bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vocational engagement among young people entering mental health treatment compared with their general population peers
Authors: Caruana Emma , Farhall John , Cotton Susan M. , Parrish Emma , van‐der‐EL Kristi , Davey Christopher G. , Chanen Andrew M. , Bryce Shayden D. , Killackey Eoin , Allott Kelly 
Published: July 2018

AimTo compare rates of vocational engagement for youth entering specialist mental health treatment with the general population.MethodsA file audit retrieved vocational data for 145 youth aged 15 to 25 entering treatment. Clinical and population data were stratified by age and sex and compared between cohorts.ResultsCompared to the population, young people entering mental health treatment were less likely to have completed at least Year 11 in school (77% vs 42%, P < 0.001); and demonstrated higher rates of “Not in Education, Employment or Training” (9% vs 33%, P < 0.001). Individuals aged 15 to 18 years entering treatment experienced greater rates of educational disengagement than the population (30% vs 11%, P < 0.001), whereas people aged 19 to 25 years showed higher unemployment rates (52% vs 35%, P = 0.003).ConclusionsYouth entering specialist mental health treatment have marked levels of vocational disengagement compared to demographically‐matched peers. Early vocational intervention for these young people is essential.
Inherited or acquired modifiers of iron status may dramatically affect the phenotype in dehydrated hereditary stomatocytosis
Authors: Orvain Corentin , Da Costa Lydie , Van Wijk Richard , Pissard Serge , Picard Véronique , Mansour‐Hendili Lamisse , Cunat Séverine , Giansily‐Blaizot Muriel , Cartron Guillaume , Schved Jean‐François , Aguilar‐Martinez Patricia 
Published: July 2018

AbstractSevere iron overload is frequent in dehydrated hereditary stomatocytosis (DHSt) despite well‐compensated hemolysis and no or little transfusion requirement. We investigated 4 patients with proven DHSt, in whom the degree of hemolysis was closely related to iron status. Genetic modifiers increasing iron stores (HFE:pCys282Tyr, HAMP:c‐153C>T mutations) were accompanied with high liver iron concentrations and increased hemolysis, whereas therapeutic phlebotomies alleviated the hemolytic phenotype. There were no manifestations of hemolysis in one patient with low iron stores. Hemolysis reappeared when iron supplementation was given. The search for genetic or acquired modifiers of iron status and the modulation of iron stores may help in the management of these patients.
The spatial structure of variation in salamander survival, body condition and morphology in a headwater stream network
Authors: Lowe Winsor H. , Addis Brett R. , Smith Margaret R. , Davenport Jon M. 
Published: July 2018

Abstract

Understanding the spatial structure of individual variation is critical to assessing the mechanisms and scale of species‐level ecological and evolutionary responses. But the continuity and complexity of streams can make it difficult to discern spatial structure, and data on individual variation spanning spatial scales are rare.

Our goal was to objectively resolve the scale of ecological and evolutionary processes affecting the salamander Gyrinophilus porphyriticus by testing for spatial structure in individual variation across a headwater stream network. We used 3 years of spatially explicit capture–mark–recapture data from four headwater streams in the Hubbard Brook Experimental Forest, New Hampshire, USA, to test for individual variation in survival at three scales: (a) among c. 2‐km2 watersheds, (b) in 500‐m downstream and upstream reaches within watersheds and (c) in riffle and pool habitats along reaches. We also tested for corresponding spatial variation in individual body condition and morphology to gain insight on the causes and implications of variation in survival.

Survival of G. porphyriticus larvae was constant among watersheds, but differed by reach and habitat. Larval survival was higher in upstream reaches than downstream reaches, matching the distribution of predatory brook trout (Salvelinus fontinalis), which were restricted to downstream reaches. Larval survival was also higher in pools than riffles. Survival of G. porphyriticus adults was constant at all scales.

Larval body condition was higher in downstream reaches than upstream reaches. Both larvae and adults differed in morphology at the habitat scale: individuals in pools had longer limbs than individuals in riffles.

Negative covariation in larval survival and body condition at the reach scale suggests that there is a trade‐off between fitness and proximate performance along streams. The surprising differences between habitats in survival and morphology show the potential for fine‐scale ecology–evolution interactions in streams, potentially driven by differences in flow and gradient conditions in riffles and pools.

Our results suggest that the larval stage is key to understanding individual, population and community‐level processes affecting G. porphyriticus. More broadly, this research provides a novel empirical link between traditional studies of fine‐scale ecological complexity in streams and recent studies showing consistent spatial dynamics at the network scale. By documenting differences in survival, body condition and morphology at reach and habitat scales, we hope this work shows the feasibility and value of spatially explicit approaches to species‐level ecological and evolutionary questions in streams.
Molecular insights into paediatric breast fibroepithelial tumours
Authors: Tay Timothy K Y , Guan Peiyong , Loke Benjamin N , Nasir Nur Diana M , Rajasegaran Vikneswari , Thike Aye Aye , Lian Derrick , Chang Kenneth T E , Teh Bin Tean , Ng Cedric C Y , Tan Puay‐Hoon 
Published: July 2018

AimsThis study aims to examine the molecular genetics of paediatric breast fibroepithelial tumours through the targeted sequencing of 50 genes.Methods and resultsFormalin‐fixed paraffin‐embedded tissues of fibroepithelial tumours diagnosed in a cohort of patients aged 18 years and below were subjected to next generation sequencing using the Haloplex Target Enrichment System. Twenty‐five conventional and 17 juvenile fibroadenomas were studied, with MED12 mutations found in 53.8 and 35% of the tumours, respectively. There was also one benign fibroepithelial neoplasm with hybrid features of juvenile papillomatosis and infarcted benign phyllodes tumour‐like areas. Most tumours did not have mutations in well‐known cancer driver genes, none harboured TERT promoter mutations, while 25.6% (11 of 43) showed no mutations. Metachronous and synchronous tumours were found to have mutational heterogeneity with some containing mutations in MED12; other genes or no mutations were detected at all. Four of eight giant fibroadenomas (size 5 cm or larger) had no mutations detected, suggesting that there are other molecular mechanisms driving their growth. Tumours with MED12 mutations incidentally had a significantly higher stromal mitotic count compared with those without.ConclusionWhile paediatric fibroepithelial lesions can have cellular stroma potentially raising concern for phyllodes tumour, their lack of TERT promoter and cancer driver mutations is reassuring. The absence of mutations in a significant proportion of tumours, especially the giant fibroadenomas, warrants investigation of pathogenetic mechanisms beyond those involving the 50 genes.
Vitamin C deficiency in Australian hospitalised patients: an observational study
Authors: Sharma Yogesh , Miller Michelle , Shahi Rashmi , Doyle Adrienne , Horwood Chris , Hakendorf Paul , Thompson Campbell 
Published: July 2018

AbstractBackgroundVitamin C has anti‐oxidant properties and acts as a cofactor for several enzymes. Hypovitaminosis C has been associated with bleeding, endothelial dysfunction and death. The prevalence of hypovitaminosis C is unknown in Australian hospitalised patients, and its clinical relevance is uncertain.AimsTo determine the prevalence, characteristics and clinical outcomes of hospitalised patients with hypovitaminosis C.MethodsThis observational study included general‐medical inpatients in a tertiary‐level hospital in Australia. High‐performance liquid chromatography (HPLC) was used to determine plasma vitamin C levels. As per Johnston’s criteria, vitamin C levels of ≥28 μmol/L were classified as normal and <28 μmol/L as low. Clinical outcomes determined included length of hospital stay (LOS), nosocomial complications, intensive care unit admission and in‐hospital mortality.ResultsA total of 200 patients participated in this study, and vitamin C levels were available for 149 patients, of whom 35 (23.5%) had normal vitamin C levels, and 114 (76.5%) had hypovitaminosis C. Patients with hypovitaminosis C were older and had higher C‐reactive protein (CRP) levels. Median LOS was 2 days longer in patients with hypovitaminosis C (6 days (interquartile range (IQR) 4, 8) vs 4 days (IQR 3, 6), P = 0.02), and they had fourfold higher odds of staying in hospital for >5 days than those with normal vitamin C levels. Other clinical outcomes were similar between the two groups.ConclusionsHypovitaminosis C is common in hospitalised patients and is associated with prolonged LOS. Further research is needed to ascertain the benefits of vitamin C supplementation in vitamin C‐depleted patients.
Public Opinion and the Shaping of Immigration Policy in the European Council of Ministers
Authors: Arregui Javier , Creighton Mathew J. 
Published: July 2018

AbstractDo EU citizens’ preferences shape EU immigration policy? Using mixed‐methods and a unique data source on policy‐making in the EU Council of Ministers, we qualitatively and quantitatively assess the link between public sentiment and immigration policy‐making. Accounting for the economic, political and institutional context, we find that domestic public opinion does not play a central role in the policy positions adopted by Member States nor in the salience Member States attach to immigration issues during the negotiation process. We discuss the implications of these findings for our understanding of how EU immigration policy reacts to public opinion.
Construction of nursing‐sensitive quality indicators for haemodialysis using Delphi method
Authors: Gao Ju‐Lin , Liu Xiao‐Min , Che Wen‐Fang , Xin Xia 
Published: July 2018

Aims and objectivesTo provide a set of nursing‐sensitive quality indicators (NSQIs) for the evaluation of clinical nursing quality in haemodialysis unit.BackgroundThere are no established objective indicators for evaluation of the quality of nursing care in haemodialysis units in China.Design and methodsWe performed a literature search for eligible studies published from 2006–2016. A total of six studies were screened out from which 13 potential NSQIs were identified. Two rounds of Delphi surveys were conducted with the purpose of collecting opinions from a panel of independent experts. At last, 11 NSQIs were selected by consensus after exclusion of 8 NSQIs and addition of another 6 NSQIs.ResultsTwo rounds of expert inquiry were conducted; the questionnaire recovery rate was 100%. The average authoritative coefficients Cr for the two rounds were 0.79 and 0.90, respectively. The Kendall W values ranged from 0.273–0.388 (p < 0.001). Eleven NSQIs were identified: nurse‐to‐patient ratio, dialysis ultrafiltration rate compliance rate, KT/V compliance rate, incidence of emergency during haemodialysis, person‐time incidence rate of haemodialysis catheter‐related bloodstream infections, incidence of coagulation in extracorporeal circulation, incidence of blood loss in extracorporeal circulation, incidence of pseudoaneurysm induced by fistula puncture, incidence of falls among haemodialysis patients, emergency dialysis rate of outpatients and incidence of fistula complications.ConclusionThe identified NSQIs reflect three aspects of haemodialysis nursing quality: importance, rationality of calculation formula and applicability of data collection methods.Relevance to clinical practiceThe study provides a reference for the evaluation of clinical nursing quality in haemodialysis units.
Development and effect of a rational‐emotive‐behaviour‐therapy‐based self‐management programme for early renal dialysis patients
Authors: Kim Eun Sook 
Published: July 2018

Aims and objectivesThis study attempts to develop and determine the effect a rational‐emotive‐behaviour‐therapy‐based self‐management programme can have on the self‐efficacy, self‐care, depression and dyssomnia of patients undergoing early renal dialysis.BackgroundWhen renal dialysis is initiated, changes in everyday life are inevitable, and patients can suffer from both psychological and physical symptoms. Hence, to obtain the best results from renal dialysis, active self‐management is required.DesignQuasi‐experimental and longitudinal.MethodsForty‐eight early‐stage renal dialysis patients registered for and undergoing renal dialysis at a hospital located in S city participated in this study. These individuals were divided into an experimental and control group. The former group engaged in a self‐management programme consisting of eight weekly sessions of 50 min in duration, while the latter received traditional nursing care. Data were collected from June 2012–May 2014 through the use of a preliminary survey, a postsurvey that was distributed after the eight sessions of the self‐management programme had been completed, and a follow‐up survey allocated 4 weeks after the postsurvey. Data collection was conducted using the Self‐efficacy Scale, Self‐care Practice Scale, Beck Depression Inventory, and Korean Sleep Scale, and a repeated‐measures ANOVA was used to perform analysis.ResultsThe experimental group significantly differed from the control group in regard to self‐efficacy (p = 0.006) and self‐care (p = 0.031), but differences in terms of depression (p = 0.492) and dyssomnia (p = 0.141) were nonsignificant. In the experimental group, the depression decreased but then increased again, while the dyssomnia gradually decreased.ConclusionsThe provision of a rational‐emotive‐behaviour‐therapy‐based self‐management programme that involves lectures, discussions, teach‐backs, demonstrations and posters explaining diet choices improves the self‐efficacy and self‐care of patients receiving renal dialysis.Relevance to clinical practiceRational‐emotive‐behaviour‐therapy‐based self‐management programmes can be used in clinical nursing sites to improve the self‐efficacy and self‐care of early renal dialysis patients.
Frequency, nature and timing of clinical deterioration in the early postoperative period
Authors: Mohammed Iddrisu Suad , Considine Julie , Hutchinson Anastasia 
Published: July 2018

AbstractAims and objectivesTo establish the frequency of clinical deterioration in the early postoperative period in patients who have undergone general or orthopaedic surgery.BackgroundWorldwide, clinical deterioration is a significant problem in acute care settings. Early recognition and response to clinical deterioration is one of the ten National Safety and Quality Health Service Standards in Australia. However, there is limited understanding of the frequency of clinical deterioration in surgical patients.MethodsA point prevalence study was conducted from September–October 2014. The records of 100 consecutive in patients admitted for orthopaedic (n = 48) or general surgery (n = 52) to a health service in Melbourne, Australia, were audited. The frequency of clinical deterioration episodes was summarised using descriptive statistics.ResultsBaseline characteristics of the two patient groups were equivalent except that orthopaedic patients were older than the general surgery patients (median age 71 [IQR19] years vs. 62 [IQR17] years). There were 17 medical emergency team calls and 23 calls for urgent clinical review in 28 patients. The main indications for emergency calls were hypotension (26%), fever (19%), hypoxia (15%), tachycardia (13%) and altered blood glucose level (11%). The majority of episodes were managed on the ward, and there were oneICUtransfer and no cardiac arrest calls.ConclusionOne in four patients experienced early postoperative clinical deterioration. Hypotension was the most common trigger for escalation of care highlighting a need to optimise fluid and haemodynamic management of postoperative patients.Relevance to clinical practiceHaemodynamic instability leading to the activation of rapid response systems is very common in the immediate postoperative period. There is the need for locally tailored interventions to optimise fluid management and decrease incidence of further complications.
Use of a national identification database to determine the lifetime prognosis in cattle with necrotic laryngitis and the predictive value of venous pCO2
Authors: Pardon Bart , Ribbens Stefaan , Van Damme Lien , Vlaminck Lieven , Martens Ann , Deprez Piet 
Published: July 2018

BackgroundNecrotic laryngitis, caused byFusobacterium necrophorum, frequently requires surgical intervention (laryngostomy) in the chronic stage.Hypothesis/ObjectivesTo determine survival until slaughter of cattle surgically treated for necrotic laryngitis and to identify predictors of mortality.AnimalsA total of 221 cattle diagnosed with necrotic laryngitis by laryngoscopy and surgically treatedMethodsRetrospective cohort study. Clinical records were matched with the national cattle identification, registration, and movement database. Information on possible predictors including clinical examination, biochemistry, and surgery was collected. A multivariable Cox proportional hazard model was used to identify predictors of mortality.ResultsThe overall survival rate was 65.2% and 58.6% of the animals with a completed life cycle could be slaughtered. Animals <6 months old experienced significantly higher mortality risk (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.1‐3.5). The venous partial pressure of carbon dioxide (pCO2; HR, 2.4; 95% CI, 1.4‐4.2) at a 64.5 mm Hg cut‐off was most significantly associated with mortality. Sensitivity and specificity of the final model consisting of age and pCO2were 49.1 and 86.4%, respectively. Instead of pCO2, total carbon dioxide (TCO2) could also be used, with similar diagnostic accuracy.Conclusions and Clinical RelevanceThe lifetime prognosis for chronic necrotic laryngitis in cattle with surgical intervention appears fair. Age, venous pCO2and TCO2are easily accessible predictors of survival to support owners and veterinarians in their decision process of whether or not to operate and to identify high risk animals that require more intensive follow‐up.
Clinicopathological and immunohistochemical analysis of plasma cell‐rich rejection in renal transplantation: Involvement of intratubular Th1/Th2 balance in plasma cell enrichment
Authors: Nishimura Ayako , Masuzawa Naoko , Nakamura Tsukasa , Harada Shumpei , Nobori Shuji , Ushigome Hidetaka , Yoshimura Norio , Konishi Eiichi 
Published: July 2018

ABSTRACTAimPlasma cell‐rich rejection (PCRR) has been considered a subtype of acute T‐cell‐mediated rejection (ATCR). However, PCRR is recognized as refractory rejection and different from ATCR in various ways. In order to elucidate the pathogenesis of PCRR, we analysed PCRR clinicopathologically and immunohistochemically by comparing it with ATCR.MethodsTwelve cases of PCRR (PCRRs) and 22 cases of usual ATCR (ATCRs) diagnosed at our hospital between January 2008 and March 2017 were included. Between PCRRs and ATCRs, we compared clinical data, Banff classification, graft outcome and the total sum number of T‐bet‐ and GATA3‐positive lymphocytes infiltrating in tubular epithelium using immunohistochemistry.ResultsPlasma cell‐rich rejections occurred later than ATCRs (median time after transplantation 1340.5 days vs. 52.5 days). Serum creatinine levels at discharge after treatment were significantly higher in PCRRs than in ATCRs (median 2.38 vs. 1.65 mg/dL). Cumulative rate of graft loss was significantly higher in PCRRs than in ATCRs (1‐, 2‐ and 5‐year: 26.7%, 51.1% and 51.1% vs. 0%, 0% and 17.5%). For profiles of Th1 and Th2, we found significantly lower ratio of T‐bet/GATA3‐positive lymphocytes in PCRRs compared with ATCRs.ConclusionThis study suggests that PCRR is more refractory than ATCR and there are significant differences in populations of helper T‐cell subsets between them. We consider helper T‐cell subset analysis valuable for developing new treatment strategies for PCRR.
Interlobular hyaline arteriopathy reflects severe arteriolopathy in renal allografts
Authors: Oguchi Hideyo , Sakai Ken , Yamaguchi Yutaka , Mikami Tetuo , Nemoto Tetsuo , Ohashi Yasushi , Kawamura Takeshi , Muramatsu Masaki , Itabashi Yoshihiro , Shinoda Kazunobu , Hyodo Yoji , Takahashi Yusuke , Kawaguchi Yuki , Onishi Hiroka , Hamasaki Yuko , Shibuya Kazutoshi , Shishido Seiichiro 
Published: July 2018

ABSTRACTAimThe present study was performed to examine the clinicopathological significance of hyaline deposits in the smooth muscle of the interlobular artery (interlobular hyaline arteriopathy [IHA]) in renal allografts.MethodsTissue specimens that included the interlobular artery from biopsies performed from January 2012 to December 2015, as well as specimens from biopsies performed ≥1 year after living kidney transplantation were analyzed. Biopsies of recipients with new‐onset diabetes mellitus after transplantation were excluded, as well as those of recipients who had undergone transplantation because of diabetic nephropathy. Arteriolopathy was evaluated using the aah score determined by the Banff 2007 classification.ResultsIn total, 51 specimens with IHA lesions were identified among 381 biopsies obtained from 243 recipients performed ≥1 year after kidney transplantation. Among these 51 biopsies, 18 specimens had a score of aah3, 29 had a score of aah2, and four had a score of aah1. The incidence of IHA lesions was 3.6% at ≥1 to <4 years, 18.5% at ≥4 to <8 years, and 54.1% at ≥8 years. Older kidney grafts exhibited more IHA lesions. Among the biopsy specimens obtained ≥8 years after transplantation, no significant differences in the recipient or donor age, duration after transplantation, or prevalence of hypertension were observed between the IHA and non‐IHA groups. The aah scores were significantly higher in the IHA group ≥8 years after transplantation as determined by the mean score test (P < 0.01).ConclusionIHA in renal allografts is associated with severe arteriolopathy.
Viral infections directly involved in kidney allograft function
Authors: Masutani Kosuke 
Published: July 2018

ABSTRACTModern immunosuppressive therapy has dramatically reduced the incidence of acute rejection and improved graft survival in kidney transplant patients. However, infectious complications remain an important issue. Amongst the various pathogens, viruses such as adenovirus and polyomavirus BK can directly cause acute or chronic graft dysfunction. Adenovirus mainly causes haemorrhagic cystitis and tubulointerstitial nephritis in kidney transplant patients. While patients show apparent clinical symptoms such as fever, dysuria, gross haematuria, frequency and urgency of urination, and most patients show acute graft dysfunction, these symptoms and graft dysfunction are reversible. Polyomavirus BK infection, however, is asymptomatic but graft outcome is poor if the patient develops tissue‐invasive nephropathy confirmed by graft biopsy. Recently, an attempt to create a pathological classification for predicting the clinical course has been made by the Banff Working Group on Polyomavirus Nephropathy. With regards to treatment, the basic strategy is a reduction of calcineurin inhibitor and/or antimetabolites, and the effectiveness of several adjunct treatments has been investigated in several clinical trials. There are other unresolved issues, such as the diagnosis of subsequent acute rejection, the definition of remission, methods of resuming immunosuppression and long‐term follow‐up. Most of all, development of effective vaccines and novel drug discovery are necessary to prevent the development and progression of BKV‐associated nephropathy.