bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recent Changes in British Wage Inequality: Evidence from Large Firms and Occupations
Authors: Schaefer Daniel , Singleton Carl 
Published: June 2019

AbstractUsing a linked employer–employee dataset covering large firms, we present new evidence on British wage inequality trends over the past two decades. Differences between firms in the average wages they paid did not drive these trends. Between 1996 and 2005, greater wage variance within firms accounted for 86% of the total increase in wage variance among employees. In the following decade, wage inequality between firms continued to increase, whereas overall wage dispersion decreased. Approximately all the contribution to inequality dynamics from estimated firm‐specific factors, throughout the employee wage distribution, disappears after accounting for the changing occupational content of wages.
Ecthyma gangrenosum in a 3‐year‐old boy post‐heart transplantation
Authors: Fukui Kana Okazaki , Shoji Kensuke , Nagai Yusa , Shindo Takahiro , Hikosaka Makoto , Kuwahara Kosuke , Ishiguro Akira , Miyairi Isao 
Published: June 2019

AbstractEcthyma gangrenosum (EG) is a serious bacterial infection in immunocompromised patients. EG in transplant recipients is rarely reported and may go unrecognized, which may delay initiation of appropriate treatment. We report a case of EG in a pediatric heart transplant recipient who was treated successfully with antibiotics and surgical debridement.
Two consecutive Wolbachia‐mediated mitochondrial introgressions obscure taxonomy in Palearctic swallowtail butterflies (Lepidoptera, Papilionidae)
Authors: Gaunet Aurélien , Dincă Vlad , Dapporto Leonardo , Montagud Sergio , Vodă Raluca , Schär Sämi , Badiane Arnaud , Font Enrique , Vila Roger 
Published: June 2019

AbstractSwallowtail butterflies (Papilionidae) are among the most spectacular and well‐known Lepidoptera in the European fauna, but their systematics is not fully elucidated. A notable case is that of Iphiclides feisthamelii which, after more than 180 years since description, still has a debated status, being often considered as a subspecies of Iphiclides podalirius. To elucidate the relationship between the two taxa and the evolutionary processes that led to their separation, we combine mitochondrial and nuclear DNA (mtDNA and nDNA) data, Wolbachia screening, genitalia morphology and wing UV reflectance. Our results show that the two taxa clearly differ in male and female genital morphology, male wing UV reflectance and nDNA. Two Wolbachia strains were found to widely infect the studied samples, apparently explaining the phylogeographic pattern displayed by mtDNA. The available data point towards a historical Wolbachia infection that spread from I. podalirius to I. feisthamelii and produced a mitochondrial introgression. Currently, a new Wolbachia strain is spreading across mainland populations of I. podalirius, mediating once more a mitochondrial genetic sweep, which has already infected and introgressed I. feisthamelii populations in south‐eastern France. We conclude that, given the marked differences in morphology and nDNA between the two taxa, and the apparent restriction of hybridization to a narrow contact area where non‐hybrid specimens are common, the taxon feisthamelii should be considered as a separate species. Within this species, two well‐differentiated nDNA lineages that represent European and Maghrebian populations are documented, here proposed as subspecies. The case of, presumably, two consecutive Wolbachia‐mediated mitochondrial introgression events, further supports the view that infection by this endosymbiont may be frequently related to mito‐nuclear discordance in insects.
Relict distribution of Microhyla (Amphibia: Microhylidae) in the Ryukyu Archipelago: High diversity in East Asia maintained by insularization
Authors: Tominaga Atsushi , Matsui Masafumi , Shimoji Naoko , Khonsue Wichase , Wu Chi‐Shiun , Toda Mamoru , Eto Koshiro , Nishikawa Kanto , Ota Hidetoshi 
Published: June 2019

AbstractThe Ryukyu Archipelago, located at the southwestern part of Japan, is known as a group of continental islands and harbours many endemic taxa, supposedly reflecting its fairly long isolation from the Eurasian continent, Taiwan and the Japanese main islands. Microhyla okinavensis has been known as an endemic member of the terrestrial fauna of this archipelago. Molecular phylogenetic analyses using samples from nearly all island populations of the species and representative samples of other east Asian congeneric species revealed that M. okinavensis consists of four distinct subclades, of which the Amami, Okinawa and Miyako subclades, though exhibiting distinct genetic differentiations from each other, formed a monophyletic group (clade A). The remaining Yaeyama subclade was exclusively sister to M. mixtura from inland China, forming another monophyletic group (clade B), rendering M. okinavensis in the current definition paraphyletic. These results, as well as estimated dates of divergence from related taxa, indicate that M. okinavensis actually includes more than one distinct species. The results indicate that M. okinavensis and M. mixtura are relict species with disjunct distributions which had been most probably caused by invasion of M. fissipes in intervening areas.
Modulation of seismic activity in Kīlauea’s upper East Rift Zone (Hawaiʻi) by summit pressurization
Authors: Wauthier Christelle , Roman Diana C. , Poland Michael P. 
Published: June 2019

AbstractKīlauea Volcano (Hawaiʻi, USA) is underlain by a complex, laterally extensive magmatic plumbing system. Although in recent decades it has mainly erupted through vents along the middle East Rift Zone and summit caldera, eruptions can occur anywhere along its laterally extensive rift zones, as demonstrated by the dramatic eruptive activity of 2018. Forecasting eruptive activity requires an understanding of whether an episode of volcano-seismic unrest at Kīlauea and similar volcanoes is caused directly at the edges of an active intrusion or reservoir, or in a volume of wall rock at a distance from the intrusion. Seismic unrest in Kīlauea’s upper East Rift Zone (UERZ) has to date been interpreted as the result either of magma intrusion in this region of the volcano or of stresses due to seaward flank migration. However, recent observations suggest that UERZ seismicity may result from variable pressurization of Kīlauea’s summit magma system. We analyze seismic and deformation (multi-temporal interferometric synthetic aperture radar [InSAR] and GPS) data during a period of variable summit deformation and UERZ seismicity in mid- to late 2007 and calculate Coulomb stress changes on UERZ faults due to modeled summit inflation or deflation. UERZ seismicity during our study period can be explained entirely by stresses arising from pressure changes within Kīlauea’s summit reservoirs. Furthermore, a comparison of UERZ fault plane solutions (FPSs) calculated for this study to published UERZ FPSs for previous periods suggests that the UERZ has undergone a transition from a mechanically strong, discontinuous, and immature magma transport system to a mature, mechanically weak, and fully connected transport system over the course of the 1983–2018 eruption.
P010 Influencing change: impactful communication – paediatric diabetes prescriptions
Authors: Barbour Emma 
Published: June 2019

AimThe paediatric wards in two hospital sites within one Trust deal with the supply of newly diagnosed diabetic prescriptions differently and the aim of this project was to have uniformity throughout the Trust with regards the supply of these discharge items, with both hospital pharmacy sites supplying the discharge items. Having completed the Pharmacy Management Clinical Leadership in Pharmacy (CLIP) program I wanted to use new skills learned throughout CLIP to be able to lead on influencing a change of practice on one hospital site and have uniformity across the Trust. I wanted to be able to persuade one site to change their practice of over 20 years and start getting the items dispensed through the hospital pharmacy.MethodsUsing the GROW model I ensured I was clear on what my plan was and that my goals were SMARTER. I had to deal with a number of different professionals and was prepared for some conflict as was expecting resistance to change. I met with the key stakeholders with regards the change. I communicated with medical staff, nursing staff and dispensary manager in the relevant hospital, and used the Colours Model1 to help me with this. The Colours Model is a simple and effective way to analyse our own communication preference and also to understand the preference of others. Knowing this I was then able to flex my communication style accordingly to engage with all parties more effectively. I identified what ‘colour’ I classed each group as and used different styles of communication for each. I also reviewed the records of newly diagnosed diabetic patients discharged from the paediatric ward over a period of one year to determine what discharge letter was given to the patient, and what detail was on it.ResultsOf the patients discharged in 2017, only 44% had a discharge on the relevant electronic system with pharmacy items on it, with just one having all required items. I communicated the following way with the different staff, once I had identified their ‘colour’. Medical staff (GREEN - Amiables, who are task focused and have indirect style). I focused on whole team and explained the benefit for change across interface. Nursing staff (RED - Drivers, who are task focused and have a direct style). I got straight to the point, explained reasons and results. Dispensary manager (BLUE - Analyticals, who are task focused and have an indirect style). I emailed in advance. Got to the point and gave exact details.ConclusionAll Staff agreed to the change in process in the paediatric ward. All discharges for newly diagnosed diabetic children on both sites will be electronically written and dispensed within the hospital pharmacy. The outcome for patient care is a more seamless transition of care between interface. By undertaking the CLIP programme I acquired a number of important skills to enable me to successfully lead this change. I made my voice heard and led with impactful communication.ReferenceCLIP workbook Leading with Impactful Communication Chapter 5 The Colours ModelJanuary 2018.
P012 Preliminary experience of the use of oral posaconazole and terbinafine to treat lomentospora prolificans and scedosporium apiospermum in children with cystic fibrosis
Authors: Bentley Sian , Balfour-Lynn IM , Carr SB 
Published: June 2019

BackgroundItraconazole and voriconazole are the drugs of choice for Lomentospora prolificans and Scedosporium apiospermum. Posaconazole, is often substituted when there is intolerance or lack of efficacy to first line agents. Terbinafine, an allylamine antifungal, is recommended with an azole for the treatment of L.prolificans, though there is no published use of this combination in children with cystic fibrosis (CF).AimTo evaluate the safety, tolerability and efficacy of this regimen in CF children.MethodsRetrospective case note review of CF children receiving terbinafine and posaconazole, from Nov 2015 to Nov 2016. Children were identified from pharmacy records and clinical data collected from case notes and laboratory records.ResultsThere were 4 children (all girls), median age 15 years (range 10–16), with a median FEV1% predicted of 70.5% (range 55–88%). 2 children chronically isolated L.prolificans, 2 isolated S.apiospermum. 3 also had CF related diabetes and chronic Pseudomonas aeruginosa infection. 1 child received treatment for 6 weeks. 3 children are taking long- term treatment (median 50 weeks; range 35–59). 2 children improved FEV1% predicted with treatment by 14% and 15%; one was stable. Importantly the trend graphs for lung function in these 3 children appear to stabilise post initiation of treatment. One child did not improve her lung function but also had recurrent MRSA infections and significant nutritional complications. No adverse effects from the combination were reported. Posaconazole levels were therapeutic (>1 mg/l) in all children (range 1.22–3.85 mg/l). Terbinafine levels were not measured.ConclusionIn this small case series, combination treatment with posaconazole and terbinafine was well tolerated and a positive clinical effect on lung function was evident. This is the first report on the use of this regimen for this indication in CF children and we will continue to use it, whilst gathering safety and efficacy data.
P036 Patients with learning disability, views on the use of a patient-held medication passport
Authors: Crook Joanne , Patel Deepa , Marvin Vanessa , Jubraj Barry 
Published: June 2019

AimTo establish the views of adolescent patients with learning disabilities and their carers, of the patient-held medication passport (My Medication Passport-MMP). MethodsA questionnaire was devised to find out if patients/carers thought a patient-held record of their medications (the MMP) was useful and to suggest improvements as appropriate. The MMP is a patient-held record of medicines use available as a passport sized booklet.1 MMPs were distributed to patients and carers for them to read and review at a patient focus group. Ethics approval was not required for this study.Results20 questionnaires were sent and a total of 17 completed questionnaires were returned (85% response rate). 70% (n=12) of the questionnaires were completed by carers, 24% (n=4) by family members and 1% (n=1) by a patient. 100% (n=17) of carers/patients who reviewed the MMP found it useful. When asked about features they liked about MMP; Seven carers noted the MMP was easy to use; four carers felt MMP was a good way to keep (personal) medicines information up to date; with three further clarifying that it could be used as a ‘concise way of keep track (of medicines)’ and two specified they liked that ‘all the information is in one book’. When Patients/carers were asked for ways MMP could be improved; two carers asked for more space to document past medication, including an area to ‘keep track of the behaviours and how it is exhibited because of the medication’; one carer noted that ‘some youngsters would benefit from more visual learning’ and one asked for a version to be made available via app on smart phone. Limitations included a small sample with limited exposure to MMP. The patient group sampled may not be representative.ConclusionPassports as tools aim to help patients better manage their medicines and have been successfully used in a patient with learning disability.2 It is encouraging to see that this small group of patients with learning disability find the MMP useful. Suggested adaptations to MMP for this patient group included it being more visual, and having areas for past medication. Other trials of MMP have suggested that it may require a section surrounding medicines administration. Patients have since been directed to the MMP app which can be downloaded onto a smartphone. There are many opportunities for future work including conducting an evaluation of the MMP in use over time and across different sectors, and to determine what patients actually record in the MMP.ReferencesBarber S, et al. Evaluation of My Medication Passport: a patient-completed aide-memoire designed by patients, for patients, to help towards medicines optimisation. BMJ Open4(8). https://bmjopen.bmj.com/content/4/8/e005608Jubraj B. Use of a medication passport in a disabled child seen across many care settings. BMJ Case Reports. 25 February 2015; http://casereports.bmj.com/content/2015/bcr-2014-208033Save
P040 Monitoring defibrotide usage in paediatric patients undergoing HSCT with known risk factors for developing VOD/SOS
Authors: Beirne Michelle , Butler Eileen , Fitzpatrick Michael 
Published: June 2019

AimDefibrotide is licensed for the treatment of hepatic venous occlusive disease (VOD) following haematopoeitic stem cell transplant (HSCT). Up to April 2015 defibrotide was used as prophylaxis against VOD in our HSCT patients who were considered at high-risk for developing VOD. This practice was discontinued due to the lack of evidence of efficacy and increasing costs of the drug. The aims of this audit were to identify patients undergoing HSCT who had one or more risk factors for the development of VOD, to measure the incidence of VOD in this patient cohort after the discontinuation of prophylactic defibrotide and calculate the cost savings associated with the discontinuation of prophylaxis.MethodsAll patients who underwent HSCT between Oct 2015 and Dec 2016 were included. Patient’s medical records were reviewed and risk factors for VOD were identified. Risk factors for developing VOD post HSCT in our patient cohort were defined following a literature review of peer-reviewed papers identifying paediatric specific risk factors.1 2 These were namely: patients aged ≤2 years, patients receiving a second transplant, conditioning with IV busulfan ± cyclophosphamide, and previous treatment with gemtuzumab ozogamicin. The theoretical dose of defibrotide for patients with known risk factors was calculated based on their weight at start of conditioning and the duration of treatment was based on the number of days conditioning the patient received plus 30 days following the date of transplant. The cost of a theoretical course of defibrotide for these patients was calculated to determine cost savings.ResultsOf the 27 patients included in the study, 16 (59%) had one or more risk factors. The most common risk factor identified was conditioning with busulfan in patients ≤2 years of age (26% of patients). At present no patient post HSCT has developed VOD requiring treatment. One patient developed sub-clinical VOD which required no treatment and resolved spontaneously. Another patient received defibrotide as prophylaxis for VOD due to severe liver dysfunction prior to HSCT. There were substantial cost savings following the discontinuation of prophylactic defibrotide with a total of 2876 vials (180 vials/patient) saved during this time period.ConclusionThis audit validates our decision to discontinue use of prophylactic defibrotide and reserve its use for treatment of early VOD.ReferencesCheuk D, Wang P, Lee T, Chiang A, Ha S, Lau Y, Chan G. Risk factors and mortality predictors of hepatic veno-occlusive disease after pediatric hematopoietic stem cell transplantation. Bone Marrow Transplantation. 2007;40:935–944.Mohty M, Malard F, Abecassis M, Aerts E, Alaskar A, Alijurf M, NiChonghaile M. Sinusoidal obstruction syndrome/veno- occlusive disease: current situation and perspectives- a position statement from the European Society for Blood and Marrow Transplantation (EBMT). 2015; Bone Marrow Transplantation. 2015;50:781–789.
P045 Value from your vitamins – optimising vitamin supplementation in children with cystic fibrosis
Authors: Turner Eleanor 
Published: June 2019

AimTo optimise fat soluble vitamin supplementation in children with CF in a tertiary children’s hospital and primary care. To compare supplementation of individual vitamins and supplementation with a new multivitamin preparation against national guidelines, cost and patient acceptability.1MethodsComparison of current practice (supplementation of individual vitamins) with a new multi-vitamin preparation, Paravit-CF. Form and dose of each of the fat soluble vitamins was compared against national CF Trust guidelines for nutrition.1 Cost of treatment per day was compared. Patient acceptability was explored by comparing medication burden and with a focus group made up of representatives from the CF multi-disciplinary team (MDT) including, consultants, specialist nurses, dieticians and a pharmacist.ResultsCurrent approach to vitamin supplementation is not in line with the CF Trust guidelines for nutrition. Supplementation with Paravit-CF preparations meets recommendations made in the CF Trust guidelines for nutrition for patients of all ages except for infants. Infants will receive vitamin A at higher doses than recommended. Cost of vitamin supplementation is reduced by approximately 50% when using Paravit-CF compared with current practice. Medication burden is reduced by more than 50% when using Paravit-CF compared with current practice. Main themes from the MDT focus group were that Paravit-CF liquid is colourless, taste free, odour free and can be mixed into food, all of which may aid compliance. Paravit-CF preparations also vegetarian friendly and comply with halal and kosher regulations. Unlike current practice, Paravit-CF does not offer flexibility in dosing of individual vitamins.ConclusionFat soluble vitamin supplementation using Paravit-CF offers several advantages over supplementation of individual vitamins. Paravit-CF offers vitamin supplementation at doses in line with the recommendations made by the CF Trust, is cheaper and reduces the medication burden for patients. Locally, the decision has been made to switch to Paravit-CF as first line vitamin supplementation in children with CF. Future work is planned to assess clinical efficacy and financial impact of the switch.ReferenceCystic Fibrosis Trust. Nutritional Management of Cystic Fibrosis. Second Edition. September 2016. Available from: https://www.cysticfibrosis.org.uk/the-work-we-do/clinical-care/consensus-documents (Accessed 10 July 2018)