bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding vulnerability to self-harm in times of economic hardship and austerity: a qualitative study
Authors: Barnes M C , Gunnell D , Davies R , Hawton K , Kapur N , Potokar J , Donovan J L 
Published: February 2016

ObjectiveSelf-harm and suicide increase in times of economic recession, but little is known about why people self-harm when in financial difficulty, and in what circumstances self-harm occurs. This study aimed to understand events and experiences leading to the episode of self-harm and to identify opportunities for prevention or mitigation of distress.SettingParticipants’ homes or university rooms.Participants19 people who had attended hospital following self-harm in two UK cities and who specifically cited job loss, economic hardship or the impact of austerity measures as a causal or contributory factor.Primary and secondary outcome measuresSemistructured, in-depth interviews. Interviews were audio recorded, transcribed and analysed cross-sectionally and as case studies.ResultsStudy participants described experiences of severe economic hardship; being unable to find employment or losing jobs, debt, housing problems and benefit sanctions. In many cases problems accumulated and felt unresolvable. For others an event, such as a call from a debt collector or benefit change triggered the self-harm. Participants also reported other current or past difficulties, including abuse, neglect, bullying, domestic violence, mental health problems, relationship difficulties, bereavements and low self-esteem. These contributed to their sense of despair and worthlessness and increased their vulnerability to self-harm. Participants struggled to gain the practical help they felt they needed for their economic difficulties or therapeutic support that might have helped with their other co-existing or historically damaging experiences.ConclusionsEconomic hardships resulting from the recession and austerity measures accumulated or acted as a ‘final straw’ to trigger self-harm, often in the context of co-existing or historically damaging life-experiences. Interventions to mitigate these effects should include providing practical advice about economic issues before difficulties become insurmountable and providing appropriate psychosocial support for vulnerable individuals.
Acknowledging unreported problems with active surveillance for prostate cancer: a prospective single-centre observational study
Authors: Hefermehl Lukas J , Disteldorf Daniel , Lehmann Kurt 
Published: February 2016

ObjectiveTo report outcomes of patients with localised prostate cancer (PCa) managed with active surveillance (AS) in a standard clinical setting.DesignSingle-centre, prospective, observational study.SettingNon-academic, average-size hospital in Switzerland.ParticipantsProspective, observational study at a non-academic, average-size hospital in Switzerland. Inclusion and progression criteria meet general recommendations. 157 patients at a median age of 67 (61–70) years were included from December 1999 to March 2012. Follow-up (FU) ended June 2013.ResultsMedian FU was 48 (30–84) months. Overall confirmed reclassification rate was 20% (32/157). 20 men underwent radical prostatectomy with 1 recurrence, 11 had radiation therapy with 2 prostate-specific antigen relapses, and 1 required primary hormone ablation with a fatal outcome. Kaplan-Meier estimates for those remaining in the study showed an overall survival of 92%, cancer-specific survival of 99% and reclassification rate of 41%. Dropout rate was 36% and occurred at a median of 48 (21–81) months after inclusion. 68 (43%) men are still under AS.ConclusionsCareful administration of AS can and will yield excellent results in long-term management of PCa, and also helps physicians and patients alike to balance quality of life and mortality. Our data revealed significant dropout from FU. Patient non-compliance can be a relevant problem in AS.
Gaining an accurate reflection of the reality of palliative care through the use of free-text feedback in questionnaires: the AFTER study
Authors: Bowyer Anna Victoria , Finlay Ilora , Baillie Jessica , Byrne Anthony , McCarthy Jacqui , Sampson Catherine , Snow Veronica , Nelson Annmarie 
Published: February 2016

BackgroundIn healthcare, many service evaluation questionnaires use free-text boxes without formal mechanisms for analysis. Patients and carers spend time documenting concerns that are often ignored or managed locally in an ad hoc manner. Currently, palliative care experiences of patients and carers in Wales are measured using a service evaluation questionnaire, comprising both closed and open-ended questions. Previous research, exploring free-text responses from this questionnaire, suggests that questionnaire refinement should accommodate service users’ expressed priorities and concerns, and highlights the need to incorporate free-text data analysis strategies during study design.MethodsResults from a previous analysis of 596 free-text responses provided the basis for an expert consensus day, where the current service evaluation questionnaire was refined. The refined version was tested during cognitive interviews with patients (n=10) and carers (n=7) receiving palliative care from 1 of 2 UK hospices. Data were analysed thematically.ResultsInterviews highlighted minor areas for change within the questionnaire and provided broader insight into patients’ experiences of palliative care services. Patients and carers place an emphasis on simplifying language, decreasing the numeric response range and reducing written instructions; relying instead on visual cues, including formatting and layout. Findings highlighted the importance patients attached to providing meaningful free-text contributions.ConclusionsQuestionnaire refinement should use the patient perspective to effectively facilitate respondent understanding, pertinence and usability. The importance of employing data analysis strategies during questionnaire design may reduce research waste, thus enabling a better interrogation of service provision.
Point-of-care testing of electrolytes and calcium using blood gas analysers: it is time we trusted the results
Authors: Mirzazadeh Mehdi , Morovat Alireza , James Tim , Smith Ian , Kirby Justin , Shine Brian 
Published: February 2016

BackgroundPoint-of-care testing allows rapid analysis of samples to facilitate prompt clinical decisions. Electrolyte and calcium abnormalities are common in acutely ill patients and can be associated with life-threatening consequences. There is uncertainty whether clinical decisions can be based on the results obtained from blood gas analysers or if laboratory results should be awaited.ObjectivesTo assess the agreement between sodium, potassium and calcium results from blood gas and laboratory mainstream analysers in a tertiary centre, with a network consisting of one referral and two peripheral hospitals, consisting of three networked clinical biochemistry laboratories.MethodUsing the laboratory information management system database and over 11 000 paired samples in three hospital sites, the results of sodium, potassium and ionised calcium on blood gas analysers were studied over a 5-year period and compared with the corresponding laboratory results from the same patients booked in the laboratory within 1 h.ResultsThe Pearson's linear correlation coefficient between laboratory and blood gas results for sodium, potassium and calcium were 0.92, 0.84 and 0.78, respectively. Deming regression analysis showed a slope of 1.04 and an intercept of −5.7 for sodium, slope of 0.93 and an intercept of 0.22 for potassium and a slope of 1.23 with an intercept of −0.55 for calcium. With some strict statistical assumptions, percentages of results lying outside the least significant difference were 9%, 26.7% and 20.8% for sodium, potassium and calcium, respectively.ConclusionsMost clinicians wait for the laboratory confirmation of results generated by blood gas analysers. In a large retrospective study we have shown that there is sufficient agreement between the results obtained from the blood gas and laboratory analysers to enable prompt clinical decisions to be made.
Investigation on Multi-Physics Simulation-Based Virtual Machining System for Vibratory Finishing of Integrally Bladed Rotors (IBRS)
Authors: Achiamah-Ampomah N. , Cheng Kai 
Published: February 2016

An investigation was carried out to improve the slow surface finishing times of integrally bladed rotors (IBRs) in the aerospace industry. Traditionally they are finished by hand, or more currently by abrasive flow machining. The use of a vibratory finishing technique to improve process times has been suggested; however as a largely empirical process, very few studies have been done to improve and optimize the cycle times, showing that critical and ongoing research is still needed in this area. An extensive review of the literature was carried out, and the findings used to identify the key parameters and model equations which govern the vibratory process. Recommendations were made towards a multi-physics-based simulation model, as well as projections made for the future of vibratory finishing and optimization of surface finishes and cycle times.
Arbitrary Lagrangian–Eulerian simulations of highly electrically charged micro-droplet Coulomb explosion deformation pathways
Authors: Radcliffe Alastair 
Published: February 2016

Numerical simulation results of the Coulomb explosion pathways of cooled water and heated glycol droplets electrically charged to the critical Rayleigh limit are presented, calculated using an axi-symmetric finite element scheme previously used for the same problem [Radcliffe A. J., Non-conforming finite elements for axisymmetric charged droplet deformation dynamics and Coulomb explosions, Int. J. Num. Meth. Fluids 71:249–268, (2013), doi:10.1002/fld.3667.] which has been adapted to use arbitrary Lagrangian–Eulerian (ALE) methods and a novel tip reconstruction technique in order to greatly improve its accuracy in matching available experimental data.
Vorapaxar and diplopia: Possible off-target PAR-receptor mismodulation
Authors: Fortmann Seth D. , Rao Sunil V. , Tanguay Jean-Francois , Lordkipanidze Marie , Hanley Daniel F. , Can Mehmet , Kim Moo Hyun , Marciniak Thomas A. , Serebruany Victor L. 
Published: February 2016

SummaryVorapaxar, a novel antiplatelet thrombin PAR-1 inhibitor, has been evaluated in the successful TRA2P trial and the failed TRACER trial. The drug is currently approved for post myocardial infarction and peripheral artery disease indications with concomitant use of clopidogrel and/or aspirin. The FDA ruled that the vorapaxar safety profile is acceptable. However, both trials revealed excess diplopia (double vision) usually reversible after vorapaxar. The diplopia risk appears to be small (about 1 extra case per 1,000 treated subjects), but real. Overall, there were 10 placebo and 34 vorapaxar diplopia cases (p=0.018) consistent for TRACER (2 vs 13 cases; p=0.010) and for TRA2P (8 vs 21 cases; p=0.018). Hence, we review the FDA-confirmed evidence and discuss potential causes and implications of such a surprising adverse association, which may be related to off-target PAR receptor mismodulation in the eye.
Ndufc2 Gene Inhibition Is Associated With Mitochondrial Dysfunction and Increased Stroke Susceptibility in an Animal Model of Complex Human Disease
Authors: Rubattu Speranza , Di Castro Sara , Schulz Herbert , Geurts Aron M. , Cotugno Maria , Bianchi Franca , Maatz Henrike , Hummel Oliver , Falak Samreen , Stanzione Rosita , Marchitti Simona , Scarpino Stefania , Giusti Betti , Kura Ada , Gensini Gian Franco , Peyvandi Flora , Mannucci Pier Mannuccio , Rasura Maurizia , Sciarretta Sebastiano , Dwinell Melinda R. , Hubner Norbert , Volpe Massimo 
Published: February 2016

Background

The genetic basis of stroke susceptibility remains to be elucidated.
STR
1 quantitative trait locus (
STR
1/
QTL
) was identified on rat chromosome 1 of stroke‐prone spontaneously hypertensive rat (
SHRSP
) upon Japanese‐style stroke‐permissive diet (
JD
), and it contributes to 20% of the stroke phenotype variance.

Methods and Results

Nine hundred eighty‐six probe sets mapping on
STR
1 were selected from the Rat
RAE
230A array and screened through a microarray differential expression analysis in brains of
SHRSP
and stroke‐resistant
SHR
(
SHRSR
) fed with either regular diet or
JD
. The gene encoding Ndufc2 (
NADH
dehydrogenase [ubiquinone] 1 subunit), mapping 8 Mb apart from
STR
1/
QTL
Lod score peak, was found significantly down‐regulated under
JD
in
SHRSP
compared to
SHRSR
.
Ndufc2
disruption altered complex I assembly and activity, reduced mitochondrial membrane potential and
ATP
levels, and increased reactive oxygen species production and inflammation both in vitro and in vivo.
SHRSR
carrying heterozygous
Ndufc2
deletion showed renal abnormalities and stroke occurrence under
JD
, similarly to
SHRSP
. In humans, T allele variant at
NDUFC
2/rs11237379 was associated with significant reduction in gene expression and with increased occurrence of early‐onset ischemic stroke by recessive mode of transmission (odds ratio [
OR
], 1.39;
CI,
1.07–1.80;
P
=0.012). Subjects carrying
TT
/rs11237379 and A allele variant at
NDUFC
2/rs641836 had further increased risk of stroke (
OR
=1.56;
CI
, 1.14–2.13;
P
=0.006).

Conclusions

A significant reduction of
Ndufc2
expression causes complex I dysfunction and contributes to stroke susceptibility in
SHRSP
. Moreover, our current evidence may suggest that Ndufc2 can contribute to an increased occurrence of early‐onset ischemic stroke in humans.
Pediatric Cortical Vein Thrombosis
Authors: Ritchey Zak , Hollatz Amanda L. , Weitzenkamp David , Fenton Laura Z. , Maxwell Emily C. , Bernard Timothy J. , Stence Nicholas V. 
Published: February 2016

Background and Purpose—
Cortical vein thrombosis (CVT) is an uncommon site of involvement in cerebral sinovenous thrombosis. Few reports have described pediatric CVT, and none has differentiated its unique attributes. This study assessed the clinical features and radiographic outcome of a cohort of children with cerebral sinovenous thrombosis, comparing those with CVT to those without CVT.

Methods—
Children diagnosed with cerebral sinovenous thrombosis were retrospectively reviewed and separated into 2 groups based on the presence or absence of cortical vein involvement.

Results—

Fifty patients met inclusion criteria, including 12 with CVT. The CVT group was more likely to present with seizure (
P
=0.0271), altered mental status (
P
=0.0271), and a family history of clotting disorder (
P
=0.0477). Acute imaging of the CVT group more commonly demonstrated concurrent superior sagittal sinus thrombosis (
P
=0.0024), parenchymal hemorrhage (
P
=0.0141), and restricted diffusion (
P
<0.0001). At follow-up, the CVT group more commonly showed headache, seizure, and focal neurological deficit (
P
=0.0449), and venous infarction (
P
=0.0007).

Conclusions—
In our cohort, CVT was significantly associated with seizures at presentation, hemorrhage and restricted diffusion on acute imaging, as well as neurological disability and venous infarction at follow-up. Involvement of cortical veins in cerebral sinovenous thrombosis is associated with an increased risk of infarction and adverse outcome in children.
Inflammatory Markers and Outcomes After Lacunar Stroke
Authors: Boehme Amelia K. , McClure Leslie A. , Zhang Yu , Luna Jorge M. , Del Brutto Oscar H. , Benavente Oscar R. , Elkind Mitchell S.V. 
Published: February 2016

Background and Purpose—
We hypothesized that concentrations of interleukin 6 (IL-6), serum amyloid A, tumor necrosis factor-α receptor 1, CD40 ligand, and monocyte chemoattractant protein 1 would predict recurrent ischemic stroke and major vascular events after recent lacunar stroke.

Methods—
Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) was an international, multicenter, prospective ancillary biomarker study nested within the Secondary Prevention of Small Subcortical Strokes (SPS3) study, a Phase III trial in patients with recent lacunar stroke. Crude and Adjusted Cox proportional hazards models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CI) for recurrence risks.

Results—

Among 1244 patients with lacunar stroke (mean age, 63.3±10.8 years), there were 115 major vascular events (stroke, myocardial infarction, and vascular death). The risk of major vascular events increased with elevated concentrations of both tumor necrosis factor-α receptor 1 (adjusted HR per SD, 1.21; 95% CI, 1.05–1.41;
P
=0.01) and IL-6 (adjusted HR per SD, 1.10; 95% CI, 1.02–1.19;
P
=0.008). Compared with the bottom quartile (tumor necrosis factor-α receptor 1 <2.24 ng/L), those in the top quartile of tumor necrosis factor-α receptor 1 (>3.63 ng/L) were at twice the risk of major vascular events after adjusting for demographics (partially adjusted HR, 1.98; 95% CI, 1.11–3.52), though the effect attenuated after adjusting for other risk factors and statin use (adjusted HR, 1.68; 95% CI, 0.93–3.04). Serum amyloid A, CD40 ligand, and monocyte chemoattractant protein 1 were not associated with prognosis.

Conclusions—
Among recent lacunar stroke patients, IL-6 and TNF receptor concentrations predict risk of recurrent vascular events, and they are associated with the effect of antiplatelet therapies.

Clinical Trial Registration—

URL:
http://www.clinicaltrials.gov
. Unique identifier: NCT00059306.
Safety and Efficacy of Solitaire Stent Thrombectomy
Authors: Campbell Bruce C.V. , Hill Michael D. , Rubiera Marta , Menon Bijoy K. , Demchuk Andrew , Donnan Geoffrey A. , Roy Daniel , Thornton John , Dorado Laura , Bonafe Alain , Levy Elad I. , Diener Hans-Christoph , Hernández-Pérez María , Pereira Vitor Mendes , Blasco Jordi , Quesada Helena , Rempel Jeremy , Jahan Reza , Davis Stephen M. , Stouch Bruce C. , Mitchell Peter J. , Jovin Tudor G. , Saver Jeffrey L. , Goyal Mayank 
Published: February 2016

Background and Purpose—
Recent positive randomized trials of endovascular therapy for ischemic stroke used predominantly stent retrievers. We pooled data to investigate the efficacy and safety of stent thrombectomy using the Solitaire device in anterior circulation ischemic stroke.

Methods—
Patient-level data were pooled from trials in which the Solitaire was the only or the predominant device used in a prespecified meta-analysis (SEER Collaboration): Solitaire FR With the Intention for Thrombectomy as Primary Endovascular Treatment (SWIFT PRIME), Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times (ESCAPE), Extending the Time for Thrombolysis in Emergency Neurological Deficits—Intra-Arterial (EXTEND-IA), and Randomized Trial of Revascularization With Solitaire FR Device Versus Best Medical Therapy in the Treatment of Acute Stroke Due to Anterior Circulation Large Vessel Occlusion Presenting Within Eight Hours of Symptom Onset (REVASCAT). The primary outcome was ordinal analysis of modified Rankin Score at 90 days. The primary analysis included all patients in the 4 trials with 2 sensitivity analyses: (1) excluding patients in whom Solitaire was not the first device used and (2) including the 3 Solitaire-only trials (excluding ESCAPE). Secondary outcomes included functional independence (modified Rankin Score 0–2), symptomatic intracerebral hemorrhage, and mortality.

Results—
The primary analysis included 787 patients: 401 randomized to endovascular thrombectomy and 386 to standard care, and 82.6% received intravenous thrombolysis. The common odds ratio for modified Rankin Score improvement was 2.7 (2.0–3.5) with no heterogeneity in effect by age, sex, baseline stroke severity, extent of computed tomography changes, site of occlusion, or pretreatment with alteplase. The number needed to treat to reduce disability was 2.5 and for an extra patient to achieve independent outcome was 4.25 (3.29–5.99). Successful revascularization occurred in 77% treated with Solitaire device. The rate of symptomatic intracerebral hemorrhage and overall mortality did not differ between treatment groups.

Conclusions—
Solitaire thrombectomy for large vessel ischemic stroke was safe and highly effective with substantially reduced disability. Benefits were consistent in all prespecified subgroups.
Systematic review of the prevalence of mental illness stigma within the Greek culture
Authors: Tzouvara Vasiliki , Papadopoulos Chris , Randhawa Gurch 
Published: February 2016

Background: A number of primary studies have now assessed mental illness stigma within the Greek culture. A synthesis and appraisal of all available evidence is now required and will contribute to our growing understanding of the relationship between the cultural context and the formation of stigmatising attitudes. Aim: To systematically review the prevalence of mental illness public stigma within the Greek and Greek Cypriot culture. Method: Empirical articles with primary data pertaining to the prevalence of mental illness public stigma among Greek and/or Greek Cypriot populations were retrieved. Included studies were assessed for quality and extracted data were narratively synthesised. Results: A total of 18 studies met the inclusion criteria. Methodological quality was highly variable; only 1 study was adequately statistically powered, 10 studies employed at least some element of probability sampling and obtained response rates of at least 70%, while 10 and 13 studies employed reliable and validated prevalence tools, respectively. Studies sampled the general population ( n = 11), students ( n = 4), healthcare professionals ( n = 2), police officers, employers and family members (all n = 1). Stigma was consistently identified in moderate and high proportions across all of these groups, particularly in terms of social discrimination and restrictiveness, social distance and authoritarianism. However, some evidence of benevolence and positivity towards high-quality social care was also identified. Conclusion: The review highlights the wide-scale prevalence of mental illness stigma within the Greek culture and the need for further rigorous research including culturally tailored stigma interventions.
Local government innovation diffusion in China: an event history analysis of a performance-based reform programme
Authors: Wu Jiannan , Zhang Pan 
Published: February 2016

The performance-based reform programme launched by Fujian province in 2000 has been adopted by many other Chinese provinces, including Zhejiang, Hebei, Anhui and Sichuan, over the past 12 years. This article aims to explore the antecedents of the adoption of this programme, in particular, the effects of senior figures' political promotion incentives and diffusion mechanisms. Specifically, event history analysis based on probit regression is used to examine data from 31 Chinese provinces for the 2000–2012 period. The results show that leaders' relative age and chances of being appointed to the Politburo, and distance to the general election, are significantly negatively correlated with the reform programme's adoption, but top-down diffusion is significantly positively correlated with it. Points for practitioners This study confirms that the nomenklatura system in China shapes the diffusion of innovations through the mechanisms of political promotion incentives and intergovernmental interactions. Thus, the dynamics of innovation diffusion are, to some extent, rooted in particular political institutions and shaped by political contexts. Furthermore, the desire for political promotions may figure as a general deep reason for decisions about whether to adopt innovations; therefore, strengthening these incentives for adopting reforms becomes a key strategy.