bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered mean platelet volume in children with Henoch-Schonlein purpura and its association with disease activity
Authors: Shi Xiang , Li Wen-Chao , Mo Li-Jun , Li Xiao-Hong , Luo Yu-Zhen , Qin Liu-Qun , Yang Zheng , Mo Wu-Ning 
Published: April 2018

Background Henoch-Schonlein purpura is a systemic small-vessel vasculitis that occurs mainly in children. A review of the literature has suggested a correlation between mean platelet volume and several inflammatory disorders. However, to the best of our knowledge, any potential correlation between mean platelet volume and Henoch-Schonlein purpura has not been reported in the literature. Therefore, our study aimed to evaluate the role of mean platelet volume concentrations in patients with Henoch-Schonlein purpura. Methods This study included 97 children with Henoch-Schonlein purpura and 120 healthy individuals as controls. Results Mean platelet volume concentrations were found to be significantly lower in Henoch-Schonlein purpura patients compared with healthy controls (8.1 ± 0.86 vs. 9.4 ± 0.81, P < 0.001). Similarly, significant negative correlations were observed between mean platelet volume and neutrophil count, platelet count and erythrocyte sedimentation rate in patients with Henoch-Schonlein purpura (r=−0.327, P = 0.001; r=−0.419, P < 0.001; r=−0.255, P = 0.012). Interestingly, mean platelet volume was significantly lower in the acute phase compared with the convalescent phase of Henoch-Schonlein purpura patients (7.8 ± 0.86 vs. 8.3 ± 0.77, P = 0.002). A cut-off value for mean platelet volume was 7.85 with area under the curve of 0.726 to identify acute phase vs. convalescent phase in patients with Henoch-Schonlein purpura. Mean platelet volume was independently associated with Henoch-Schonlein purpura in logistic regression analysis (odds ratio = 0.114, 95% confidence interval = 0.053–0.243, P < 0.001). Conclusions Our results suggest that mean platelet volume is inversely associated with disease in patients with Henoch-Schonlein purpura, and mean platelet volume may be a useful marker to identify active disease in Henoch-Schonlein purpura patients.
Patient and therapist experiences of using affordable feedback-based technology in rehabilitation: a qualitative study nested in a randomized controlled trial
Authors: Hamilton Caitlin , McCluskey Annie , Hassett Leanne , Killington Maggie , Lovarini Meryl 
Published: April 2018

Objective: To explore how technologies are used and experienced in rehabilitation. Design: A qualitative study using a grounded theory approach within a randomized controlled trial investigating the effectiveness of tailored, affordable technologies to improve mobility and physical activity. Settings: Aged care and neurological rehabilitation wards with community follow-up. Participants: Twenty patients undergoing rehabilitation and randomized to the experimental arm of a trial (mean age 64 years (SD 23)) were recruited for interviews, plus 11 physiotherapists involved in technology prescription as part of the trial. Method: Two interviews per patient (one in hospital, one post-discharge) and four focus groups with physiotherapists were conducted. Transcribed data were coded and synthesized. Memo-writing and constant comparison methods guided data analysis. Results: A process of patient engagement with technology involving two stages: (1) initial patient engagement and (2) maintaining patient engagement was identified. Therapists used a series of steps and strategies to gain and maintain patient engagement. A positive first experience and continued input into patient programmes was needed. The level of patient engagement was not consistent across the duration of the trial, increasing or decreasing due to changes in the technologies prescribed or setting of use. Two conditions were key to optimizing patient engagement: sufficient support and perceived benefit from using technology. Conclusions: Patients can engage with technology during rehabilitation when prescription is tailored by a therapist. Perceiving benefit from using technology, in addition to receiving the right support to enable use appears to influence the level of patient engagement.
Pharmacokinetics/Pharmacodynamics of Dabigatran 75 mg Twice Daily in Patients With Nonvalvular Atrial Fibrillation and Severely Impaired Renal Function
Authors: Martin Jack L. , Esmaeili Habib , Manuel Raymond C. , Petrini Michaela , Wiebe Sabrina , Maas Hugo 
Published: April 2018

Introduction: Dabigatran etexilate is an oral direct thrombin inhibitor. Dabigatran excretion is 80% renal, so exposure increases with severity of renal failure. The US Food and Drug Administration-approved dabigatran etexilate 75 mg twice daily (BID) for patients with nonvalvular atrial fibrillation (NVAF) having severely impaired renal function (creatinine clearance: 15-30 mL/min), based on post hoc pharmacokinetic modeling. We assessed dabigatran exposure at trough and peak levels in patients with NVAF and severely impaired renal function and compared with model predictions. Methods: Patients received dabigatran etexilate (75 mg BID) for ≥7 days before blood sampling; Cpre,ss (steady-state predose concentration; trough) was taken 10 to 16 hours postdose (prior to next dose), and C2,ss (steady-state concentration; peak) was taken 2 hours (± 30 minutes) postdose. Pharmacodynamic parameters at baseline (Ebase), trough concentrations (Epre,ss), and peak concentrations (E2,ss) were assessed by established coagulation assays. Results: Of the 150 patients screened, 60 were treated, of which 40% were male and 78.3% were white; median age was 84 years. Cpre,ss values (n = 51) were close to pharmacokinetic modeling predictions with a geometric mean (gMean) of 155 ng/mL, geometric coefficient of variation (gCV) of 76.9%, and range of 15.6 to 498 ng/mL. The C2,ss values (n = 59) had a gMean of 202 ng/mL, gCV of 70.6%, and range of 42.0 to 680 ng/mL. Pharmacodynamic effects on coagulation paralleled dabigatran concentrations. Eleven (18.3%) patients had ≥1 adverse event (AE); pharmacokinetic results for these patients versus those without AEs (n = 49) were Cpre, ss: gMean = 206 versus 145 ng/mL, gCV = 64.0% versus 78.3%; C2,ss: gMean = 243 versus 193 ng/mL, gCV = 68.9% versus 70.8%. All bleeding events (8 events in 5 patients) were considered minor by the investigators. Conclusion: Dabigatran exposure levels largely confirmed earlier pharmacokinetic predictions, supporting the use of dabigatran etexilate 75 mg BID in patients with NVAF and severely impaired renal function. Pharmacodynamic results were also in agreement with earlier studies. Trial Registration: ClinicalTrials.gov NCT01896297.
A virtual academy of polydrug use: Masters, novices and the art of combinations
Authors: Kataja Kati , Törrönen Jukka , Hakkarainen Pekka , Tigerstedt Christoffer 
Published: April 2018

Aims: Information technology has become an essential part of drug culture, providing a platform for lay knowledge concerning drug use. Due to the co-effects of different substances, making substance “combos” requires advanced skills to enhance pleasures and manage risks. In this study, we focussed on Finnish and Swedish online discussions as a context for learning and sharing experiences of combining substances. Methods: Taking influences from positioning theory, we used qualitative methods to map what kinds of mutual interactive positions related to the expertise in polydrug use online discussants take and how these positions are negotiated and reformulated in the online setting. We reflect these results through Howard S. Becker’s theory of social learning, according to which becoming a drug user is a process that occurs in interaction with other users, as the beginners need a model and advice from experienced users in order to claim their place in the users’ community. Results: In online forums, users discuss the risks and pleasures of combining drugs – on the one hand, in relation to different situations and, on the other hand, in relation to different competence positions. This occurs by asking for advice, presenting one’s knowledge, challenging others, repositioning oneself, defending one’s position or proving one’s competence. Conclusion: Online discussion forums constitute a kind of virtual academy where knowledge of the pleasures and risks of combining substances is produced and circulated, and where experienced masters mediate their expertise to less experienced novices.
Interobserver and intraobserver comparison of imaging glenoid morphology, glenoid version and humeral head subluxation
Authors: Cagle Paul J , Werner Birgit , Shukla Dave R , London Daniel A , Parsons Bradford O , Millar Neal L 
Published: April 2018

Background Glenoid morphology, glenoid version and humeral head subluxation represent important parameters for the treating physician. The most common method of assessing glenoid morphology is the Walch classification which has only been validated with computed tomography (CT). Methods CT images and magnetic resonance imaging (MRI) images of 25 patients were de-identified and randomized. Three reviewers assessed the images for each parameter twice. The Walch classification was assessed with a weighted kappa value. Glenoid version and humeral head subluxation were comparted with a reproducibility coefficient. Results The Walch classification demonstrated almost perfect intraobserver agreement for MRI and CT images (k = 0.87). Weighted interobserver agreement values for the Walch classification were fair for CT and MRI (k = 0.34). The weighted reproducibility coefficient for glenoid version measured 9.13 (CI 7.16–12.60) degrees for CT and 13.44 (CI 10.54–18.55) degrees for MRI images. The weighted reproducibility coefficient for percentage of humeral head subluxation was 17.43% (CI 13.67–24.06) for CT and 18.49% (CI 14.5–25.52) for MRI images. Discussion CT and MRI images demonstrated similar efficacy in classifying glenoid morphology, measuring glenoid version and measuring posterior humeral head subluxation. MRI can be used as an alternative to CT for measuring these parameters.
Biotin-Thiamine-Responsive Basal Ganglia Disease: Case Report and Follow-Up of a Patient With Poor Compliance
Authors: Alabdulqader Muneera A. , Al Hajjaj Sumayah 
Published: April 2018

Background: Biotin-thiamine-responsive basal ganglia disease (BTBGD) is a rare treatable autosomal recessive neurometabolic disorder characterized by progressive encephalopathy that eventually leads to severe disability and death if not treated with biotin and thiamine supplements. Objectives: We aimed to determine the optimal management of BTBGD presenting in acute encephalopathic episodes. Method: Case report. Results: An 8-year-old girl born to consanguineous parents was diagnosed with BTBGD at the age of 3 years after presenting with acute encephalopathy and ataxia. The patient was treated with biotin and thiamine, and the family was instructed to continue these medications for life. When she was 7 years old, her supplements were stopped for 2 weeks for social reasons. Afterward, the patient began to have tremor in both hands and an unsteady gait. The family then resumed the medications at the usual dosages. However, the patient remained symptomatic. The patient was admitted with acute BTBGD because of discontinuation of medications. The patient’s condition was then managed with high doses of intravenous thiamine and oral biotin. She showed gradual improvement after 48 hours. She was then discharged home 1 week later with residual mild upper and lower limb tremor, as well as right lower limb dystonia. Further follow-up showed a good neurological condition with no apparent long-term sequel. The family was further educated about the importance of strict compliance. Conclusion: Patients with BTBGD should remain on lifelong treatment with thiamine and biotin. For those who present with acute relapse, we recommend inpatient treatment with high doses of intravenous thiamine and oral biotin. Further clinical research is required to determine the optimal doses and durations.
Long-term bedaquiline-related treatment outcomes in patients with extensively drug-resistant tuberculosis from South Africa
Authors: Olayanju Olatunde , Limberis Jason , Esmail Aliasgar , Oelofse Suzette , Gina Phindile , Pietersen Elize , Fadul Mohammed , Warren Rob , Dheda Keertan 
Published: April 2018

Optimal treatment regimens for patients with extensively drug-resistant tuberculosis (XDR-TB) remain unclear. Long-term prospective outcome data comparing XDR-TB regimens with and without bedaquiline from an endemic setting are lacking.We prospectively followed-up 272 South African patients (49.3% HIV-infected; median CD4 count 169 cells·µL−1) with newly diagnosed XDR-TB between 2008 and 2017. Outcomes were compared between those who had not received bedaquiline (pre-2013; n=204) and those who had (post-2013; n=68; 80.9% received linezolid in addition).The 24-month favourable outcome rate was substantially better in the bedaquilineversusthe non-bedaquiline group (66.2% (45 out of 68)versus13.2% (27 out of 204); p<0.001). In addition, the bedaquiline group exhibited reduced 24-month rates of treatment failure (5.9%versus26.0%; p<0.001) and default (1.5%versus15.2%; p<0.001). However, linezolid was withdrawn in 32.7% (18 out of 55) of patients in the bedaquiline group because of adverse events. Admission weight >50 kg, an increasing number of anti-TB drugs and bedaquiline were independent predictors of survival (the bedaquiline survival effect remained significant in HIV-infected persons, irrespective of CD4 count).XDR-TB patients receiving a backbone of bedaquiline and linezolid had substantially better favourable outcomes compared to those not using these drugs. These data inform the selection of XDR-TB treatment regimens and roll-out of newer drugs in TB-endemic countries.
Maximal exercise capacity in patients with obstructive sleep apnoea syndrome: a systematic review and meta-analysis
Authors: Mendelson Monique , Marillier Mathieu , Bailly Sébastien , Flore Patrice , Borel Jean-Christian , Vivodtzev Isabelle , Doutreleau Stéphane , Tamisier Renaud , Pépin Jean-Louis , Verges Samuel 
Published: April 2018

Maximal aerobic capacity is a strong health predictor and peak oxygen consumption (V′O2peak) is considered a reflection of total body health. No systematic reviews or meta-analyses to date have synthesised the existing data regardingV′O2peakin patients with obstructive sleep apnoea (OSA).A systematic review of English and French articles using PubMed/MEDLINE and Embase included studies assessingV′O2peakin OSA patients either in mL·kg−1·min−1compared with controls or in % predicted. Two independent reviewers analysed the studies, extracted the data and assessed the quality of evidence.MeanV′O2peakexpressed in mL·kg−1·min−1was significantly lower in patients with OSA than in controls (mean difference −2.7 mL·kg−1·min−1; p<0.001; n=850). This reduction inV′O2peakwas found to be larger in non-obese patients (body mass index <30 kg·m−2). MeanV′O2peak% pred was 89.9% in OSA patients (n=643).OSA patients have reduced maximal aerobic capacity, which can be associated with increased cardiovascular risks and reduced survival in certain patient subgroups. Maximal exercise testing can be useful to characterise functional limitation and to evaluate health status in OSA patients.
Elastic potential and pressure dependence of elastic moduli in fluid-saturated rock with double porosity
Authors: Morozov Igor B. , Deng Wubing 
Published: April 2018

Models of seismic velocity dispersion and attenuation in porous rock are often based on quantitative relations between empirical moduli by Gassmann, Mavko-Jizba, Sayers-Kachanov, and others. All of these relations have a common origin in the concept of elastic potential; nevertheless, this concept itself has been insufficiently used in the context of multiple porosities and squirt flows. Regardless of the microstructure of a rock, knowledge of its macroscopic elastic potential reveals the complete set of parameters that are necessary and sufficient for characterizing its elasticity and obtaining rigorous equations of deformation. For isotropic rock with double (such as stiff and/or compliant) porosity, this parameter set contains six elements of the bulk-modulus matrix and six moduli for shear. The elastic matrices predict all observable elastic properties, such as bulk, shear and Young’s moduli, pore compressibilities, Skempton coefficients, consolidation parameters, Poisson’s ratios, static (Gassmann’s) and ultrasonic (Mavko-Jizba’s) undrained moduli, as well as the hypothetical high-pressure modulus [Formula: see text] and unrelaxed-frame moduli. By using laboratory observations with Westerly granite, all six elements of the elastic matrix for bulk deformation are inverted for exactly; three moduli for shear are determined with uncertainties due to insufficient data. The inverted matrices of the elastic moduli predict all observations (drained and low- and high-frequency undrained moduli) within measurement accuracy, with minor uncertainties for shear deformation. The secondary pores are approximately 50 times more compressible than are the primary ones, which explains their interpretation as “soft.” Most of the inverted elastic moduli vary with the confining pressure. Despite its usually assumed constancy, the high-pressure modulus [Formula: see text] exhibits an approximately 10% decrease with confining pressure from 0 to 100 MPa, which is opposite of the trend of the solid-grain modulus [Formula: see text].
Gendered differentials in climate change adaptation amongst the Shona ethnic group in Marondera Rural District, Zimbabwe: A social inclusions lens.
Authors: Garutsa Tendayi C. , Mubaya Chipo P. , Zhou Leocadia 
Published: April 2018

Background: Various studies on climate change treat men and women as unitary categories with contrasting needs. There is a dearth of studies which use a social inclusions lens to understand the impacts of climate change on gender. Other social markers that give an in-depth insight of the social differences within and between genders to the impacts of climate change are consequently ignored. Methods: Utilizing a mixed methods approach, this study aimed to explore and investigate the gendered crops grown as a climate adaptation strategy to respond to perennial droughts, increased temperatures and unreliable rainfall patterns amongst the Shona in Marondera rural district. Results: The findings indicated that social differences between gender lines like age, household types, income, education and employment status amongst other social variables produce differentiated vulnerabilities and potential opportunities towards climate adaptation. Conclusions: The main position advanced in this article is that treating gender as the primary cause of vulnerability produces a narrow analysis making other social markers (age, types of households, income and ethnicity) analytically invisible. This paper recommends a holistic and comprehensive analysis to inform climate change programming and policy frameworks. This would in turn address and improve climate adaptation strategies within and between genders which are often obscured to address the needs of all vulnerable members of a given economy.
Risk Aversion and Precautionary Savings in Dynamic Settings
Authors: Bommier Antoine , Grand François Le 
Published: April 2018

We study the saving behavior of infinitely long-lived agents who face income uncertainty and deterministic interest rates. Using monotone recursive preferences, we prove that risk aversion unambiguously increases savings. The result accounts for possibly binding borrowing constraints and holds for very general specification of income uncertainty, which can follow any kind of stochastically monotone process. Codes are available at https://doi.org/10.1287/mnsc.2017.2959 . This paper was accepted by Han Bleichrodt, decision analysis.
This way to the playground: A drama therapeutic treatment protocol for the parentified child who has witnessed domestic violence
Authors: Martinez Ashley Kleinman 
Published: April 2018

Abstract
This article is an exploration of drama therapy for the treatment of the parentified child, ages 4–6, who has witnessed domestic violence. A theoretical model is presented exploring how the therapeutic needs of parentified children who have experienced domestic violence can be met. Following the review of related literature, a three-phase drama therapeutic treatment protocol will be offered as a treatment to correct the potentially detrimental role reversal of parentification, prompted by domestic violence.
Reviews
Authors: McAdam Elizabeth , Haen Craig 
Published: April 2018

Abstract
Play in Family Therapy, Eliana Gil (2016) (2ND ED.) New York: The Guilford Press, 202 pp., ISBN-10: 1462517498, h/bk, $30.00; ISBN-10: 1462526451, p/bk, $21.25
Drama, Creativity and Intersubjectivity, Salvo Pitruzzella (2017) New York: Routledge, 148 pp., ISBN: 9781138927223, h/bk, $170.00; ISBN: 9781138927230, p/bk, $52.95
Performing status manoeuvres in conducting couples therapy
Authors: Wiener Daniel J. 
Published: April 2018

Abstract
Status, defined as the perceived importance of persons relative to others within a social system, is manifested by intentional behaviours, termed status manoeuvres (SMs), which aim to alter or maintain the status of each person relative to others. In couples therapy, the Treatment System (consisting of a therapist and the two client partners in a couples relationship) can be assessed meaningfully and changed by attending to its recurrent SMs. This article first illustrates SMs in dyads and triads by examples encountered in everyday life; next sets forth descriptions of three exercises useful in training therapists to detect and experience SMs; then offers examples of intentional SMs applicable to couples therapy; and finally presents a case vignette illustrating the effective performance of SMs by the therapist. Some advantages over other mental health professionals possessed by drama therapists in utilizing SMs are cited.
Improvisation and meditation as interactional (relational) approaches: Theory and practice for drama therapy for couples
Authors: Gale Jerry 
Published: April 2018

Abstract
This article presents an interactional framework for working with couples. Building on theories of social constructionism, systems theory and ethnomethodology, and incorporating practices of improvisation and meditation, a new framework is provided for conducting drama therapy with couples. This is a relational perspective that attends to interaction focused on dialogue. This relational perspective also brings into practice a theory-based approach to address relational power and social inequalities. How we interact determines how we come to assign and define what is real.
How we use action explorations to improve and enhance our relationship
Authors: Blatner Adam , Blatner Allee 
Published: April 2018

Abstract
‘Action explorations’ is the term we use for drama therapy and psychodrama techniques applied outside of psychotherapy. This article also describes how sublimated pretend play can be explored for role relief and fun in a relationship. These approaches have helped us as a couple to expand our capacity to understand and manage various day-to-day issues, compassionately respond to one another and provide new perspectives on disagreements. We have actively used these methods in our own relationship for over 40 years. Illustrated examples of these methods can serve as tools for practitioners to add to their therapeutic repertoire when working with couples, and more importantly, as ways of improving and enhancing their own interpersonal lives.