bluuebunny/crossref_metadata_2025_split huggingface dataset:
A INFLUÊNCIA DA INOVAÇÃO EM PRODUTOS E PROCESSOS NO DESEMPENHO DE EMPRESAS BRASILEIRAS
Authors: Terra Natália Mendonça , Barbosa Jose Geraldo Pereira , Bouzada Marco Aurélio Carino 
Published: June 2016

O principal objetivo desse trabalho foi avaliar as relações entre desempenho de inovações em produtos (processos) e crescimento (lucratividade) de empresas brasileiras pertencentes a três setores: fabricação de máquinas e equipamentos; fabricação de produtos químicos e fabricação de equipamentos de informática, produtos eletrônicos e ópticos. Foram utilizados dados das pesquisas PINTEC (2003, 2005 e 2008) e PIA (2003 a 2010) coletados no Instituto Brasileiro de Geografia e Estatística - IBGE. Verificou-se, com base em resultados de regressões múltiplas e tratamento estatístico efetuado, a inexistência de uma relação positiva entre o desempenho de inovação em processo (produto) e lucratividade (crescimento). Em certa medida já se esperava que as inovações não fornecessem um nível de explicação alto para a variância em desempenho financeiro de empresas tendo em vista que a literatura indica outros fatores que também ajudam a explicar tal variância (atratividade do mercado, domínio de fontes de insumos, para citar apenas dois exemplos). Verificou-se também que a literatura visitada não é conclusiva sobre a relação entre inovação e desempenho financeiro, o que se deve em grande parte à diversidade de variáveis utilizadas na mensuração do desempenho tanto da inovação quanto financeiro. Além da rejeição das hipóteses da pesquisa, o trabalho revelou outros resultados relevantes que podem subsidiar o gestor no processo decisório relacionado ao processo de inovação.
Unemployment as a source of mental distress to individuals and their family: Unemployed parents’ perceptions during the economic recession
Authors: Frasquilho Diana , de Matos Margarida Gaspar , Santos Teresa , Gaspar Tânia , Caldas de Almeida JM 
Published: June 2016

Background: Due to the economic recession, several people in Europe became unemployed. This situation may risk their mental health. Aim: This study explored parents’ perceptions about their unemployment’s effects in daily life during the recession. Methods: A total of 59 unemployed parents (40.7% fathers and 59.3% mothers), ageing 44.4 years (±6.2), answer a question on how the unemployment affected their family lives. Thematic analysis was used to analyse data. Results: The findings suggest that unemployment is a source of adult and youth mental distress and of economic hardship and changes in family relations. Conclusion: Support to unemployed individuals and their families could benefit from these insights when granting the needed financial and socioemotional assistance.
Caregiving for mental health service users: A study exploring the perceptions of mental health service users and their caregivers in Cape Town, South Africa
Authors: Sibeko Goodman , Milligan Peter D , Temmingh Henk , Lund Crick , Stein Dan J , Mall Sumaya 
Published: June 2016

Background: Our study explores perceptions of the caregiver support for mental health service users (MHSUs) in a low- to middle-income country setting. Materials: We conducted in-depth individual interviews with 16 MHSUs and their treatment partners/caregivers from a treatment partner and text-message intervention study. Discussion: Treatment partners/caregivers felt obligated to care for MHSUs, but had a limited understanding of mental illness. They found supporting adherence to treatment difficult due to a number of factors including violence, food insecurity and substance abuse. Conclusion: Socioeconomic and environmental factors affecting the lives of MHSUs have impact on caregiver relationships with MHSUs in their care.
Correlation of Venous Blood Gas and Pulse Oximetry With Arterial Blood Gas in the Undifferentiated Critically Ill Patient
Authors: Zeserson Eli , Goodgame Ben , Hess J. Daniel , Schultz Kristine , Hoon Cynthia , Lamb Keith , Maheshwari Vinay , Johnson Steven , Papas Mia , Reed James , Breyer Michael 
Published: June 2016

Rationale: Blood gas analysis is often used to assess acid–base, ventilation, and oxygenation status in critically ill patients. Although arterial blood gas (ABG) analysis remains the gold standard, venous blood gas (VBG) analysis has been shown to correlate with ABG analysis and has been proposed as a safer less invasive alternative to ABG analysis. Objective: The purpose of this study was to evaluate the correlation of VBG analysis plus pulse oximetry (SpO2) with ABG analysis. Methods: We performed a prospective cohort study of patients in the emergency department (ED) and intensive care unit (ICU) at a single academic tertiary referral center. Patients were eligible for enrollment if the treating physician ordered an ABG. Statistical analysis of VBG, SpO2, and ABG data was done using paired t test, Pearson χ2, and Pearson correlation. Main Results: There were 156 patients enrolled, and 129 patients completed the study. Of the patients completing the study, 53 (41.1%) were in the ED, 41 (31.8%) were in the medical ICU, and 35 (27.1%) were in the surgical ICU. The mean difference for pH between VBG and ABG was 0.03 (95% confidence interval: 0.03-0.04) with a Pearson correlation of 0.94. The mean difference for pCO2 between VBG and ABG was 4.8 mm Hg (95% confidence interval: 3.7-6.0 mm Hg) with a Pearson correlation of 0.93. The SpO2 correlated well with PaO2 (the partial pressure of oxygen in arterial blood) as predicted by the standard oxygen–hemoglobin dissociation curve. Conclusion: In this population of undifferentiated critically ill patients, pH and pCO2 on VBG analysis correlated with pH and pCO2 on ABG analysis. The SpO2 correlated well with pO2 on ABG analysis. The combination of VBG analysis plus SpO2 provided accurate information on acid–base, ventilation, and oxygenation status for undifferentiated critically ill patients in the ED and ICU.
Utilization of Pharmacists in Addressing Medication Abuse in the Pacific Northwest
Authors: Nguyen Duy Q. , Chung Brian , Osburn Loryn L. , Della Paolera Mark A. , Chavez Benjamin 
Published: June 2016

Objective: This article aims to explore the statistics observed in the Pacific Northwest regarding substance abuse, as Oregon and Washington have been shown to be most affected given the increased treatment admissions for opioid utilization and mortality related to medication overdose. Methods: Using PubMed and National Conference of State Legislatures database, articles detailing prescription drug abuse statistics, programs, and laws were collected and analyzed in order to identify possible solutions. Summary: Many studies report that pain medication prescriptions have seen a rise in recent years, however, there still exists an inadequacy in pain management. This increase in prescriptions may also contribute to the rising number in substance misuse and subsequently overdose deaths. Pharmacists can have a global effect on abuse prevention if certain monitoring strategies are implemented and enforced. Conclusion: Health-care providers and pharmacists should contribute to abuse prevention by helping to detect fraudulent prescriptions, staying up to date with current guidelines, and being aware of new safety programs such as prescription drug monitoring programs (PDMPs).
Distrust and patients in intercultural healthcare: A qualitative interview study
Authors: Alpers Lise-Merete 
Published: June 2016

Background: The importance of trust between patients and healthcare personnel is emphasised in nurses’ and physicians’ ethical codes. Trust is crucial for an effective healthcare personnel–patient relationship and thus for treatment and treatment outcomes. Cultural and linguistic differences may make building a trusting and positive relationship with ethnic minority patients particularly challenging. Although there is a great deal of research on cultural competence, there is a conspicuous lack of focus on the concepts of trust and distrust concerning ethnic minority patients, particularly in relation to the concept of ‘othering’. Aim: To study which factors help build trust or create distrust in encounters between healthcare professionals and hospitalised ethnic minority patients, as well as study the dynamic complexities inherent within the process of ‘othering’. Research design: Qualitative design, in-depth interviews and hermeneutic analysis. Participants and research context: The interviewees were 10 immigrant patients (six women and four men – eight Asians, two Africans – ages 32–85 years) recruited from a south-eastern Norwegian hospital. Ethical considerations: Study approval was obtained from the hospital’s Privacy Ombudsman for Research and the hospital’s leadership. Participation was voluntary and participants signed an informed consent form. Conclusion: Distrust and othering may be caused by differences in belief systems, values, perceptions, expectations, and style of expression and behaviour. Othering is a reciprocal phenomenon in minority ethnic patient–healthcare personnel encounters, and it influences trust building negatively. Besides demonstrating general professional skill and competence, healthcare personnel require cultural competence to create trust.
All at Sea? Maritime Dimensions of Europe’s Relations with Africa
Authors: Styan David 
Published: June 2016

The article examines three dimensions of Europe’s maritime relations with Africa: first, the notion that Europe’s strategic maritime frontiers are linked to Africa; second, the coherence or ‘actorness’ of the European Union’s (EU) anti-piracy force operating off the Horn of Africa; and third, the relationship between the EU’s own military and naval objectives and its wider regional policies in Africa. While the EU adopted a ‘Maritime Security Strategy’ in 2014, the article notes that, in practice, the EU’s strategy at sea has focused on two groups of ‘non-state actors’: the Africans who are ‘pirates’; and the migrants crossing the Mediterranean, who are the object of the EU’s Frontex patrols. As such, the initial question examined charts the somewhat fluid notion of the sea as a maritime frontier: where do Europe’s strategic interests in terms of its maritime frontiers lie? Is the EU’s anti-piracy mission defending them? Is this first-ever maritime mission a more tangible manifestation of EU’s common foreign and defence policy than some of the other shorter and smaller military and policing missions in Africa?
‘Voluntary’ and ‘involuntary’ child welfare: Challenging the distinction
Authors: Pösö Tarja , Pekkarinen Elina , Helavirta Susanna , Laakso Riitta 
Published: June 2016

Summary Finnish child welfare divides care orders into voluntary and involuntary care orders, based on the consent or objection of different parties. When giving consent to a care order, the parties allow their rights to family life and self-determination to be restricted. This article examines how the voluntary care order differs in practice from the involuntary one and how voluntarism and involuntarism are represented in these two types of care order. Findings The analysis of 37 care orders highlights different shades of voluntarism and involuntarism as well as formal and informal spheres of consent and objection. The binary distinction between voluntarism and involuntarism becomes problematic. Instead, new forms and arenas for consent and objection, e.g., resistance, become topical in child welfare. Applications The spectrum of voluntarism and involuntarism should be recognised in every type of child welfare. The study points out several critical points in the dual decision-making system in Finland, in particular informed consent.
Long-Term Experience of Endovascular Repair for Thoracic Aortic Aneurysms and Dissections
Authors: Väärämäki Suvi , Suominen Velipekka , Pimenoff Georg , Saarinen Jukka , Uurto Ilkka , Salenius Juha 
Published: June 2016

Purpose: To report the long-term results of thoracic endovascular aortic repair (TEVAR) in both elective and emergency cases of thoracic aortic aneurysm (TAA) and type B dissection. Material and Methods: A prospective single-center study of 78 TEVAR patients treated between February 1998 and February 2013. Stent-graft implantation was performed in 51 (65%) patients for TAA (43 elective and 8 emergency cases) and in 27 (35%) patients for type B dissection (11 elective and 16 emergency cases). Short- and long-term results were evaluated, and a subgroup of patients with left subclavian artery (LSA) coverage was also analyzed. Results: The patients were followed for a mean of 55 months (1-160 months). The technical success rate was 81% and 30-day mortality 6.4% (n = 5). The stroke rate was 7.7% (n = 6) and permanent paraparesis 2.6% ( n = 2). In follow-up, there were 28 (36%) primary (15 type I and 13 type II) and 10 secondary endoleaks (8 type I and 2 type II). Multivariate analysis showed no significant predictive factors for developing a type I endoleak. Secondary interventions were required in 24% of the patients. There was 1 late thoracic aortic rupture and 1 late conversion (1.3%). Patients with LSA coverage had a higher incidence of stroke (12.5% vs 4.3%, P = .18) and paraparesis (3.1% vs 2.2%, P = .79) compared to those without LSA coverage, although this difference was not statistically significant. Stroke rates were significantly higher in patients treated in an emergency setting ( P = .048). Conclusion: Thoracic endovascular aortic repair is a relatively safe and effective therapy for different aortic pathologies with good long-term success. The risk of stroke and paraparesis is notable whether the LSA is covered, and strokes clearly accumulate in the emergency setting. A type I endoleak is the most common complication, but there are no predictive factors for its development.
Brain morphological alternation in chronic pain patients with neuropathic characteristics
Authors: Sugimine Satomi , Ogino Yuichi , Kawamichi Hiroaki , Obata Hideaki , Saito Shigeru 
Published: June 2016

Background Neuropathic characteristics are highly involved in the development of chronic pain both physically and psychologically. However, little is known about the relationship between neuropathic characteristics and brain morphological alteration. Objectives The aim of this study is to investigate the mechanisms of chronic pain development by examining the above-mentioned relationships by voxel-based morphometry in patients with chronic pain. Methods First, we assessed neuropathic characteristics using the painDETECT Questionnaire in 12 chronic pain patients. Second, to assess the gray matter volume changes by voxel-based morphometry, we conducted magnetic resonance imaging of the brain. We applied multiregression analysis of these two assessment methods. Results There were significant positive correlations between painDETECT Questionnaire scores and the gray matter volume in the bilateral anterior cingulate cortex and right posterior cingulate cortex. Conclusions Our findings suggest that neuropathic characteristics strongly affect the brain regions related to modulation of pain in patients with chronic pain and, therefore, contribute to the severity of chronic pain.
Confidence in Assessment of Lumbar Spondylolysis Using Three-Dimensional Volumetric T2-Weighted MRI Compared With Limited Field of View, Decreased-Dose CT
Authors: Delavan Joshua Adam , Stence Nicholas V. , Mirsky David M. , Gralla Jane , Fadell Michael F. 
Published: June 2016

Background: Limited z-axis–coverage computed tomography (CT) to evaluate for pediatric lumbar spondylolysis, altering the technique such that the dose to the patient is comparable or lower than radiographs, is currently used at our institution. The objective of the study was to determine whether volumetric 3-dimensional fast spin echo magnetic resonance imaging (3D MRI) can provide equal or greater diagnostic accuracy compared with limited CT in the diagnosis of pediatric lumbar spondylolysis without ionizing radiation. Hypothesis: Volumetric 3D MRI can provide equal or greater diagnostic accuracy compared with low-dose CT for pediatric lumbar spondylolysis without ionizing radiation. Study Design: Clinical review. Level of Evidence: Level 2. Methods: Three pediatric neuroradiologists evaluated 2-dimensional (2D) MRI, 2D + 3D MRI, and limited CT examinations in 42 pediatric patients who obtained imaging for low back pain and suspected spondylolysis. As there is no gold standard for the diagnosis of spondylolysis besides surgery, interobserver agreement and degree of confidence were compared to determine which modality is preferable. Results: Decreased-dose CT provided a greater level of agreement than 2D MRI and 2D + 3D MRI. The kappa for rater agreement with 2D MRI, 2D + 3D MRI, and CT was 0.19, 0.32, and 1.0, respectively. All raters agreed in 31%, 40%, and 100% of cases with 2D MRI, 2D + 3D MRI, and CT. Lack of confidence was significantly lower with CT (0%) than with 2D MRI (30%) and 2D + 3D MRI (25%). Conclusion: For diagnosing spondylolysis, radiologist agreement and confidence trended toward improvement with the addition of a volumetric 3D MRI sequence to standard 2D MRI sequences compared with 2D MRI alone; however, agreement and confidence remain significantly greater using decreased-dose CT when compared with either MRI acquisition. Clinical Relevance: Decreased-dose CT of the lumbar spine remains the optimal examination to confirm a high suspicion of spondylolysis, with dose essentially equivalent to radiographs. If clinical symptoms are not classic for spondylolysis, 2D MRI is still very good at detecting spondylolysis while remaining sensitive for detection of alternative diagnoses such as disc abnormalities and pars stress reaction. The data suggest that standard 2D MRI sequences should not be entirely replaced by a volumetric T2-weighted 3D sequence (despite promising features of rapid acquisition time, increased spatial resolution, and reconstruction capability).
tarSVM: Improving the accuracy of variant calls derived from microfluidic PCR-based targeted next generation sequencing using a support vector machine
Authors: Gillies Christopher E. , Otto Edgar A. , Vega-Warner Virginia , Robertson Catherine C. , Sanna-Cherchi Simone , Gharavi Ali , Crawford Brendan , Bhimma Rajendra , Winkler Cheryl ,   Nephrotic Syndrome Study Network (NEPTUNE),   C-PROBE InvestigatorGroup of the Michigan Kidney Translational Core Center, Kang Hyun Min , Sampson Matthew G. 
Published: June 2016

Abstract
Background
Targeted sequencing of discrete gene sets is a cost effective strategy to screen subjects for monogenic forms of disease. One method to achieve this pairs microfluidic PCR with next generation sequencing. The PCR step of this pipeline creates challenges in accurate variant calling. This includes that most reads targeting a specific exon are duplicates that have been amplified from the PCR step. To reduce false positive variant calls from these experiments, previous studies have used threshold-based filtering of alternative allele depth ratio and manual inspection of the alignments. However even after manual inspection and filtering, many variants fail to be validated via Sanger sequencing. To improve the accuracy of variant calling from these experiments, we are challenged to design a variant filtering strategy that sufficiently models microfluidic PCR-specific issues.

Results
We developed an open source variant filtering pipeline, targeted sequencing support vector machine (“tarSVM”), that uses a Support Vector Machine (SVM) and a new score the normalized allele dosage test to identify high quality variants from microfluidic PCR data. tarSVM maximizes training knowledge by selecting variants that are likely true and likely false variants by incorporating knowledge from the 1000 Genomes and the Exome Aggregation Consortium projects. tarSVM improves on previous approaches by synthesizing variant features from the Genome Analysis Toolkit and allele dosage information. We compared the accuracy of tarSVM versus existing variant quality filtering strategies on two cohorts (n = 474 and n = 1152), and validated our method on a third cohort (n = 75). In the first cohort, our method achieved 84.5 % accuracy of predicting whether or not a variant would be validated with Sanger sequencing versus 78.8 % for the second most accurate method. In the second cohort, our method had an accuracy of 73.3 %, versus 61.5 % for the second best method. Finally, our method had a false discovery rate of 5 % for the validation cohort.

Conclusions
tarSVM increases the accuracy of variant calling when using microfluidic PCR based targeted sequencing approaches. This results in higher confidence downstream analyses, and ultimately reduces the costs Sanger validation. Our approach is less labor intensive than existing approaches, and is available as an open source pipeline for read trimming, aligning, variant calling, and variant quality filtering on GitHub at https://github.com/christopher-gillies/TargetSpecificGATKSequencingPipeline.
Rates of voluntary and compulsory psychiatric in-patient treatment in England: An ecological study investigating associations with deprivation and demographics
Authors: Keown Patrick , McBride Orla , Twigg Liz , Crepaz-Keay David , Cyhlarova Eva , Parsons Helen , Scott Jan , Bhui Kamaldeep , Weich Scott 
Published: June 2016

BackgroundIndividual variables and area-level variables have been identified as explaining much of the variance in rates of compulsory in-patient treatment.AimsTo describe rates of voluntary and compulsory psychiatric in-patient treatment in rural and urban settings in England, and to explore the associations with age, ethnicity and deprivation.MethodSecondary analysis of 2010/11 data from the Mental Health Minimum Dataset.ResultsAreas with higher levels of deprivation had increased rates of in-patient treatment. Areas with high proportions of adults aged 20–39 years had the highest rates of compulsory in-patient treatment as well as the lowest rates of voluntary in-patient treatment. Urban settings had higher rates of compulsory in-patient treatment and ethnic density was associated with compulsory treatment in these areas. After adjusting for age, deprivation and urban/rural setting, the association between ethnicity and compulsory treatment was not statistically significant.ConclusionsAge structure of the adult population and ethnic density along with higher levels of deprivation can account for the markedly higher rates of compulsory in-patient treatment in urban areas.