bluuebunny/crossref_metadata_2025_split huggingface dataset:
A standardized protocol for the perioperative management of myasthenia gravis patients. Experience with 110 patients
Authors: GRITTI P. , SGARZI M. , CARRARA B. , LANTERNA L. A. , NOVELLINO L. , SPINELLI L. , KHOTCHOLAVA M. , POLI G. , LORINI F. L. , SONZOGNI V. 
Published: October 2011

BackgroundVideo‐assisted thoracoscopic extended thymectomy (VATET) is well established in the treatment of myasthenia gravis; however, patient selection remains controversial. Perioperative management protocol is lacking, and concerns regarding post‐operative myasthenic crisis still remain. We performed a retrospective observational study evaluating the impact of the introduction of a protocol in the perioperative management of patients with myasthenia gravis who underwent VATET.MethodsThe perioperative management protocol was developed by a team of neurologists and anesthesiologists who reviewed the literature and their previous experience on myasthenia gravis patients. Respiratory, clinical, and neurological patient features were included in the protocol evaluation. A retrospective review of patients who underwent VATET before and after introduction to the protocol was finally performed.ResultsThe medical records of 66 patients (pre‐protocol group) and 44 patients (protocol group) were available for the study. In the pre‐protocol group, 17 patients (26%) were admitted to intensive care unit (ICU) during the post‐operative period, while three patients (6.8%) of the protocol group met the criteria for ICU post‐operative admission. This resulted in a reduction of 73.5% of patients admitted to ICU (P = 0.023) and in an 80% (P = 0.002) reduction of the use neuromuscular blocking agents. Two post‐operative myasthenic crises preceded by bulbar symptoms (1.8%) were identified in the pre‐protocol group patients.ConclusionsAlthough the application of our protocol results in a substantial reduction in the recovery of patients in the ICU and in hospital costs, there was no substantial difference in mortality and morbidity between patients admitted to the surgical ward or to ICU.
Integrated model for providing tactical emergency medicine support (TEMS): analysis of 120 tactical situations
Authors: VAINIONPÄÄ T. , PERÄJOKI K. , HILTUNEN T. , PORTHAN K. , TASKINEN A. , BOYD J. , KUISMA M. 
Published: October 2011

BackgroundVarious models for organising tactical emergency medicine support (TEMS) in law enforcement operations exist. In Helsinki, TEMS is organised as an integral part of emergency medical service (EMS) and applied in hostage, siege, bomb threat and crowd control situations and in other tactical situations after police request. Our aim was to analyse TEMS operations, patient profile, and the level of on‐site care provided.MethodsWe conducted a retrospective cohort study of TEMS operations in Helsinki from 2004 to 2009. Data were retrieved from EMS, hospital and dispatching centre files and from TEMS reports.ResultsOne hundred twenty TEMS operations were analysed. Median time from dispatching to arrival on scene was 10 min [Interquartile Range (IQR) 7–14]. Median duration of operations was 41 min (IQR 19–63). Standby was the only activity in 72 operations, four patients were dead on arrival, 16 requests were called off en route and patient examination or care was needed in 28 operations. Twenty‐eight patients (records retrieved) were alive on arrival and were classified as trauma (n = 12) or medical (n = 16). Of traumas, two sustained a gunshot wound, one sustained a penetrating abdominal wound, three sustained medium severity injuries and nine sustained minor injuries. There was neither on‐scene nor in‐hospital mortality among patients who were alive on arrival. The level of on‐site care performed was basic life support in all cases.ConclusionsThe results showed that TEMS integrated to daily EMS services including safe zone working only was a feasible, rapid and efficient way to provide medical support to law enforcement operations.
Evaluation of sublingual microcirculatory blood flow in the critically ill
Authors: SALLISALMI M. , OKSALA N. , PETTILÄ V. , TENHUNEN J. 
Published: October 2011

BackgroundThe microcirculation regulates the supply of oxygen and nutrients to tissues. The sublingual region is frequently used as a window to microcirculation in critically ill patients. Numerous studies have reported impaired sublingual microcirculatory flow. We hypothesized that the quality of sidestream dark field imaging (SDF) recordings could be systematically analyzed to justify the monitoring of sublingual microcirculation in interventional studies or in clinical practice.MethodsThe sublingual microcirculation in critically ill patients with septic shock, open heart surgery, or alcoholic pancreatitis, and healthy subjects was recorded with a hand held SDF device by one trained investigator in observational setting. A total of 82 video recording sessions were performed and 240 video clips eligible for quality assessment were identified. Quality assessment was performed offline by two investigators independently and blinded for the origin of the video file.ResultsOf the 240 clips, pressure artifact was detected in 86 (36%), major blood in 5 (2.1%), major saliva in 21 (8.8%) and extreme brightness causing loss of visible capillaries in 16 (6.7%) clips. The dominating vessel architecture was multiple size vessels in 228 (95%) and repeating capillary loop motif in 12 (5.0%). The mean (± SD) relative size reduction during stabilization was −6.9% (± 4.7%). Excellent technical quality was detected in 74 of 240 (30.8%) recordings.ConclusionsOur findings highlight the need of a comprehensive training period and reporting of data quality before findings with SDF imaging can be accepted as surrogate end points in interventional studies or as guidance in clinical practice.
Collective Vigilance in the Greater Kudu: Towards a Better Understanding of Synchronization Patterns
Authors: Pays Olivier , Sirot Etienne , Fritz Hervé 
Published: October 2011

AbstractCollective detection of predators is one of the main advantages of living in groups in prey species. However, the mechanisms linking individual and collective vigilance remain largely unknown. Here, we investigated individual and collective vigilance in a natural population of greater kudu (Tragelaphus strepsiceros), a gregarious ruminant living under high predation risk. Controlling for environmental, individual and group factors, we show that the proportion of time during which at least one individual was vigilant increased with group size, whereas individual investment in vigilance decreased. We also show that individuals tended to synchronize both vigilance and feeding activities. More generally, and whatever the considered group size, we demonstrate how the independent scanning assumption underestimated both the proportion of time during which no individual was vigilant and the proportion of time during which all individuals were simultaneously vigilant, but overestimated the proportion of time during which one vigilant individual only was present. Our results thus contrast with the point of view that the alternative to independent vigilance is coordinated vigilance and plead for a better description of the processes whereby reciprocal influences between individuals shape collective patterns of vigilance.
Reduction in overweight and obesity from a 3‐year community‐based intervention in Australia: the ‘It's Your Move!’ project
Authors: Millar L. , Kremer P. , de Silva‐Sanigorski A. , McCabe M. P. , Mavoa H. , Moodie M. , Utter J. , Bell C. , Malakellis M. , Mathews L. , Roberts G. , Robertson N. , Swinburn B. A. 
Published: October 2011

Summary‘It's Your Move!’ was a 3‐year intervention study implemented in secondary schools in Australia as part of the Pacific Obesity Prevention In Communities Project. This paper reports the outcome results of anthropometric indices and relevant obesity‐related behaviours. The interventions focused on building the capacity of families, schools and communities to promote healthy eating and physical activity. Baseline response rates and follow‐up rates were 53% and 69% respectively for the intervention group (n = 5 schools) and 47% and 66% respectively for the comparison group (n = 7 schools). Statistically significant relative reductions in the intervention versus comparison group were observed: weight (−0.74 kg, P < 0.04), and standardized body mass index (−0.07, P < 0.03), and non‐significant reductions in prevalence of overweight and obesity (0.75 odds ratio, P = 0.12) and body mass index (−0.22, P = 0.06). Obesity‐related behavioural variables showed mixed results with no pattern of positive intervention outcomes. In conclusion, this is the first study to show that long‐term, community‐based interventions using a capacity‐building approach can prevent unhealthy weight gain in adolescents. Obesity prevention efforts in this important transitional stage of life can be successful and these findings need to be translated to scale for a national effort to reverse the epidemic in children and adolescents.
The role of policy in improving diets: experiences from the Pacific Obesity Prevention in Communities food policy project
Authors: Thow A. M. , Snowdon W. , Schultz J. T. , Leeder S. , Vivili P. , Swinburn B. A. 
Published: October 2011

SummaryThere is global interest in using multisectoral policy approaches to improve diets, and reduce obesity and non‐communicable disease. However, there has been ad hoc implementation, which in some sectors such as the economic sector has been very limited, because of the lack of quality evidence on potential costs and impacts, and the inherent challenges associated with cross‐sectoral policy development and implementation. The Pacific Obesity Prevention in Communities food policy project aimed to inform relevant policy development and implementation in Pacific Island countries. The project developed an innovative participatory approach to identifying and assessing potential policy options in terms of their effectiveness and feasibility. It also used policy analysis methodology to assess three policy initiatives to reduce fatty meat availability and four soft drink taxes in the region, in order to identify strategies for supporting effective policy implementation.
Reducing unhealthy weight gain in Fijian adolescents: results of the Healthy Youth Healthy Communities study
Authors: Kremer P. , Waqa G. , Vanualailai N. , Schultz J. T. , Roberts G. , Moodie M. , Mavoa H. , Malakellis M. , McCabe M. P. , Swinburn B. A. 
Published: October 2011

SummaryObesity is a significant problem among adolescents in Pacific populations. This paper reports on the outcomes of a 3‐year obesity prevention study, Healthy Youth Healthy Communities, which was part of the Pacific Obesity Prevention in Communities project, undertaken with Fijian adolescents. The intervention was developed with schools and comprised social marketing, nutrition and physical activity initiatives and capacity building designed to reduce unhealthy weight, and the individual exposure period was just over 2‐year duration. The evaluation incorporated a quasi‐experimental, longitudinal design in seven intervention secondary schools near Suva (n = 874) and a matched sample of 11 comparison secondary schools from western Viti Levu (n = 2,062). There were significant differences between groups at baseline; the intervention group was shorter, weighed less, had a higher proportion of underweight and lower proportion of overweight, and better quality of life (Pediatric Quality of Life Inventory only). At follow‐up, the intervention group had lower percentage body fat (−1.17) but also a lower increase in quality of life (Assessment of Quality of Life instrument: −0.02; Pediatric Quality of Life Inventory: −1.94) than the comparison group. There were no other differences in anthropometry, and behaviours' changes showed a mixed pattern. In conclusion, this school‐based health promotion programme lowered percentage body fat but did not reduce unhealthy weight gain or influence most obesity‐promoting behaviours among Fijian adolescents. Despite growing evidence supporting the efficacy of community‐based approaches to reduce obesity among children of European descent, findings from this study failed to demonstrate the efficacy of a community capacity‐building approach among an adolescent sample drawn from a different sociocultural, economic and geographical context. Additional ‘top–down’ or other innovative approaches may be needed to reduce adolescent obesity in the Pacific.
Socio‐cultural agents and their impact on body image and body change strategies among adolescents in Fiji, Tonga, Tongans in New Zealand and Australia
Authors: McCabe M. P. , Mavoa H. , Ricciardelli L. A. , Schultz J. T. , Waqa G. , Fotu K. F. 
Published: October 2011

SummaryThis paper reports on the findings of studies that were conducted as part of the Pacific Obesity Prevention in Communities project. The studies evaluated the types of messages that adolescents received in relation to body image, physical activity and eating. The participants were male and female adolescents from Fiji (two cultural groups), Tonga, New Zealand (Tongans) and Australia (European Australians). Three studies were conducted: interviews with 48 adolescents (24 male, 24 female) from each cultural group, questionnaires with 600 adolescents (300 male, 300 female) from each cultural group and the perceptual distortion study with 100 adolescents (50 male, 50 female) from the two cultural groups in Fiji and European Australians. The results demonstrate that parents, peers, the media, as well as religious influences impact on the type of body valued by adolescents in each of the cultural groups, as well as their levels of body satisfaction. These influences also shape the type and volume of food consumed, and the type and frequency of physical activity. The results of these studies highlight the major role played by the broader societal values in shaping the nature of the messages that adolescents receive in relation to their body size, eating and physical activity.
The Determinants and Some Consequences of Unemployed Workers' Wage Demands
Authors: Eriksson Stefan , Lagerström Jonas 
Published: October 2011

AbstractThis paper studies the determinants and consequences in the early stages of the hiring process of unemployed workers' wage demands using direct data on workers' wage requests. We show that most unemployed workers want a wage close to their previous wage, and thus much more than they get in unemployment benefits. However, some groups, such as women, tend to demand lower wages. Moreover, we find that workers with high wage demands are contacted by firms less often than otherwise similar workers with lower wage demands. Thus, our results suggest that too high wage demands may contribute to high unemployment.
Rationalism and Necessitarianism
Authors: Lin Martin 
Published: October 2011

AbstractMetaphysical rationalism, the doctrine which affirms the Principle of Sufficient Reason (the PSR), is out of favor today. The best argument against it is that it appears to lead to necessitarianism, the claim that all truths are necessarily true. Whatever the intuitive appeal of the PSR, the intuitive appeal of the claim that things could have been otherwise is greater. This problem did not go unnoticed by the great metaphysical rationalists Spinoza and Leibniz. Spinoza’s response was to embrace necessitarianism. Leibniz’s response was to argue that, despite appearances, rationalism does not lead to necessitarianism. This paper examines the debate between these two rationalists and concludes that Leibniz has persuasive grounds for his opinion. This has significant implications both for the plausibility of the PSR and for our understanding of modality.
Non‐wage benefits, costs of turnover and labour attachment
Authors: Juurikkala Tuuli , Lazareva Olga 
Published: October 2011

AbstractLike firms in established market economies, many Russian firms provide non‐wage benefits to their workers, such as housing, medical care or day care. This article explains the provision of benefits as a strategic choice for firms in the presence of labour and service market imperfections. Analysing unique survey data for 404 industrial establishments from 40 Russian regions, the authors provide strong evidence that non‐wage benefits are used by firms to attach workers and thereby reduce the costs of labour turnover in the face of tight labour markets. It is also shown that this attachment strategy works due to imperfections in the regional markets for social services.
The Russian–Ukrainian earnings divide1
Authors: Constant Amelie F. , Kahanec Martin , Zimmermann Klaus F. 
Published: October 2011

AbstractEthnic differences are often considered to be powerful sources of diverse economic behaviour. In this article, we investigate to what extent ethnicity affects Ukrainian labour market outcomes. Using microdata from the Ukrainian Longitudinal Monitoring Survey and the Oaxaca–Blinder decomposition of earnings, we find a persistent and increasing labour market divide between ethnic Russians and Ukrainians throughout Ukraine’s transition era. We establish that language, rather than nationality, is the key factor behind this ethnic premium favouring Russians. Our findings further document that this premium is larger amongst males than females.
Capital Income Taxation, Economic Growth and Heterogeneity in the Motivation to Give
Authors: Kunze Lars 
Published: October 2011

Abstract
This study provides a comprehensive analysis of the relationship between capital income taxation and economic growth within an overlapping generations model when individuals may bequeath wealth. The altruistic concern is modeled as a synthesis of joy-of-giving and family altruism so that individuals may derive utility from the amount of bequest itself and by providing children with a disposable income later on in life. Using this framework, it is shown that, in contrast to the existing literature, increasing the capital income tax rate may well enhance growth under operative bequests.
Regional Integration and Economic Convergence in the Post‐Soviet Space: Experience of the Decade of Growth
Authors: LIBMAN ALEXANDER , VINOKUROV EVGENY 
Published: October 2011

AbstractThis article examines the dynamics of regional integration and economic convergence in the post‐Soviet world during the period 1999–2008, both considered as a whole and on the level of individual country groups. While the trade integration experienced a negative trend, at the same time one can observe an unprecedented expansion of labour migration – thus suggesting that integration of factor flows can outperform integration of markets for goods and services, at least in this specific case. Clustering processes of the post‐Soviet states for economic convergence and for economic integration seem to be unaffected by each other.
Rice DUR3 mediates high‐affinity urea transport and plays an effective role in improvement of urea acquisition and utilization when expressed in Arabidopsis
Authors: Wang Wei‐Hong , Köhler Barbara , Cao Feng‐Qiu , Liu Guo‐Wei , Gong Yuan‐Yong , Sheng Song , Song Qi‐Chao , Cheng Xiao‐Yuan , Garnett Trevor , Okamoto Mamoru , Qin Rui , Mueller‐Roeber Bernd , Tester Mark , Liu Lai‐Hua 
Published: October 2011

Summary
Despite the great agricultural and ecological importance of efficient use of urea‐containing nitrogen fertilizers by crops, molecular and physiological identities of urea transport in higher plants have been investigated only in Arabidopsis.
We performed short‐time urea‐influx assays which have identified a low‐affinity and high‐affinity (Km of 7.55 μM) transport system for urea‐uptake by rice roots (Oryza sativa).
A high‐affinity urea transporter OsDUR3 from rice was functionally characterized here for the first time among crops. OsDUR3 encodes an integral membrane‐protein with 721 amino acid residues and 15 predicted transmembrane domains. Heterologous expression demonstrated that OsDUR3 restored yeast dur3‐mutant growth on urea and facilitated urea import with a Km of c. 10 μM in Xenopus oocytes.
Quantitative reverse‐transcription polymerase chain reaction (qPCR) analysis revealed upregulation of OsDUR3 in rice roots under nitrogen‐deficiency and urea‐resupply after nitrogen‐starvation. Importantly, overexpression of OsDUR3 complemented the Arabidopsis atdur3‐1 mutant, improving growth on low urea and increasing root urea‐uptake markedly. Together with its plasma membrane localization detected by green fluorescent protein (GFP)‐tagging and with findings that disruption of OsDUR3 by T‐DNA reduces rice growth on urea and urea uptake, we suggest that OsDUR3 is an active urea transporter that plays a significant role in effective urea acquisition and utilisation in rice.
The Pain Impact Inventory—Further Validation in Various Subgroups
Authors: Jakobsson Ulf , Kristensson Jimmie 
Published: October 2011

AbstractObjectives:  The aim of the study was to further psychometrically evaluate the instrument “Pain Impact Inventory” (PII) in various subgroups.Methods:  The sample comprised 384 persons (aged between 18 and 102 years) who reported chronic pain. The instrument PII was evaluated in terms of construct validity as well as reliability. The instrument’s validity was investigated through corrected item–total correlation, floor and ceiling effects, and item response rate. Reliability was assessed by means of test–retest (with a 2‐week interval) and Cronbach’s alpha. All analyses were performed in various subgroups, men and women, as well as in 6 different age‐groups and 5 primary pain location.Results:  The result showed an item–total correlation above 0.30 for all items in all subgroups with exception for the 2 items in F5 in the age‐group, 30 to 44. In the test–retest analysis, all kappa coefficients in the test–retest analysis were significant (P < 0.001) and varied between 0.482 and 0.879. The alpha values for factor 1 to 4 ranged between 0.80 and 0.94. Alpha values below 0.7 were only found for F5.Conclusion:  The PII showed satisfactory psychometric properties in terms of construct validity and reliability with regard to gender, age‐groups, and primary pain location.
Inadequate vitamin D status in pregnancy: evidence for supplementation
Authors: FINER SARAH , KHAN KHALID S. , HITMAN GRAHAM A. , GRIFFITHS CHRIS , MARTINEAU ADRIAN , MEADS CATHERINE 
Published: October 2011

AbstractThe role of vitamin D in maintaining a healthy pregnancy has seen emerging interest among clinicians and researchers in recent years. The functions of this hormone are widespread and complex, and during pregnancy and breastfeeding it facilitates crucial transfer of calcium from mother to child for skeletal development. Aside from the role of vitamin D in bone development and health, a myriad of other physiological actions are now known, and it is hypothesized that maternal deficiency may increase susceptibility to adverse pregnancy events during pregnancy such as pre‐eclampsia. The role of vitamin D in pregnancy and breastfeeding is summarized and applied to the knowledge from studies associating vitamin D deficiency with a range of adverse pregnancy outcomes, including pre‐eclampsia and childhood asthma. Current clinical guidelines for vitamin D supplementation in pregnancy are discussed in the context of the available evidence. The need for robust randomized controlled trials to address areas of existing uncertainty is highlighted.