long‐term surveillance of cavity or box‐nesting species and ordinary off‐the‐shelf cameras are employed.We present methodology and data on the effectiveness of nest box monitoring using a camera system embedded in four ‘smart nest boxes’ (SNBoxes). We applied theSNBoxes to eight Tengmalm's owl (Aegolius funereus) nests in the Czech Republic during a 5‐month period in 2014. EachSNBox consisted of a pair of cameras with infrared lighting, an event detector, a radiofrequency identification reader, auxiliary sensors and a 60 Ah 12 V battery to power the whole system. All devices used were centrally managed by an embedded computer with specifically developed software.Using fourSNBoxes, we observed owl nesting continually during the incubation, nestling and fledgling phases, in total 309 days, resulting in 3382 owl video events. Batteries were changed every 6·5 days. A memory of 4 GB was found sufficient to store monthly data. We identified 12 types of male and female parental activities and their timing, the diet composition and frequency of prey delivery, the manner of prey storage, the light intensity at the time of each parental activity, the temperature inside the clutch and outside the box and the duration of nestling period of each young. We also produced a video on owl nesting for the general public.TheSNBox and related methodology show enormous potential as a non‐invasive tool for monitoring animals using boxes or natural cavities. The main advantage of theSNBox is the possibility to study both nocturnal and diurnal animal species and great flexibility in use of the software and hardware for different tasks. As a result, theSNBox provides an opportunity for novel insights into the breeding, roosting, hibernating, and food storage activities of a wide range of cavity‐living birds, mammals and reptiles.
Overtesting and the Downstream Consequences of Overtreatment: Implications of “Preventing Overdiagnosis” for Emergency Medicine
Authors: Carpenter Christopher R. , Raja Ali S. , Brown Michael D. 
Published: November 2015

AbstractOvertesting, the downstream consequences of overdiagnosis, and overtreatment of some patients are topics of growing debate within emergency medicine (EM). The “Preventing Overdiagnosis” conference, hosted by The Dartmouth Institute for Health Policy and Clinical Practice, with sponsorship from consumer organizations, medical journals, and academic institutions, is evidence of an expanding interest in this topic. However, EM represents a compellingly unique environment, with increased decision density tied to high stakes for patients and providers with missed or delayed diagnoses in a professional atmosphere that does not tolerate mistakes. This article reviews the relevance of this reductionist paradigm to EM, provides a first‐hand synopsis of the first “Preventing Overdiagnosis” conference, and assesses barriers to moving the concept of less test ordering to reality.
Choosing Wisely in Emergency Medicine: A National Survey of Emergency Medicine Academic Chairs and Division Chiefs
Authors: Maughan Brandon C. , Baren Jill M. , Shea Judy A. , Merchant Raina M. 
Published: November 2015

AbstractObjectivesThe Choosing Wisely campaign was launched in 2011 to promote stewardship of medical resources by encouraging patients and physicians to speak with each other regarding the appropriateness of common tests and procedures. Medical societies including the American College of Emergency Physicians (ACEP) have developed lists of potentially low‐value practices for their members to address with patients. No research has described the awareness or attitudes of emergency physicians (EPs) regarding the Choosing Wisely campaign. The study objective was to assess these beliefs among leaders of academic departments of emergency medicine (EM).MethodsThis was a Web‐based survey of emergency department (ED) chairs and division chiefs at institutions with allopathic EM residency programs. The survey examined awareness of Choosing Wisely, anticipated effects of the program, and discussions of Choosing Wisely with patients and professional colleagues. Participants also identified factors they associated with the use of potentially low‐value services in the ED. Questions and answer scales were refined using iterative pilot testing with EPs and health services researchers.ResultsSeventy‐eight percent (105/134) of invited participants responded to the survey. Eighty percent of respondents were aware of Choosing Wisely. A majority of participants anticipate the program will decrease costs of care (72% of respondents) and use of ED diagnostic imaging (69%) but will have no effect on EP salaries (94%) or medical–legal risks (65%). Only 45% of chairs have ever addressed Choosing Wisely with patients, in contrast to 88 and 82% who have discussed it with faculty and residents, respectively. Consultant‐requested tests were identified by 97% of residents as a potential contributor to low‐value services in the ED.ConclusionsA substantial majority of academic EM leaders in our study were aware of Choosing Wisely, but only slightly more than half could recall any ACEP recommendations for the program. Respondents familiar with Choosing Wisely anticipated generally positive effects, but chairs reported only infrequently discussing Choosing Wisely with patients. Future research should identify potentially low‐value tests requested by consultants and objectively measure the utility and cost of these tests among ED patient populations.
Understanding Overuse of Computed Tomography for Minor Head Injury in the Emergency Department: A Triangulated Qualitative Study
Authors: Melnick Edward R. , Shafer Katherine , Rodulfo Nayeli , Shi Joyce , Hess Erik P. , Wears Robert L. , Qureshi Rija A. , Post Lori A. 
Published: November 2015

AbstractBackgroundOveruse of computed tomography (CT) for minor head injury continues despite developed and rigorously validated clinical decision rules like the Canadian CT Head Rule (CCHR). Adherence to this sensitive and specific rule could decrease the number of CT scans performed in minor head injury by 35%. But in practice, the CCHR has failed to reduce testing, despite its accurate performance.ObjectivesThe objective was to identify nonclinical, human factors that promote or inhibit the appropriate use of CT in patients presenting to the emergency department (ED) with minor head injury.MethodsThis was a qualitative study in three phases, each with interview guides developed by a multidisciplinary team. Subjects were recruited from patients treated and released with minor head injuries and providers in an urban academic ED and a satellite community ED. Focus groups of patients (four groups, 22 subjects total) and providers (three groups, 22 subjects total) were conducted until thematic saturation was reached. The findings from the focus groups were triangulated with a cognitive task analysis, including direct observation in the ED (>150 hours), and individual semistructured interviews using the critical decision method with four senior physician subject matter experts. These experts are recognized by their peers for their skill in safely minimizing testing while maintaining patient safety and engagement. Focus groups and interviews were audio recorded and notes were taken by two independent note takers. Notes were entered into ATLAS.ti and analyzed using the constant comparative method of grounded theory, an iterative coding process to determine themes. Data were double‐coded and examined for discrepancies to establish consensus.ResultsFive core domains emerged from the analysis: establishing trust, anxiety (patient and provider), constraints related to ED practice, the influence of others, and patient expectations. Key themes within these domains included patient engagement, provider confidence and experience, ability to identify and manage patient anxiety, time constraints, concussion knowledge gap, influence of health care providers, and patient expectations to get a CT.ConclusionsDespite high‐quality evidence informing use of CT in minor head injury, multiple factors influence the decision to obtain CT in practice. Identifying and disseminating approaches and designing systems that help clinicians establish trust and manage uncertainty within the ED context could optimize CT use in minor head injury.
Policy Measures and Reimbursement for Emergency Medical Imaging in the Era of Payment Reform: Proceedings From a Panel Discussion of the 2015 Academic Emergency Medicine Consensus Conference
Authors: Berdahl Carl , Schuur Jeremiah D. , Fisher Nancy L. , Burstin Helen , Pines Jesse M. 
Published: November 2015

AbstractThe Affordable Care Act (ACA) of 2010 is expanding the use of quality measurement and promulgating new payment models that place downward pressure on health care utilization and costs. As emergency department (ED) computed tomography utilization has tripled in the past decade, stakeholders have identified advanced imaging as an area where quality and efficiency measures should expand. On May 12, 2015, Academic Emergency Medicine convened a consensus conference titled “Diagnostic Imaging in the Emergency Department: A Research Agenda to Optimize Utilization.” As part of the conference, a panel of health care policy leaders and emergency physicians discussed the effect of the ACA and other quality programs on ED diagnostic imaging, specifically the way that quality metrics may affect ED care and how ED diagnostic imaging fits in the broader strategy of the U.S. government. This article discusses the content of the panel's presentations.
Respiratory sinus arrhythmia as a potential measure in substance use treatment–outcome studies
Authors: Price C. J. , Crowell S. E. 
Published: November 2015

AbstractBackground and AimsDysfunction of physiological regulation systems may underlie the disrupted emotional and self‐regulatory processes among people with substance use disorder (SUD). This paper reviews evidence as to whether or not respiratory sinus arrhythmia (RSA), as a psychophysiological index of emotional regulation, could provide useful information in treatment–outcome research to provide insights into recovery processes.MethodsWe reviewed the use of RSA in clinical research and studies on SUD treatment. Search terms for the review of RSA in clinical research included respiratory sinus arrhythmia, heart rate variability, vagal, cardiac vagal control, psychophysiology, intervention, treatment, mindfulness, mind–body, mental health, substance use, chemical dependence, regulation and emotion regulation. For the review of RSA in intervention studies, we included only those that provided adequate description of psychophysiological methods, and examined RSA in the context of an intervention study.ResultsRSA appears to be able to provide an index of self‐regulatory capacity; however, it has been little used in either intervention or treatment research. Of the four intervention studies included in this review, all were mindfulness‐based interventions. Two studies were with substance‐using samples, and both showed pre–post increases in RSA and related improved substance use outcomes. Two of the three studies were randomized controlled trials (RCTs), and both showed significant increases in RSA in the experimental compared to comparison condition.ConclusionRespiratory sinus arrhythmia may be a useful index of emotional regulation in people with substance use disorder, and a potential measure of underlying mechanisms for SUD treatment studies, particularly mindfulness‐based interventions.
An assessment of clinical pathways and missed opportunities for the diagnosis of nodular melanoma versus superficial spreading melanoma
Authors: Cicchiello Mark , Lin Matthew J , Pan Yan , McLean Catriona , Kelly John W 
Published: November 2015

AbstractBackgroundMissed opportunities in the diagnosis of nodular melanoma (NM) carry high prognostic penalties due to the rapid rate of NM growth. To date, an assessment of the pathways to diagnosis of NM versus superficial spreading melanoma (SSM) specifically comparing numbers of opportunities missed to undertake biopsy has not been performed.MethodsA retrospective questionnaire of 120 patients (60 NM patients, age and sex matched to 60 SSM patients) from the Victorian Melanoma Service (VMS) database was undertaken to assess pathways to diagnosis. The numbers of opportunities missed to undertake a biopsy and doctor behaviour at such encounters were recorded. Diagnostic delay (overall, patient's and doctor's delay) in terms of time was assessed.ResultsSignificant differences in opportunities missed to make a diagnosis of NM compared to SSM were found. In all, 43% of NM were biopsied at a first encounter compared to 70% of SSM. All SSM were diagnosed within three reviews. Overall, 33% of NM required at least three and up six reviews until biopsy. Patients with NM were more likely than those with SSM to be reassured that their lesions were benign. No significant differences in terms of time delay to diagnosis between NM and SSM were found.ConclusionsNM contributes disproportionately to melanoma mortality in Australia. Addressing earlier diagnosis of NM with renewed focus may make the biggest impact on the overall mortality of melanoma. The message that a period of observation is not appropriate for patients re‐presenting with lesions of concern must be more effectively communicated.
A randomised controlled trial of peri‐operative pregabalin vs. placebo for video‐assisted thoracoscopic surgery
Authors: Konstantatos A. H. , Howard W. , Story D. , Mok L. Y. H. , Boyd D. , Chan M. T. V. 
Published: November 2015

SummaryWe allocated 52 participants to oral pregabalin 300 mg and 48 participants to placebo tablets before thoracoscopic surgery and for five postoperative days. The median (IQR [range]) cumulative pain scores at rest for nine postoperative months were 184 (94–274 [51–1454]) after pregabalin and 166 (66–266 [48–1628]) after placebo, p = 0.39. The corresponding scores on deep breathing were 468 (281–655 [87–2870]) and 347 (133–561 [52–3666]), respectively, p = 0.16. After three postoperative months, 29/100 participants had persistent surgical site pain, 19/52 after pregabalin and 10/48 after placebo, p = 0.12, of whom four and five, respectively, attended a pain management clinic, p = 0.24. The median (IQR [range]) morphine equivalent consumption six days after surgery was 273 (128–619 [39–2243]) mg after pregabalin and 319 (190–663 [47–2258]) mg after placebo, p = 0.35.
Ethnic patterns of hypospadias in New Zealand do not resemble those observed for cryptorchidism and testicular cancer: evidence of differential aetiology?
Authors: Gurney J. K. , Stanley J. , Shaw C. , Sarfati D. 
Published: November 2015

SummaryIt has been proposed that hypospadias, cryptorchidism, poor semen quality and testicular cancer might share common prenatal causes. We have previously demonstrated similar ethnic patterns for the incidence of testicular cancer and cryptorchidism – a known risk factor for testicular cancer. If the underlying exposure(s) that cause hypospadias, cryptorchidism and testicular cancer are shared, then we would expect the incidence relationship between ethnic groups to follow the same pattern across all three conditions. We followed a birth cohort of 318 345 eligible male neonates born in New Zealand between 2000–2010, and linked routinely collected maternity records with inpatient hospitalization and mortality records through to 2011. We searched hospitalization records for diagnoses of hypospadias, and used mortality records for censoring. We used Poisson regression methods to compare the relative risk of hypospadias between ethnic groups, adjusting for perinatal risk factors and total person time. We observed that European/Other children had the highest risk of hypospadias, with Māori, Pacific and Asian boys having around 40% lower risk of disease compared with this group (adjusted relative risk [RR]: Māori 0.62, 95% CI 0.55–0.70; Pacific 0.62, 95% CI 0.53–0.72; Asian 0.57, 95% CI 0.47–0.69). This contrasts substantially with our previous observations for cryptorchidism and testicular cancer, where Māori males have the greatest risk. Our observations suggest that – at least in New Zealand – the exposures that drive the development of hypospadias may differ to those that that drive the development of cryptorchidism and/or testicular cancer.
Is pregnancy planning associated with background characteristics and pregnancy‐planning behavior?
Authors: Stern Jenny , Salih Joelsson Lana , Tydén Tanja , Berglund Anna , Ekstrand Maria , Hegaard Hanne , Aarts Clara , Rosenblad Andreas , Larsson Margareta , Kristiansson Per 
Published: November 2015

AbstractIntroductionPrevalence of planned pregnancies varies between countries but is often measured in a dichotomous manner. The aim of this study was to investigate to what level pregnant women had planned their pregnancies and whether pregnancy planning was associated with background characteristics and pregnancy‐planning behavior.Material and methodsA cross‐sectional study that utilized the baseline measurements from the Swedish Pregnancy Planning study. Pregnant women (n = 3390) recruited at antenatal clinics answered a questionnaire. Data were analyzed with multinomial logistic regression, Kruskal–Wallis H and chi‐squared tests.ResultsThree of four pregnancies were very or fairly planned and 12% fairly or very unplanned. Of women with very unplanned pregnancies, 32% had considered an induced abortion. Women with planned pregnancies were more likely to have a higher level of education, higher household income, to be currently working (≥50%) and to have longer relationships than women with unplanned pregnancies. The level of pregnancy planning was associated with planning behavior, such as information‐seeking and intake of folic acid, but without a reduction in alcohol consumption. One‐third of all women took folic acid 1 month prior to conception, 17% used tobacco daily and 11% used alcohol weekly 3 months before conception.ConclusionsA majority rated their pregnancy as very or fairly planned, with socio‐economic factors as explanatory variables. The level of pregnancy planning should be queried routinely to enable individualized counseling, especially for women with unplanned pregnancies. Preconception recommendations need to be established and communicated to the public to increase health promoting planning behavior.
The issue of consent in medical practice
Authors: Larner Elizabeth , Carter Rachel 
Published: November 2015

SummaryFollowing a recent court judgment, legal and moral issues surrounding consent have been thrown into the spotlight. Elizabeth Larner, Solicitor, and Rachel Carter, Partner, of Wollen Michelmore LLP, look at the issues surrounding consent, including where problems arise in the fields of clinical negligence and non‐accidental injury and what health care professionals can do to ensure that their advice to a patient about a procedure or treatment is sufficiently cogent and appropriately recorded so as to avoid later criticism and possible legal action. This annotation gives an overview of the legal principles surrounding consent in medical practice including informed consent, refusal of treatment and issues of capacity.
Adult perceptions of dental fluorosis and select dental conditions‐an Asian perspective
Authors: Nair Rahul , Chuang Janice Cheah Ping , Lee Pauline Shih Jia , Leo Song Jie , Yang Naomi QiYue , Yee Robert , Tong Huei Jinn 
Published: November 2015

AbstractObjectiveTo compare lay people's perceptions with regard to various levels of dental fluorosis and select dental defects versus normal dentition.MethodsAdults rated digitally created photographs made showing lips (without retraction) and teeth depicting the following conditions: no apparent aesthetic defects (normal, Thylstrup– Fejerskov score 0 – TF0), 6 levels of fluorosis (TF1–6), carious lesions (two cavitated and one noncavitated), malocclusions (Class II, Class III, anterior open bite and greater spacing), extrinsic staining and an incisal chip. The photographs were displayed on colour‐calibrated iPads™. Participants used a self‐administered questionnaire to rate their perceptions on (Item 1) how normal teeth were, (Item 2) how attractive the teeth were, (Item 3) need to seek correction of teeth, (Item 4) how well the person took care of their teeth and (Item 5) whether the person was born like this. Data from Item 5 were excluded due to low reliability.ResultsRatings for Item 1 showed that TF1–4 was similar or significantly better than TF0. For Item 2, TF1 and TF4 were significantly better than TF0, with TF2 and TF3 being similar. For Item 3, there was significantly lower need to seek correction with TF2 and TF4 versus TF0, whereas TF1 and TF3 were similar to TF0. TF5 and TF6 were rated significantly lower than TF0 for Item 1 and Item 2, and significantly higher rating for Item 3 (need to seek correction). Ratings for Item 4 were similar, with TF1, TF2 and TF4 being rated significantly higher than TF0, and TF5 and TF6 being rated lower. Cavitated caries and staining were generally perceived as being significantly less favourable than TF6, with higher need to seek correction as well. Noncavitated carious lesion and incisal chip were rated similar to TF0. Cavitated carious lesions were rated aesthetically similar or significantly worse than TF0 and TF6.ConclusionsSevere fluorosis (TF5 and 6) was perceived to be less aesthetically pleasing and received higher ratings for need to seek correction than normal teeth. Mild‐to‐moderate fluorosis (TF1–4) showed similar or better aesthetic perceptions and similar or lower need to seek correction, when compared to normal teeth (TF0). Easily visible cavitated dental caries was rated worse than teeth with severe fluorosis (TF6) and normal teeth (TF0).
Autoantibodies and their potential roles in diseases of the nervous system
Authors: Beasley Shannon J. , Greer Judith M. 
Published: November 2015

AbstractAutoantibodies are found in many disorders of the nervous system, including diseases affecting the peripheral nervous system (e.g. Guillain–Barré syndrome and other peripheral neuropathies), the central nervous system (e.g. neuromyelitis optica, multiple sclerosis and limbic encephalitis) and the neuromuscular junction (e.g. myasthenia gravis), as well as in neuropsychiatric disorders and in paraneoplastic syndromes. Some of these antibodies are likely to play an important pathogenic role in disease development, whereas others might be useful biomarkers for disease. In the present review, the features of an autoantibody that enable it to be pathogenic (e.g. the antibody isotype and the target antigen against which the antibody is directed) and some of the different mechanisms by which pathogenic autoantibodies could act will be discussed. These mechanisms include antibody‐mediated cell lysis, opsonization of target proteins for attack by macrophages, cross‐linking of Fc receptors, blocking or destroying receptors involved in neurotransmission or cellular homeostasis, and blocking of repair mechanisms such as remyelination. Examples will be given of diseases where these antibody‐mediated mechanisms are known or thought to be active. Finally, approaches to treating autoantibody‐mediated disease in the nervous system will be briefly reviewed.