bluuebunny/crossref_metadata_2025_split huggingface dataset:
The regulation of competition in the National Health Service (NHS): what difference has the Health and Social Care Act 2012 made?
Authors: Sanderson Marie , Allen Pauline , Osipovic Dorota 
Published: March 2016

AbstractThis article examines the impact of the Health and Social Care Act 2012 on the regulation of competition in the English National Health Service (NHS), by focussing on the change it marked from a system of sector-specific regulation to one which is clearly based in competition law. It has been suggested that the Act and its associated reforms would significantly alter accountability in the NHS, and would change decisions from the remit of public policy to that of the law. To assess the impact the Act has had in practice, the article compares the interpretation of the rules regarding competition in the NHS by the regulators of competition immediately before, and following, the passing of the Act. It argues that, whilst the reforms have the potential significantly to alter the way competition in the NHS is regulated, the impact of the reforms in this area is limited by the development of systems within the NHS to manage and resolve issues internally where possible.
Quality of care indicators for schizophrenia: determinants of observed variations among Italian Departments of Mental Health. Results from the ETAS DSM study
Authors: Fantini G. , Tibaldi G. , Rucci P. , Gibertoni D. , Vezzoli M. , Cifarelli L. , Tiraferri R. , Munizza C. 
Published: March 2016

Aims.The primary aim of this study is to analyse the conformance of usual care patterns for persons with schizophrenia to treatment guidelines in three Italian Departments of Mental Health (DMHs). The secondary aim is to examine possible organisational and structural reasons accounting for variations among DMHs.Methods.Within the framework of the Evaluation of Treatment Appropriateness in Schizophrenia (ETAS) project, 20 consensus quality of care indicators were developed. Ten concerned pharmacological treatment and ten encompassed general care and psychosocial rehabilitation interventions. Indicators were calculated using data from a stratified random sample of 458 patients treated at three DMHs located in North-Eastern, North-Western and Southern Italy. Patients’ data were collected by combining information from medical charts and from a survey carried out by the health care professionals in charge of the patients. Data on the structural and organisational characteristics of the DMHs were retrieved from administrative databases. For each indicator, the number and percentage of appropriate interventions with and without moderators were calculated. Appropriateness was defined as the percentage of eligible patients receiving an intervention conformant with guidelines. Moderators, i.e., reasons justifying a discrepancy between the interventions actually provided and that recommended by guidelines were recorded. Indicators based on a sufficient number of eligible patients were further explored in a statistical analysis to compare the performance of the DMHs.Results.In the overall sample, the percentage of inappropriate interventions ranged from 11.1 to 59.3% for non-pharmacological interventions and from 5.9 to 66.8% for pharmacological interventions. Comparisons among DMHs revealed significant variability in appropriateness for the indicators ‘prevention and monitoring of metabolic effects’, ‘psychiatric visits’, ‘psychosocial rehabilitation’, ‘family involvement’ and ‘work’. After adjusting the patient's gender, age and functioning, only the indicators ‘Prevention and monitoring of metabolic effects’, ‘psychiatric visits’ and ‘work’ continued to differ significantly among DMHs. The percentage of patients receiving appropriate integrated care (at least one appropriate non-pharmacological intervention and one pharmacological intervention) was significantly different among the three DMHs and lower than expected.Conclusions.Our results underscore discrepancies among Italian DMHs in indicators that explore key aspects of care of patients with schizophrenia. The use of quality indicators and improved guideline adherence can address suboptimal clinical outcomes, and has the potential to reduce practice variations and narrow the gap between optimal and routine care.
A comparison of the cumulative incidence and early risk factors for psychotic disorder in young adults in the Northern Finland Birth Cohorts 1966 and 1986
Authors: Filatova S. , Marttila R. , Koivumaa-Honkanen H. , Nordström T. , Veijola J. , Mäki P. , Khandaker G. M. , Isohanni M. , Jääskeläinen E. , Moilanen K. , Miettunen J. 
Published: March 2016

Aims.Few studies have compared time trends for the incidence of psychosis. To date, the results have been inconsistent, showing a decline, an increase or no significant change. As far as we know, no studies explored changes in prevalence of early risk factors. The aim of this study was to investigate differences in early risk factors and cumulative incidences of psychosis by type of psychosis in two comparable birth cohorts.Methods.The Northern Finland Birth cohorts (NFBCs) 1966 (N = 12 058) and 1986 (N = 9432) are prospective general population-based cohorts with the children followed since mother's mid-pregnancy. The data for psychoses, i.e. schizophrenia (narrow, spectrum), bipolar disorder with psychotic features, major depressive episode with psychotic features, brief psychosis and other psychoses (ICD 8–10) were collected from nationwide registers including both inpatients and outpatients. The data on early risk factors including sex and place of birth of the offspring, parental age and psychosis, maternal education at birth were prospectively collected from the population registers. The follow-up reached until the age of 27 years.Results.An increase in the cumulative incidence of all psychoses was seen (1.01% in NFBC 1966 v. 1.90% in NFBC 1986; p < 0.001), which was due to an increase in diagnosed affective and other psychoses. Earlier onset of cases and relatively more psychoses in women were observed in the NFBC 1986. Changes in prevalence of potential early risk factors were identified, but only parental psychosis was a significant predictor in both cohorts (hazard ratios ≥3.0; 95% CI 1.86–4.88). The difference in psychosis incidence was not dependent on changes in prevalence of studied early risk factors.Conclusions.Surprisingly, increase in the cumulative incidence of psychosis and also changes in the types of psychoses were found between two birth cohorts 20 years apart. The observed differences could be due to real changes in incidence or they can be attributable to changes in diagnostic practices, or to early psychosis detection and treatment.
Growth Retardation (Hemiepiphyseal Stapling) and Growth Acceleration (Periosteal Resection) as a Method to Improve Guided Growth in a Lamb Model
Authors: Noonan Kennett J. , Halanski Matthew A. , Leiferman Ellen , Wilsman Norman 
Published: March 2016

Background:
Guided growth corrects pediatric limb deformity by inhibiting growth on the convexity of the bone. Both modular and rigid implants have been used; we endeavor to determine whether a clear advantage of one implant exists. We further hypothesize that improved correction could be realized by accelerating growth with resection of the periosteum.

Methods:
Sixteen lambs underwent guided growth of the medial proximal tibia (the opposite limb served as a control). Group 1 used a rigid staple (n=5); group 2 a modular plate and screw construct (n=5), and group 3 had a similar device plus periosteal resection (n=6). Radiographs tracked the progression of deformity in the coronal plane. Before sacrifice, pulsed fluorochrome labels allowed for temporal and spatial growth rate analysis. At sacrifice, True Deformity was calculated (and compared with control tibia) from standardized radiographs in the coronal and sagittal planes. Device Efficiencies were normalized by dividing True Deformity produced (degrees) by the Expected Growth gain (mm) from the control limb.

Results:
Group 3 produced greater coronal plane deformity than group 1 by an average of 2.2 degrees per month (P=0.001) and group 2 by an average of 2.4 degrees per month (P=0.0007). At sacrifice, groups 1 and 2 were equally effective at limiting growth to 75% of control; no differences in growth retardation were noted. No differences in Device Efficiency were noted between groups 1 and 2. The Device Efficiency was significantly different between groups 1 and 2 with comparison with group 3 (P=0.05 and P=0.022); with a 2.5 degree/mm faster deformation in the stripped cohort.

Conclusions:
Rigid implants initially produced deformity quicker than modular constructs; yet ultimately, both implants were equally effective at guiding growth. Device Efficiency for the modular group improved significantly with the addition of periosteal stripping as method to accelerate growth.
Div-Seq: A single nucleus RNA-Seq method reveals dynamics of rare adult newborn neurons in the CNS
Authors: Habib Naomi , Li Yinqing , Heidenreich Matthias , Swiech Lukasz , Trombetta John J. , Zhang Feng , Regev Aviv 
Published: March 2016

AbstractTranscriptomes of individual neurons provide rich information about cell types and dynamic states. However, it is difficult to capture rare dynamic processes, such as adult neurogenesis, because isolation from dense adult tissue is challenging, and markers for each phase are limited. Here, we developed Div-Seq, which combines Nuc-Seq, a scalable single nucleus RNA-Seq method, with EdU-mediated labeling of proliferating cells. We first show that Nuc-Seq can sensitively identify closely related cell types within the adult hippocampus. We apply Div-Seq to track transcriptional dynamics of newborn neurons in an adult neurogenic region in the hippocampus. Finally, we find rare adult newborn GABAergic neurons in the spinal cord, a non-canonical neurogenic region. Taken together, Nuc-Seq and Div-Seq open the way for unbiased analysis of any complex tissue.
The social meaning of disability: a reflection on categorisation, stigma and identity
Authors: Grue Jan 
Published: March 2016

AbstractAs disability becomes an ever more salient concept in international political and legal discourse, its social meaning must be better understood. Traditionally defined in medical terms and as an individual problem, it has for the last several decades increasingly become a socio‐politically defined phenomenon. Disability pride has emerged as a social movement patterned after ethnic minority and sexual orientation movements. The one billion people who count as disabled nevertheless have illnesses and impairments that are largely understood as medical problems. Medicine continues to exert great influence on the social meaning of disability in general and the social valuation of various illnesses and impairments in particular. Whereas specific conditions may be socially valued, the overall category and label of disability connotes marginality and stigma. Under these conditions, disability policy, which ought to be a universal concern, risks being construed as a marginal and special‐interest issue rather than a broadly relevant topic; this has potentially negative consequences for the majority of disabled people.
The minor house dust mite allergen Der p 13 is a fatty acid‐binding protein and an activator of a TLR2‐mediated innate immune response
Authors: Satitsuksanoa P. , Kennedy M. , Gilis D. , Le Mignon M. , Suratannon N. , Soh W. T. , Wongpiyabovorn J. , Chatchatee P. , Vangveravong M. , Rerkpattanapipat T. , Sangasapaviliya A. , Piboonpocanun S. , Nony E. , Ruxrungtham K. , Jacquet A. ,   the Mite Allergy Research Cohort (MARC) study team
Published: March 2016

AbstractBackgroundThe house dust mite (HDM) allergen Der p 13 could be a lipid‐binding protein able to activate key innate signaling pathways in the initiation of the allergic response. We investigated the IgE reactivity of recombinant Der p 13 (rDer p 13), its lipid‐binding activities, and its capacity to stimulate airway epithelium cells.MethodsPurified rDer p 13 was characterized by mass spectrometry, circular dichroism, fluorescence‐based lipid‐binding assays, and in silico structural prediction. IgE‐binding activity and allergenic potential of Der p 13 were examined by ELISA, basophil degranulation assays, and in vitro airway epithelial cell activation assays.ResultsProtein modeling and biophysical analysis indicated that Der p 13 adopts a β‐barrel structure with a predominately apolar pocket representing a potential binding site for hydrophobic ligands. Fluorescent lipid‐binding assays confirmed that the protein is highly selective for ligands and that it binds a fatty acid with a dissociation constant typical of lipid transporter proteins. The low IgE‐binding frequency (7%, n = 224) in Thai HDM‐allergic patients as well as the limited propensity to activate basophil degranulation classifies Der p 13 as a minor HDM allergen. Nevertheless, the protein with its presumptively associated lipid(s) triggered the production of IL‐8 and GM‐CSF in respiratory epithelial cells through a TLR2‐, MyD88‐, NF‐kB‐, and MAPK‐dependent signaling pathway.ConclusionsAlthough a minor allergen, Der p 13 may, through its lipid‐binding capacity, play a role in the initiation of the HDM‐allergic response through TLR2 activation.
Prognostic Value of QRS Fragmentation in Patients with Acute Myocardial Infarction: A Meta‐Analysis
Authors: Güngör Barış , Özcan Kazım Serhan , Karataş Mehmet Baran , Şahin İrfan , Öztürk Recep , Bolca Osman 
Published: March 2016

AimsFragmented QRS has emerged as a novel electrocardiographic parameter associated with adverse clinical events in various diseases. The aim of this study was to investigate the association of fQRS with in‐hospital and long‐term cardiovascular events in patients with ST‐segment elevation myocardial infarction (STEMI) and non‐ST segment elevation myocardial infarction (NSTEMI).Methods and ResultsWe searched PubMed, Embase, Web of Science, and Cochrane Library up to October 2015 for eligible studies. We selected studies with fQRS defined with 12‐lead ECG during the index hospitalization of STEMI/NSTEMI. Primary outcomes were in‐hospital and long‐term cardiovascular events. In‐hospital mortality was significantly higher in fQRS (+) group (99/733; 13.5%) compared to fQRS (–) group (47/1293; 3.6%) (OR 4.03 95% CI 1.81–8.94; P = 0.0006). Long‐term mortality rate was higher in fQRS (+) group (89/473; 18.8%) compared to fQRS (–) group (54/1009; 5.3%) (OR 3.93 95% CI 1.92–8.05; P = 0.0002). In addition the frequency of long‐term MACE was higher in fQRS (+) group (46.9%) compared to fQRS (–) group (14.6%) (OR 5.13 95% CI 2.77–9.51; P < 0.00001)ConclusionPresence of fQRS on admission ECG was found to be predictor of mortality, MACE, deterioration of LV function, and presence of multivessel disease in patients with STEMI and NSTEMI.
Evaluation of Tp‐e Interval, Tp‐e/QT Ratio, and Tp‐e/QTc Ratio in Patients with Asymptomatic Arrhythmogenic Right Ventricular Cardiomyopathy
Authors: Alizade Elnur , Yesin Mahmut , Yazicioğlu Mehmet Vefik , Karaayvaz Ekrem Bilal , Atici Adem , Arslan Şükrü , Avci Anıl , Acar Göksel , Tabakci Mustafa , Izci Servet , Pala Selçuk 
Published: March 2016

BackgroundArrhythmogenic right ventricular dysplasia (ARVD) is characterized by progressive replacement of ventricular myocytes with variable amounts of fibrous and adipose tissue. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp‐e) may correspond to the transmural dispersion of repolarization and that increased Tp‐e interval and Tp‐e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate repolarization dispersion measured from the 12‐lead surface electrocardiogram (including Tp‐e interval, Tp‐e/QT, and Tp‐e/QTc ratio) in asymptomatic ARVD patientsMethodsWe selected 27 patients with asymptomatic ARVD and 27 age‐ and gender‐match young, healthy volunteers.ResultsTp‐e interval, Tp‐e/QT and Tp‐e/QTc ratio were also significantly higher in ARVD group compared to the control group (all P < 0.001). There were negative correlation between S global and Tp‐e, Tp‐e/QT, Tp‐e/QTc ration (r = −0.57, P = 0.02; r = −0.85, P = 0.02; r = −0.63, P < 0.01; respectively). There were also negative correlation between Sm global and Tp‐e, Tp‐e/QT, Tp‐e/QTc ration (r = −0.61, P < 0.01; r = −0.67, P < 0.01; r = −0.68, P < 0.01; respectively). Moreover, Em global were negative correlation between Tp‐e, Tp‐e/QT, and Tp‐e/QTc (r = − 0.64, P < 0.001, r = − 0.75, P < 0.01; r = −0,69, P < 0.01; respectively)ConclusionIn conclusion, we have presented strong evidence suggesting that Tp‐e interval, Tp‐e/QT ratio, and Tp‐e/QTc ratio were increased in asymptomatic ARVD patients.
Impact of Iron and Homocysteine Levels on T Peak‐to‐End Interval and Tp‐e/QT Ratio in Elite Athletes
Authors: Duyuler Serkan , Türker Duyuler Pınar , Batur Mustafa Kemal 
Published: March 2016

BackgroundElectrocardiography (ECG) is frequently used in preparticipation evaluation of competitive athletes. Repolarization heterogeneities on ECG is a well‐known indicator for malignant ventricular arrhythmias and sudden cardiac death. We aimed to investigate the effect of iron and homocysteine levels on arrhythmogenic indicators, T peak‐to‐end (Tp‐e) interval, and Tp‐e/QT ratio in elite athletes.MethodsA total of 72 players (48 football and 24 basketball) with a mean age of 25.4 ± 5.0 years were included to the analysis. Blood biochemistry, homocysteine level, and iron parameters (transferrin saturation and serum iron) were obtained by standard methods. Duration of QRS, QT interval, and Tp‐e interval were measured manually on the precordial leads and Tp‐e/QT ratio was calculated.ResultsBaseline demographic and clinical characteristics of the study population were compared in two groups according to the median value of Tp‐e/QT = 0.219. Both iron and transferrin saturations were higher in the above median group (P = 0.001 and P = 0.002, respectively), however, homocysteine levels were not statistically different among two groups (P = 0.405). In correlation analysis, both serum iron and transferrin saturation were significantly correlated with Tp‐e interval (r = 0.368; P = 0.001 and r = 0.394; P = 0.00, respectively) and Tp‐e/QT ratio (r = 0.357; P = 0.002 and r = 0.372; P = 0.001, respectively). Multiple stepwise regression analysis revealed that transferrin saturation was an independent predictor of Tp‐e interval and Tp‐e/QT ratio (β = 0.325; P = 0.002 and β = 0.372; P = 0.001, respectively).ConclusionThis study showed an independent relationship between iron status and Tp‐e interval and Tp‐e/QT ratios of elite sport players which were also not correlated with serum homocysteine levels.
Infection rates with use of intra‐articular pain catheters in total knee arthroplasty
Authors: Ham Andrew , Goyal Navendu , Harris Ian A. , Chen Darren B. , MacDessi Samuel J. 
Published: March 2016

BackgroundIntra‐articular pain catheters effectively reduce postoperative pain in total knee arthroplasty (TKA) by delivering analgesia to the surgical site. However, concerns exist regarding the potential for increasing deep infections. This study tested the hypothesis that intra‐articular pain catheters in TKA increase the rate of deep surgical site infections.MethodsA retrospective analysis of 1915 patients undergoing primary TKA between January 2008 and December 2013 was undertaken, comparing infection rates between patients with intra‐articular catheters inserted and those without.ResultsDeep infection rate was 0.53% with intra‐articular pain catheters, compared with 0.77% when the catheters were not inserted. There was no statistically significant difference between the groups (P = 0.56).ConclusionIntra‐articular pain catheters in TKA did not increase the rate of deep infection.
Generalised Rank Regression Estimator with Standard Error Adjusted Lasso
Authors: Turkmen A.S. , Ozturk O. 
Published: March 2016

SummaryOne of the standard variable selection procedures in multiple linear regression is to use a penalisation technique in least‐squares (LS) analysis. In this setting, many different types of penalties have been introduced to achieve variable selection. It is well known that LS analysis is sensitive to outliers, and consequently outliers can present serious problems for the classical variable selection procedures. Since rank‐based procedures have desirable robustness properties compared to LS procedures, we propose a rank‐based adaptive lasso‐type penalised regression estimator and a corresponding variable selection procedure for linear regression models. The proposed estimator and variable selection procedure are robust against outliers in both response and predictor space. Furthermore, since rank regression can yield unstable estimators in the presence of multicollinearity, in order to provide inference that is robust against multicollinearity, we adjust the penalty term in the adaptive lasso function by incorporating the standard errors of the rank estimator. The theoretical properties of the proposed procedures are established and their performances are investigated by means of simulations. Finally, the estimator and variable selection procedure are applied to the Plasma Beta‐Carotene Level data set.
Dietary administration of probiotics to sows and/or their neonates improves the reproductive performance, incidence of post‐weaning diarrhea and histopathological parameters in the intestine of weaned piglets
Authors: Hayakawa Teruo , Masuda Tomohide , Kurosawa Daisuke , Tsukahara Takamitsu 
Published: March 2016

AbstractProbiotics have gained considerable attention with respect to their beneficial effects on livestock performance and health. The most significant effects of probiotics on the gut microbiota and the host animals take place when they are included in diets during particularly stressful periods such as weaning and/or at the beginning of the lactation period. The probiotics Bacillus mesentericus strain TO‐A at 1 × 108 colony forming units (CFU)/g, Clostridium butyricum strain TO‐A at 1 × 108 CFU/g and Enterococcus faecalis strain T‐110 at 1 × 109 CFU/g were used. Litter weight at delivery and ratio of return to estrous improved significantly (17% and 24% improvement, respectively) by probiotic administration to sows (0.2% (w/w)). Furthermore, the feed intake of the probiotics‐administered sows was greater than that of the control sows during the late lactation period. Post‐weaning diarrheal incidence and growth performance was improved by probiotics administration to neonates (0.02% (w/w)), while the combined use of probiotics in sows and their neonates induced the enlargement of villous height and prevented muscle layer thinning in the small intestine of weaning piglets. The administration of probiotics of three species of live bacteria improved the porcine reproductive performance around stressful periods of sows (farrowing) and piglets (weaning). [Corrections added on 26 April 2016, after first online publication: ‘Enterococcus faecalis strain T‐100’ has been corrected to ‘Enterococcus faecalis strain T‐110’ in the above paragraph and in the ‘Probiotics’ section under the Materials and Methods heading.]