bluuebunny/crossref_metadata_2025_split huggingface dataset:
Positive Behavior Supports for Individuals who Are Deafblind with Charge Syndrome
Authors: Bruce Susan M. , Bashinski Susan M. , Covelli Andrea J. , Bernstein Veronika , Zatta Mary C. , Briggs Stevi 
Published: December 2018

Introduction The purpose of this study was to identify effective individualized positive behavior support strategies and cognitive behavior therapy strategies for young adults who are deafblind. It discusses findings specific to four young adult students with CHARGE syndrome. Methods This collaborative action research study employed collective case study design and elements of grounded theory analysis. Principles of positive behavior support and modified cognitive behavior therapy supported the identification and implementation of individualized behavioral interventions that addressed environment arrangement, sensory needs and sensitivities, and how adults communicated with the students. Results Eight themes were identified as being important to each of the students, although to varying degrees. These were: provide structure, establish and maintain a positive climate, address students’ sensory needs and sensitivities, support on-task behavior, support transitions between activities and environments, support mature behavior, support students in coping with anxiety, and use adult language supports. Each theme included multiple strategies. Discussion Proactive and reactive strategies must be individualized even when children share an etiology. Educational team members must know each student's preferences, likes, dislikes, reinforcers, and unique communication needs in order to identify and effectively implement behavioral supports. Modified cognitive behavior therapy may be helpful in addressing the anxiety experienced by individuals with CHARGE syndrome. Teams require time to collaborate on behavioral assessment, the identification of individualized behavioral strategies, and the effectiveness of behavioral plans. Implications for practitioners Providing well-structured environments and teaching rules and routines can reduce anxiety because students know what to expect. Educational team members should prevent sensory overload, provide structured desensitization opportunities, and teach relaxation techniques to these students. Adult communication must be positive, clarify what will happen next, and redirect behaviors when needed.
A Phenomenological Inquiry into the Meaning Ascribed to Physical Activity by Brazilian Men with Visual Impairments
Authors: Haegele Justin A. , Hodge Samuel R. , Filho Paulo Gutierres , Ribeiro Nillianne , Martínez-Rivera Christian 
Published: December 2018

Introduction Research examining how adults with visual impairments experience physical activities is currently limited to specific age ranges (for example, youths or older adults) and geographic locations (such as Europe and North America). In an effort to extend the current literature base, the study presented here focuses on a cohort of young or middle-aged adults with visual impairments who live in Brazil. Thus, the purpose of this exploratory study was to examine the meaning Brazilian adults with visual impairments ascribed to their physical activity experiences. Methods This study was situated in the qualitative paradigm utilizing a phenomenological design. Three male participants (aged 22 to 47 years) were purposively recruited to participate. The main source of data for this study was a focus group interview using an open-ended, guided approach that was recorded on audiotape. A three-step, line-by-line, thematic analysis, informed by the phenomenological research approach, was utilized to extract meaning from the participants’ experiences. Several strategies were employed to reduce subjective bias, establish trustworthiness, and enhance transferability. Results Two interrelated themes emerged when participants described how they experienced physical activities and the meaning they ascribed to those experiences. The first theme, physical activity–indispensable, describes the importance the participants ascribed to physical activity engagement and the benefits that they garnered from these experiences. The second theme, perceived physical activity impediments, exposed the obstacles participants experienced when trying to engage in physical activities. Discussion This study's findings expose the meaning that a cohort of Brazilians with visual impairments ascribe to physical activity engagement. The participants explained how engagement in physical activity helped alleviate some social issues they previously experienced, but also noted barriers to engaging in these activities. Implications for practitioners Programs targeting physical activity promotion for adults with visual impairments should show the reported benefits of engaging in physical activity programs while attempting to manage potential obstacles that would discourage a physically active lifestyle.
Electroretinograms in idiopathic infantile nystagmus, optic nerve hypoplasia and albinism
Authors: Kurent Alma , Brecelj Jelka , Stirn-Kranjc Branka 
Published: December 2018

Purpose: To study electroretinograms in infantile nystagmus syndrome associated with idiopathic infantile nystagmus, optic nerve hypoplasia, and albinism. Methods: A total of 30 children with idiopathic infantile nystagmus, 18 with optic nerve hypoplasia, and 18 with albinism were studied. Three electroretinogram protocols were applied according to child’s age: 58 (mean: 2.0 years) were recorded with skin electrode to Great Ormond Street Hospital protocol, 11 (mean: 5.3 years) with skin electrode to International Society for Clinical Electrophysiology of Vision protocol, and 7 children (mean: 12.2 years) with HK electrode to International Society for Clinical Electrophysiology of Vision protocol. The electroretinograms were compared to those of age-matched controls. Results: Electroretinogram waveforms in idiopathic infantile nystagmus, optic nerve hypoplasia, and albinism were comparable to controls in all protocols. Electroretinogram amplitudes in idiopathic infantile nystagmus group showed increased white scotopic and photopic electroretinograms in 26 children (skin electrode to Great Ormond Street Hospital protocol), no difference to the controls in 3 children (skin electrode to International Society for Clinical Electrophysiology of Vision protocol), and increased rod electroretinogram in 3 children (HK electrode to International Society for Clinical Electrophysiology of Vision protocol). Optic nerve hypoplasia group showed increased white scotopic, photopic, and blue electroretinograms in 15 children (skin electrode to Great Ormond Street Hospital protocol); increased 30-Hz electroretinogram in 3 children (HK electrode to International Society for Clinical Electrophysiology of Vision protocol); and reduced combined rod-cone, cone, and 30-Hz electroretinograms in 3 children (skin electrode to International Society for Clinical Electrophysiology of Vision protocol). Albinism group showed increased white scotopic, photopic, and 30-Hz electroretinograms in 17 children (skin electrode to Great Ormond Street Hospital protocol), while it showed reduced cone and 30-Hz electroretinograms in 5 children (skin electrode to International Society for Clinical Electrophysiology of Vision protocol). Implicit times were shorter in albinism. Conclusion: Electroretinogram waveforms in idiopathic infantile nystagmus, optic nerve hypoplasia, and albinism were normal with mostly increased electroretinograms, while reduced electroretinograms did not show a specific pattern as in early-onset retinal dystrophies.
Effectiveness of telemonitoring versus usual care for chronic obstructive pulmonary disease: A systematic review and meta-analysis
Authors: Sul Ah-Ram , Lyu Da-Hyun , Park Dong-Ah 
Published: December 2018

Aims The purpose of this research was to investigate the effectiveness of telemonitoring for chronic obstructive pulmonary disease. Methods We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials and CINAHL up to September 2018. We selected randomised controlled trials comparing telemonitoring and control groups for chronic obstructive pulmonary disease management. Two reviewers independently examined articles based on eligibility, extracted data and evaluated the risk of bias. The Cochrane tool was applied for assessing the risk of bias. The 95% confidence interval was calculated. Results A total of 28 randomised controlled trials were included. Meta-analysis revealed that there were no variables showing a statistically significant difference between telemonitoring and control groups. Chronic obstructive pulmonary disease exacerbation rate (six studies) was not different between two groups (risk ratio 0.67, 95% confidence interval 0.31–1.42). Subgroup analysis showed that telemonitoring reduced exacerbation rates when the intervention continued for longer than six months or pulmonary function was monitored. No differences between groups were noticed for mortality (seven studies, risk ratio 0.89, 95% confidence interval 0.60–1.34). Similarly, no differences between groups were observed in the patient-reported outcomes (St George’s Respiratory Questionnaire, Chronic Respiratory Disease Questionnaire-Dyspnea score) and for health service utilization (length of hospital stay, number of hospital admissions, number of emergency room visits). Conclusions Telemonitoring for chronic obstructive pulmonary disease was unlikely to result in statistically significant improvements in health outcomes. However, our novel finding was that at least six months of intervention duration and monitoring of pulmonary function play roles in activating the effects of telemonitoring.
Between empowerment and discipline: Practicing contractualism in social work
Authors: Solvang Ida M , Juritzen Truls I 
Published: December 2018

Summary As a contemporary development in welfare policy, contractualism stipulates discretionary rights and obligations for each client, some of whom are quite vulnerable. The contractual design promotes empowerment, but entails sanctions for non-compliance. This article investigates how rationales of empowerment and discipline shape social work practice and uses a Foucauldian governmentality perspective to investigate interrelations between political objectives and individual practices. Two contrasting cases are used to explicate how rationales of empowerment and discipline simultaneously operate in social work within the contractual design. Findings With its emphasis on clients’ responsibility and empowerment, contractualism is a subtle yet efficient mode of governance, but disciplinary actions both rely on and undermine objectives of empowerment. Applications Social workers and clients must manoeuvre complexities as they exert empowering and disciplinary practices. These rationales of governance should be explicit and subject to professional and ethical considerations in the same way as other forms of professional authority directed at reliant, vulnerable clients.
Processing Escape Mechanisms Through Altered Proteasomal Cleavage of Epitopes Affect Immune Response in Pulmonary Neuroendocrine Tumors
Authors: Wessolly Michael , Walter Robert F. H. , Vollbrecht Claudia , Werner Robert , Borchert Sabrina , Schmeller Jan , Mairinger Elena , Herold Thomas , Streubel Anna , Christoph Daniel C. , Eberhardt Wilfried E. E. , Kollmeier Jens , Mairinger Thomas , Schmid Kurt W. , Wohlschlaeger Jeremias , Hager Thomas , Mairinger Fabian D. 
Published: December 2018

Background: Immunotherapy, especially immune checkpoint inhibition, is one of the most sophisticated approaches in cancer therapy. Immune checkpoint inhibition has already been successfully applied for treatment of non-small cell lung cancer and various other entities. Unfortunately, 60% of the cases show signs of therapy resistance. Additionally, a proportion of cases shows initial insensitivity to immune checkpoint inhibition. We consider a novel escape mechanism in association with deficient proteasomal epitope processing to be one prominent reason for initial insensitivity and therapy resistance. Therefore, we aim to identify mutations in association with these so-called processing escapes, in a highly diverse collective of pulmonary neuroendocrine lung tumors. Materials and Methods: Seventy representative tumor specimens of pulmonary neuroendocrine lung tumors were analyzed retrospectively via immunohistochemical detection of CD4, CD8, CD68, and CD20 as well as programmed cell death protein 1 and programmed cell death 1 ligand 1 for tumor immune infiltration and composition. Afterward, samples were screened for alterations in 48 genes, including 221 known mutational hotspots by massive parallel sequencing using the Illumina TruSeq Amplicon-Cancer Panel. For prediction of proteasomal cleavage probabilities, an R implementation of the machine learning tool NetChop 3.1 was utilized. Results: Immune cell infiltration of different compositions could be found in the majority of tumors. Deficient epitope processing was revealed to be a common event in those with steady distribution across all different subtypes. Despite immune infiltration, no significant antitumor response could be detected. Conclusion: Since it is widely acknowledged that tumors need to avoid the immune system to ensure their survival, processing escapes should already be present during primary tumor development. In line, processing escapes can be found in all tumors, regardless of subtype and mutational burden. Furthermore, there is solid evidence that processing escapes have a negative impact on the antitumor activity of tumor infiltrating immune cells.
Self-report sleep quality combined with sleep time variability distinguishes differences in fatigue, anxiety, and depression in individuals with multiple sclerosis: A secondary analysis
Authors: Siengsukon Catherine F , Alshehri Mohammed , Aldughmi Mayis 
Published: December 2018

Background Nearly 70% of individuals with multiple sclerosis report sleep disturbances or poor sleep quality. Sleep disturbances may exacerbate or complicate the management of multiple sclerosis-related symptoms. While sleep variability has been associated with several health outcomes, it is unclear how sleep variability is associated with multiple sclerosis-related symptoms. Objective The purpose of this study was to determine how total sleep time variability combined with self-reported sleep quality is associated with fatigue, depression, and anxiety in individuals with multiple sclerosis. Methods This study involved a secondary analysis of actigraphy data and questionnaires to assess sleep quality, fatigue, anxiety, and depression. Results There were significant differences between the Good Sleepers (good sleep quality/low sleep time variability; n=14) and Bad Sleepers (poor sleep quality/high sleep time variability; n=23) in overall fatigue ( p=0.003), cognitive ( p=0.002) and psychosocial fatigue ( p=0.01) subscales, and in trait anxiety ( p=0.007). There were significant differences in state ( p=0.004) and trait ( p=0.001) anxiety and depression ( p=0.002) between the Good Sleepers and Poor Reported Sleepers (poor sleep quality/low sleep time variability; n=24). Conclusion These results indicate different factors are associated with poor sleep quality in individuals with low versus high total sleep time variability. Considering the factors that are associated with sleep quality and variability may allow for better tailoring of interventions aimed at improving sleep issues or comorbid conditions.
Organic geochemical characteristics and hydrocarbon generation simulation of shallow sediments in Shaobo Lake, Eastern China
Authors: Niu Congkai , Jiang Fujie , Li Yaxi , Chen Jian , Jiang Wenli , Shi Zhengyong 
Published: December 2018

We selected the two Holocene shallow surface sediments (depths of 1.42–1.48 and 1.56–1.62 m) of Shaobo Lake in Yangzhou City, Jiangsu Province, China, to analyze the geochemical characteristics and hydrocarbon generation ability of organic matter (OM) from its raw state to the formation of kerogen. We have used the Rock-Eval (RE) VI, low-temperature hydrous pyrolysis, and macerals identified under microscopy to test the whole-rock samples, as well as gas chromatography-mass spectrometry and gas chromatography analysis of the pyrolysis oil and pyrolysis gas. The results indicate that the surface sediments had poor to fair gas-prone hydrocarbon generation potential and that the type of insoluble OM was III-IV. The macerals were dominantly vitrinite, followed by sapropelic amorphogen. Bulk geochemistry data and biomarker compositions indicated that the studied samples deposited in a lacustrine environment with suboxic to anoxic conditions and OM of mixed plankton, bacterial, and land plant origin. RE data and the biomarker index suggested that unheated and thermally simulated samples were from immaturity to just entering the maturity stage. Under the thermal simulation conditions of 250°C–450°C, a peak of pyrolysis oil appeared at 300°C, and the yield increased slowly after 350°C. At 300°C, the hydrocarbon gas (C1–C5) began to produce. As the simulated temperature increased, the yield (in volume) of the hydrocarbon gas increased exponentially and the methane content was also gradually enriched. In general, thermal simulation experiments indicated that the OM could generate slight hydrocarbon from the death of living organisms to early diagenesis.
Continuous Etomidate Infusion for the Management of Severe Cushing Syndrome: Validation of a Standard Protocol
Authors: Carroll Ty B , Peppard William J , Herrmann David J , Javorsky Bradley R , Wang Tracy S , Patel Hina , Zarnecki Katarzyna , Findling James W 
Published: December 2018

Abstract

Objective
Demonstrate the safety and efficacy of a standardized intravenous etomidate infusion protocol in normalizing cortisol levels in patients with severe and life-threatening hypercortisolism.

Methods
A retrospective case series of seven patients representing nine episodes of severe hypercortisolism at two large academic medical centers was conducted. Patients were included in this series if they received an etomidate infusion for the treatment of severe and life-threatening hypercortisolism. The etomidate infusion was administered via a newly developed protocol designed to safely reduce cortisol levels until more long-term medical or definitive surgical therapy could be instituted.

Results
Seven patients representing nine episodes received etomidate treatment. In eight of nine episodes of therapy, rapid control of hypercortisolemia was achieved, generally defined as a serum cortisol level of 10 to 20 µg/dL. Patients with a median baseline cortisol of 105 µg/dL (range, 32 to 245 µg/dL) achieved a median nadir serum cortisol of 15.8 µg/dL (range, 6.9 to 27 µg/dL) after a median of 38 hours (range, 26 to 134 hours).

Conclusions
A standardized continuous intravenous etomidate infusion protocol is a safe and effective means of achieving a serum cortisol level of 10 to 20 µg/dL in patients with severe hypercortisolemia.
Estimating the contribution of studies in network meta-analysis: paths, flows and streams
Authors: Papakonstantinou Theodoros , Nikolakopoulou Adriani , Rücker Gerta , Chaimani Anna , Schwarzer Guido , Egger Matthias , Salanti Georgia 
Published: December 2018

In network meta-analysis, it is important to assess the influence of the limitations or other characteristics of individual studies on the estimates obtained from the network. The proportion contribution matrix, which shows how much each direct treatment effect contributes to each treatment effect estimate from network meta-analysis, is crucial in this context. We use ideas from graph theory to derive the proportion that is contributed by each direct treatment effect. We start with the ‘projection’ matrix in a two-step network meta-analysis model, called the H matrix, which is analogous to the hat matrix in a linear regression model. We develop a method to translate H entries to proportion contributions based on the observation that the rows of H can be interpreted as flow networks, where a stream is defined as the composition of a path and its associated flow. We present an algorithm that identifies the flow of evidence in each path and decomposes it into direct comparisons. To illustrate the methodology, we use two published networks of interventions. The first compares no treatment, quinolone antibiotics, non-quinolone antibiotics and antiseptics for underlying eardrum perforations and the second compares 14 antimanic drugs. We believe that this approach is a useful and novel addition to network meta-analysis methodology, which allows the consistent derivation of the proportion contributions of direct evidence from individual studies to network treatment effects.
Non-invasive visualisation and identification of fluorescent Leishmania tarentolae in infected sand flies
Authors: Diaz-Albiter Hector M. , Regnault Clément , Alpizar-Sosa Edubiel A. , McGuinness Dagmara , Barrett Michael P. , Dillon Rod J. 
Published: December 2018

Background: The leishmaniases are neglected diseases that affect some of the most vulnerable populations in the tropical and sub-tropical world. The parasites are transmitted by sand flies and novel strategies to control this neglected vector-borne disease are needed. Blocking transmission by targeting the parasite inside the phlebotomine vector offers potential in this regard. Some experimental approaches can be best performed by longitudinal study of parasites within flies, for which non-destructive methods to identify infected flies and to follow parasite population changes are required. Methods: Lutzomyia longipalpis were reared under standard insectary conditions at the Wellcome Centre for Molecular Parasitology. Flies were artificially infected with L. tarentolae expressing green fluorescent protein (GFP. Parasite counts were carried out 5 days post-infection and the percentage of infected flies and survival of infected females was established up to days 5 post-infection. Whole living females were visualised using an epifluorescence inverted microscope to detect the presence parasites inferred by a localised green fluorescent region in the upper thorax. Confirmation of infection was performed by localised-fluorescence of dissected flies and estimates of the parasite population. Results: Leishmania tarentolae was successfully transfected and expressed GFP in vitro. L. tarentolae-GFP Infected flies showed similar parasite populations when compared to non-transfected parasites (L. tarentolae-WT). Survival of non-infected females was higher than L. tarentolae-infected groups, (Log-rank (Mantel-Cox) test, p<0.05). L. tarentolae-GFP infected females displayed an intense localised fluorescence in the thorax while other specimens from the same infected group did not. Localised fluorescent flies were dissected and showed higher parasite populations compared to those that did not demonstrate high concentrations in this region (t-test, p<0.005). Conclusion: These results demonstrate the feasibility of establishing a safe non-human infectious fluorescent Leishmania-sand fly infection model by allowing non-destructive imaging to signal the establishment of Leishmania infections in living sand flies.