bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal and biochemical predictors of antepartum stillbirth among nulliparous women in relation to gestational age of fetal death
Authors: Smith GCS , Shah I , White IR , Pell JP , Crossley JA , Dobbie R 
Published: May 2007

Objective  To determine whether maternal serum levels of alphafetoprotein (α‐FP) and human chorionic gonadotrophin (hCG) at 15–21 weeks provided clinically useful prediction of stillbirth in first pregnancies.Design  Retrospective study of record linkage of a regional serum screening laboratory to national registries of pregnancy outcome and perinatal death.Setting  West of Scotland, 1992–2001.Population  A total of 84 769 eligible primigravid women delivering an infant at or beyond 24 weeks of gestation.Methods  The risk of stillbirth between 24 and 43 weeks was assessed using the Cox proportional hazards model. Logistic regression models within gestational windows were then used to estimate predicted probability. Screening performance was assessed as area under the receiver operating characteristic (ROC) curve.Main outcome measure  Antepartum stillbirth unrelated to congenital abnormality.Results  The odds ratio (95% CI) for stillbirth at 24–28 weeks for women in the top 1% were 11.97 (5.34–26.83) for α‐FP and 5.80 (2.19–15.40) for hCG. The corresponding odds ratios for stillbirth at or after 37 weeks were 2.44 (0.74–8.10) and 0.79 (0.11–5.86), respectively. Adding biochemical to maternal data increased the area under the ROC curve from 0.66 to 0.75 for stillbirth between 24 and 28 weeks but only increased it from 0.64 to 0.65 for stillbirth at term and post‐term. Women in the top 5% of predicted risk had a positive likelihood ratio of 7.8 at 24–28 weeks, 3.7 at 29–32 weeks, 5.1 at 33–36 weeks and 3.4 at 37–43 weeks, and the corresponding positive predictive values were 0.97, 0.33, 0.47 and 0.63%, respectively.Conclusions  Maternal serum levels of α‐FP and hCG were statistically associated with stillbirth risk. However, the predictive ability was generally poor except for losses at extreme preterm gestations, where prevention may be difficult and interventions have the potential to cause significant harm.
Aromatherapy in childbirth: a pilot randomised controlled trial
Authors: Burns E , Zobbi V , Panzeri D , Oskrochi R , Regalia A 
Published: May 2007

Objectives  We aimed to determine the feasibility of conducting a randomised controlled trial (RCT) on the use of aromatherapy during labour as a care option that could improve maternal and neonatal outcomes.Design  RCT comparing aromatherapy with standard care during labour.Setting  District general maternity unit in Italy.Sample  Two hundred and fifty‐one women randomised to aromatherapy and 262 controls.Methods  Participants randomly assigned to administration of selected essential oils during labour by midwives specifically trained in their use and modes of application.Main outcome measures  Intrapartum outcomes were the following: operative delivery, spontaneous delivery, first‐ and second‐stage augmentation, pharmacological pain relief, artificial rupture of membranes, vaginal examinations, episiotomy, labour length, neonatal wellbeing (Apgar scores) and transfer to neonatal intensive care unit (NICU).Results  There were no significant differences for the following outcomes: caesarean section (relative risk [RR] 0.99, 95% CI: 0.70–1.41), ventouse (RR 1.5, 95% CI: 0.31–7.62), Kristeller manoeuvre (RR 0.97, 95% CI: 0.64–1.48), spontaneous vaginal delivery (RR 0.99, 95% CI: 0.75–1.3), first‐stage augmentation (RR 1.01, 95% CI: 0.83–1.4) and second‐stage augmentation (RR 1.18, 95% CI: 0.82–1.7). Significantly more babies born to control participants were transferred to NICU, 0 versus 6 (2%), P= 0.017. Pain perception was reduced in aromatherapy group for nulliparae. The study, however, was underpowered.Conclusion  This study demonstrated that it is possible to undertake an RCT using aromatherapy as an intervention to examine a range of intrapartum outcomes, and it provides useful information for future sample size calculations.
Does Quality Improvement Work? Evaluation of the Organ Donation Breakthrough Collaborative
Authors: Howard David H. , Siminoff Laura A. , McBride Virginia , Lin Monica 
Published: May 2007

Objective. The Organ Donation Breakthrough Collaborative is a quality improvement initiative to encourage adoption of “best practices” for identifying potential donors and obtaining consent for deceased organ donation. We evaluate the impact of the first phase on organ donation rates.Setting. We study donation rates in the 95 hospitals that participated in the first phase and a control group of 125 hospitals.Design. We use a controlled pre/post design. The preperiod is the year before the start of the Collaborative (September 2002 to August 2003), the postperiod is the final 6 months of the first phase (March 2004 to August 2004).Data. We use administrative data from the Organ Procurement and Transplantation Network to compute the conversion rate in each hospital group and time period. The conversion rate is the proportion of eligible donors who became actual donors.Principal Findings. Preperiod conversion rates in Collaborative and control hospitals were similar: 52 and 51 percent, respectively. In the postperiod, the conversion rate increased to 60 percent among Collaborative hospitals and remained at 51 percent among control hospitals. The relative change was 8 percentage points (95 percent confidence interval: 2–13: p<.001).Conclusions. Our findings suggest that the Breakthrough Collaborative led to an increase in donation rates at participating hospitals.
Coconut oil as a fuel in the Pacific Islands
Authors: Cloin Jan 
Published: May 2007

Abstract The steadily increasing world market prices for fossil fuels in the past years have significantly increased interest in the development of indigenous sources of energy in the Pacific islands. As an import substitution strategy, many Pacific island Governments are looking into the use of local biomass resources to replace traditionally imported fuels such as petrol and diesel by biofuels. An overview of biofuel activities is given, with experiences and key achievements in Fiji, Samoa, Vanuatu, Solomon Islands, Papua New Guinea, Kiribati and Marshall Islands with regard to efforts to develop alternative fuels. There are strong linkages between developments in the various Pacific island countries and lessons to be learned from experiences and policies implemented among Governments in the Pacific region. The paper concludes that there is a need for standardization, quality control and testing facilities for biofuels in the region. Governments need to investigate further the level of support that is required to make biofuel operations viable and maximize macroeconomic and environmental benefits.
Patient Preference for Triptan Formulations: A Prospective Study With Zolmitriptan
Authors: Dowson Andrew , Bundy Michael , Salt Rebecca , Kilminster Shaun 
Published: May 2007

Objectives.—To investigate patterns of patient preference for 3 formulations of zolmitriptan, in a primary care study utilizing a naturalistic longitudinal design.Background.—Although differences in efficacy between individual triptans tend to be small, migraine patients show clear preferences for individual triptans and formulations. The groups of patients suitable for the different triptan formulations, and the reasons underlying individual preferences, are not clearly understood.Methods.—Migraine patients entered a prospective, randomized, open, crossover, longitudinal design study, with patients receiving zolmitriptan formulations according to UK prescribing recommendations. Patients naïve to zolmitriptan received zolmitriptan 2.5‐mg film‐coated tablets or 2.5‐mg Orally Disintegrating Tablets (ODT) for 1 month, before being crossed over to receive the alternative formulation for Month 2. All patients then received zolmitriptan nasal spray 5 mg for Month 3. Patients could then choose the formulation(s) of their choice for a further 7 months. Patients recorded their preferences for individual formulations, the reasons for their preferences, and also the headache‐related disability (measured by the Migraine Disability Assessment [MIDAS] score) at clinic visits. Primary endpoints were the individual preferences and changes in MIDAS scores. Adverse events were also recorded.Results.—Forty‐eight patients took part in the study. At baseline, most patients expressed a preference for conventional tablets. After 4 months, 46.9% of patients preferred zolmitriptan ODT, 43.8% zolmitriptan nasal spray, and 6.3% the conventional tablet. The most common reasons given for preferring conventional tablets were personal reasons: for zolmitriptan ODT, convenience and, to a lesser extent, speed of onset: for zolmitriptan nasal spray, speed of onset, and overall efficacy. MIDAS scores decreased significantly following treatment with zolmitriptan. Zolmitriptan was well tolerated.Conclusions.—Patient experience of newer zolmitriptan formulations influenced a change in preference away from conventional tablets. Speed and efficacy were the key drivers of preference for zolmitriptan nasal spray, while convenience mostly drove preference for the ODT formulation. Open, longitudinal, naturalistic studies may, allowing for biases, sometimes be an appropriate way of conducting migraine studies in primary care.
MOLECULAR CLONING AND CHARACTERIZATION OF HIGH‐AFFINITY NITRATE TRANSPORTERS IN MARINE PHYTOPLANKTON1
Authors: Song Bongkeun , Ward Bess B. 
Published: May 2007

Nitrate transporter systems initiate nitrate uptake in photoautotrophic organisms including marine phytoplankton. The functional genes encoding high‐affinity nitrate transporters (Nrt2) in marine phytoplankton were investigated in this study. Direct PCR amplification with newly developed primers was used to detect Nrt2 genes in cultured marine phytoplankton species: Dunaliella tertiolecta Butcher (Chlorophyceae); Emiliania huxleyi (Lohmann) W. H. Hay et H. Mohler (Haptophyceae); and four diatoms, including Thalassiosira weissflogii (Grunow) G. A. Fryxell et Hasle, Skeletonema costatum (Grev.) Cleve, Ditylum brightwellii (T. West) Grunow, and Chaetoceros muelleri Lemmerm. (Bacillariophyceae). Phylogenetic analysis of the detected Nrt2 genes identified three distinct clusters grouped by each class of phytoplankton species. Transcriptional abundance (mRNA) of Nrt2 genes in D. tertiolecta, E. huxleyi, T. weissflogii, and C. muelleri were measured using quantitative reverse transcriptase‐PCR assays under various nitrogen conditions. The diatoms and E. huxleyi induced Nrt2 gene transcripts both in the presence of nitrate and under nitrogen (N) starvation, while the Nrt2 transcript in D. tertiolecta was induced only when nitrate was present. Chaetoceros muelleri exhibited the highest transcript induction of the Nrt2 gene. The transcriptional abundance of the Nrt2 genes in C. muelleri was further examined with short‐term nitrate incubation of cells grown under N‐sufficient or N‐starved conditions. The maximum induction of Nrt2 gene transcripts was observed within 1 h after nitrate was added. Thus, we report differential induction and regulation of Nrt2 genes in the selected phytoplankton species to varying conditions of external N.
Risk Management, Capital Budgeting, and Capital Structure Policy for Insurers and Reinsurers
Authors: Froot Kenneth A. 
Published: May 2007

AbstractThis article builds on Froot and Stein in developing a framework for analyzing the risk allocation, capital budgeting, and capital structure decisions facing insurers and reinsurers. The model incorporates three key features: (i) value‐maximizing insurers and reinsurers face product‐market as well as capital‐market imperfections that give rise to well‐founded concerns with risk management and capital allocation; (ii) some, but not all, of the risks they face can be frictionlessly hedged in the capital market; and (iii) the distribution of their cash flows may be asymmetric, which alters the demand for underwriting and hedging. We show these features result in a three‐factor model that determines the optimal pricing and allocation of risk and capital structure of the firm. This approach allows us to integrate these features into: (i) the pricing of risky investment, underwriting, reinsurance, and hedging; and (ii) the allocation of risk across all of these opportunities, and the optimal amount of surplus capital held by the firm.
Robustly Hedging Variable Annuities With Guarantees Under Jump and Volatility Risks
Authors: Coleman T. F. , Kim Y. , Li Y. , Patron M. 
Published: May 2007

AbstractRecent variable annuities offer participation in the equity market and attractive protection against downside movements. Accurately quantifying this additional equity market risk and robustly hedging options embedded in the guarantees of variable annuities are new challenges for insurance companies. Due to sensitivities of the benefits to tails of the account value distribution, a simple Black–Scholes model is inadequate in preventing excessive liabilities. A model which realistically describes the real world price dynamics over a long time horizon is essential for the risk management of the variable annuities. In this article, both jump risk and volatility risk are considered for risk management of lookback options embedded in guarantees with a ratchet feature. We evaluate relative performances of delta hedging and dynamic discrete risk minimization hedging strategies. Using the underlying as the hedging instrument, we show that, under a Black–Scholes model, local risk minimization hedging can be significantly better than delta hedging. In addition, we compare risk minimization hedging using the underlying with that of using standard options. We demonstrate that, under a Merton's jump diffusion model, hedging using standard options is superior to hedging using the underlying in terms of the risk reduction. Finally, we consider a market model for volatility risks in which the at‐the‐money implied volatility is a state variable. We compute risk minimization hedging by modeling at‐the‐money Black–Scholes implied volatility explicitly; the hedging effectiveness is evaluated, however, under a joint model for the underlying price and implied volatility. Our computational results suggest that, when implied volatility risk is suitably modeled, risk minimization hedging using standard options, compared to hedging using the underlying, can potentially be more effective in risk reduction under both jump and volatility risks.
A Test of the Eclectic Paradigm: Evidence From the U.S. Reinsurance Market
Authors: Cole Cassandra R. , Lee Ryan B. , McCullough Kathleen A. 
Published: May 2007

AbstractThis study provides a test of the eclectic paradigm with data from U.S. reinsurers. The U.S. reinsurance industry provides a unique setting to test the eclectic paradigm due to the extensive data available on U.S. reinsurers and the well‐developed literature related to reinsurance. The ability to test the hypotheses related to the eclectic paradigm in a service industry and incorporate industry‐specific factors adds to the eclectic paradigm literature which has traditionally focused primarily on manufacturing firms. In addition, the application of the eclectic paradigm to the reinsurance industry provides an empirical framework that combines several prior streams of literature which examine the reinsurer's decision to internationalize. The current study includes firm‐specific factors, country‐specific factors of the international markets, and factors related to the U.S. reinsurance industry. This article finds support for traditional factors impacting globalization such as host market size, loss experience, and competitiveness as well as reinsurer's ability to expand based on available capacity. Understanding the importance of firm‐, country‐, and industry‐specific factors is key for managers, as analyzing these issues in isolation may lead to an incomplete picture of the factors impacting the internationalization decision, hindering managers' ability to make decisions that are in the best interest of the firm. With the continued interdependence of the world reinsurance marketplace, as well as the recent expansion of the European Union, internationalization issues are of critical importance not only to U.S. insurers, reinsurers, and regulators, but also to their global counterparts.
The Effect of Antihistamine Cetirizine on Ventricular Repolarization in Congenital Long QT Syndrome
Authors: HEKKALA ANNA‐MARI , SWAN HEIKKI , VÄÄNÄNEN HEIKKI , VIITASALO MATTI , TOIVONEN LAURI 
Published: May 2007

Introduction: Many drugs are known to block cardiac potassium channels, thus prolonging QT interval and predisposing to malignant arrhythmias. Patients with congenital long QT syndrome are particularly vulnerable, but usually electrophysiological effects of drugs have not been assessed in these patients at risk. Methods: Fifteen asymptomatic patients with type 1 (LQT1), 15 patients with type 2 (LQT2) long QT syndrome, and 15 healthy volunteers took a placebo and cetirizine 10 mg. In addition, healthy volunteers took cetirizine 50 mg. The study was single‐blinded and randomized. Exercise tests were performed during stable plasma concentrations. The electrocardiogram was recorded with a body surface potential mapping system (BSPM). Data were analyzed with an automated analyze program. QT intervals to the T wave apex and T wave end and their difference (Tp‐e) were determined at rest and at specified heart rates during and after exercise. Results: Cetirizine did not lengthen the QT intervals at rest or during exercise and recovery in any group. It shortened Tp‐e at rest in LQT1 and LQT2 patients and during exercise test in LQT1 patients, thus slightly decreasing electrocardiographic transmural dispersion of repolarization. Conclusions: Cetirizine does not adversely modify ventricular repolarization in types 1 and 2 long QT syndrome, suggesting that it might be used safely in these long QT syndrome patients.
Voluntary consumption of substances of unknown palatability by vervet monkeys: a refinement
Authors: Seier J.V. , Mdhluli M. , Collop T. , Davids A. , Laubscher R. 
Published: May 2007

AbstractBackground  Pure compounds and herbal medicines, had to be administered orally to vervet monkeys for testing. A reliable method was sought to avoid daily gavaging.Methods  Substances were incorporated into the maize meal based diet of this facility for voluntary consumption. Food intake was monitored.Results  In all but one case, consumption of the treated food was in excess of 90%. In all cases, the purpose of the study was achieved. Habituation was usually only required to the vehicle, and was accomplished by incremental increases to the desired concentration. Aversion was overcome by the addition of a small amount of honey. Plasma concentrations of a compound metabolite could be measured in one case after gavage and food consumption, and were similar for both methods.Conclusion  The method enables reliable voluntary consumption of diverse substances. Since stressful gavaging is avoided, it is a valuable contribution to the 3Rs.
Association of ground hardness with injuries in rugby union
Authors: Takemura Masahiro , Schneiders Anthony G , Bell Melanie L , Milburn Peter D 
Published: May 2007

Background:Ground hardness is considered one of the possible risk factors associated with rugby injuries.Objectives:To examine the contribution of ground hardness, rainfall and evapotranspiration to the incidence of injury, and to investigate seasonal injury bias throughout one full season of rugby union.Methods:A prospective epidemiological study of rugby injuries was performed on 271 players from rugby union teams involved in the premier grade rugby competition in Dunedin, New Zealand. Ground hardness was measured before each match over 20 rounds with an industrial penetrometer, and local weather information was collected through the National Institute of Weather and Atmospheric Research and the Otago Regional Council. Poisson mixed models were used to describe injury incidence as a function of ground hardness throughout the season.Results:The overall injury incidence during the season was 52 injuries per 1000 match player-hours (95% CI 42 to 65). Although injury incidence decreased gradually by round with a rate ratio of 0.98 (95% CI 0.96 to 0.99) (p = 0.036), and the hardness of match grounds decreased significantly over the season (0.16 MPa/round, 95% CI 0.12 to 0.21, p<0.001), a non-significant association was demonstrated between injury incidence and ground hardness. Injury incidence was not associated with a combination of ground hardness, rainfall and evapotranspiration on the day of the match or cumulative rainfall and evapotranspiration before each match.Conclusions:Seasonal change in ground hardness and an early-season bias of injuries was demonstrated. Although the contribution of ground hardness to injury incidence was not statistically significant, match round and injury incidence were highly correlated, confirming a seasonal bias, which may confound the relationship of injury to ground condition.
THE RADAR ARCHITECTURE FOR PERSONAL COGNITIVE ASSISTANCE
Authors: GARLAN DAVID , SCHMERL BRADLEY 
Published: May 2007

Current desktop environments provide weak support for carrying out complex user-oriented tasks. Although individual applications are becoming increasingly sophisticated and feature-rich, users must map their high-level goals to the low-level operational vocabulary of applications, and deal with a myriad of routine tasks (such as keeping up with email, keeping calendars and websites up-to-date, etc.). An alternative vision is that of a personal cognitive assistant. Like a good secretary, such an assistant would help users accomplish their high-level goals, coordinating the use of multiple applications, automatically handling routine tasks, and, most importantly, adapting to the individual needs of a user over time. In this paper we describe the architecture and its implementation for a personal cognitive assistant called RADAR. Key features include. (a) extensibility through the use of a plug-in agent architecture. (b) transparent integration with legacy applications and data of today's desktop environments, and. (c) extensive use of learning so that the environment adapts to the individual user over time.