bluuebunny/crossref_metadata_2025_split huggingface dataset:
“Everyone thought I was a very very bad person… no one want to know you like the nurses and doctors”: Using focus groups to elicit the views of adults with learning disability who use challenging behaviour services
Authors: Haydon‐Laurelut Mark , Edmonds Jane , Daynes Shona , Clare Amy , Byles Rosalind , Barber Victoria 
Published: August 2017

Accessible summary

We wanted to find out what adults with learning disabilities who receive challenging behaviour services thought about challenging behaviour and the services they receive.

We met with people in small groups and talked with them about challenging behaviour.

There were barriers to attending the groups like services not having enough staff or transport.

People in the groups told us what they thought of words like challenging behaviour, what they understood about challenging behaviour services, and what it was like meeting with them.

AbstractBackgroundFollowing scandals such as Winterbourne view, Department of Health, (A national response to Winterbourne View Hospital, 2012) seeks changes in challenging behaviour services. A key part of this change is ensuring people with learning disabilities who use challenging behaviour services have more personalised support and their voices are heard.Materials and MethodsThis article describes a study that used focus groups to explore challenging behaviour and challenging behaviour services with people with learning disabilities who used community‐based challenging behaviour services. We analysed the focus groups using thematic analysis.ResultsWe found three main themes: Engaging with service terminology: the language of Challenging Behaviour; Locating and Framing behaviour; and Engaging with Professionals.ConclusionPeople with learning disabilities who receive challenging behaviour services are able to participate in focus groups and tell us about their experiences. Further consideration is required concerning how people with learning disabilities experience their engagement with challenging behaviour services. This study has led to a larger study currently in progress.
Motion Perception and Form Discrimination in Extremely Preterm School‐Aged Children
Authors: Benassi Mariagrazia , Bolzani Roberto , Forsman Lea , Ådén Ulrika , Jacobson Lena , Giovagnoli Sara , Hellgren Kerstin 
Published: August 2017

This population‐based study evaluated motion and form perception in 71 children born extreme premature (EPT; < 27 gestational weeks), aged 6.5 years, as compared to a matched group of 79 control children born at term. Motion and form perception were evaluated by motion coherence and form coherence tests. The EPT group showed a poorer performance on both tasks as compared to the control group. However, after controlling for IQ and visual acuity, the EPT group showed only a significant deficit in motion perception. No association was found between motion perception accuracy and gestational age, previous retinopathy of prematurity, or previous intraventricular hemorrhage in the EPT group. The results highlight the long‐term motion perception deficits in children born EPT.
Corticosteroid and long‐acting ß‐agonist therapy reduces epithelial goblet cell metaplasia
Authors: Lachowicz‐Scroggins M. E. , Finkbeiner W. E. , Gordon E. D. , Yuan S. , Zlock L. , Bhakta N. R. , Woodruff P. G. , Fahy J. V. , Boushey H. A. 
Published: August 2017

SummaryBackgroundBronchial epithelial goblet cell metaplasia (GCM) with hyperplasia is a prominent feature of asthma, but the effects of treatment with corticosteroids alone or in combination with a long‐acting β2‐adrenergic receptor agonist (LABA) on GCM in the bronchial epithelium are unknown.ObjectivesTo determine whether corticosteroid alone or in combination with a LABA alters protein and gene expression pathways associated with IL‐13–induced goblet cell metaplasia.ResultsWe evaluated the effects of fluticasone propionate (FP) and of salmeterol (SM), on the response of well‐differentiated cultured bronchial epithelial cells to interleukin‐13 (IL‐13). Outcome measures included gene expression of SPDEF/FOXa2, gene expression and protein production of MUC5AC/MUC5B and morphologic appearance of cultured epithelial cell sheets. We additionally analysed expression of these genes in bronchial epithelial brushings from healthy, steroid‐naïve asthmatic and steroid‐treated asthmatic subjects. In cultured airway epithelial cells, FP treatment inhibited IL‐13–induced suppression of FOXa2 gene expression and up‐regulation of SPDEF, alterations in gene and protein measures of MUC5AC and MUC5B and induction of GCM. The addition of SM synergistically modified the effects of FP modestly—only for gel‐forming mucin MUC5AC. In bronchial epithelial cells recovered from asthmatic vs healthy human subjects, we found FOXa2 and MUC5B gene expression to be reduced and SPDEF and MUC5AC gene expression to be increased; these alterations were not observed in bronchial epithelial cells recovered after treatment with inhaled corticosteroids.Conclusion and Clinical RelevanceCorticosteroid treatment inhibits IL‐13–induced GCM of the airways in asthma, possibly through its effects on SPDEF and FOXa2 regulation of mucin gene expression. These effects are modestly augmented by the addition of a long‐acting ß‐agonist. As we found evidence for drug treatment counteracting the effects of IL‐13 on the epithelium, we conclude that further exploration into the mechanisms by which corticosteroids and long‐acting β2‐adrenergic agonists confer protection against pathologic airway changes is warranted.
Primary hyperparathyroidism in Chinese children and adolescents: A single‐centre experience at Peking Union Medical College Hospital
Authors: Wang Wenbo , Kong Jing , Nie Min , Jiang Yan , Li Mei , Xia Weibo , Meng Xunwu , Xing Xiaoping , Wang Ou 
Published: August 2017

SummaryObjectivePrimary hyperparathyroidism (PHPT) in children is thought to be extremely rare. Our study aimed to summarize the clinical characteristics and the molecular genetics in patients with paediatric PHPT in China.DesignRetrospective observational study.MethodsA total of 59 paediatric PHPT patients (onset age <18 years) admitted to Peking Union Medical College Hospital from 1975 to 2015 were retrospectively identified. A group of 118 adult PHPT patients who presented during the same period were selected for comparing clinical characteristics between the two groups. Germline mutation analyses of the MEN1, CDC73, RET, CDKN1B and CaSR genes were performed in 24 patients.ResultsOnly one paediatric patient (1.7%) with PHPT was asymptomatic. Bone involvement, urolithiasis, acute pancreatitis and hypercalcaemic crisis were present in 86.4%, 39.0%, 6.8% and 10.2% of cases, respectively. Paediatric PHPT presented more commonly with rickets/osteomalacia compared to adult PHPT. Fifty‐seven paediatric patients underwent surgery. Adenoma, hyperplasia, atypical adenoma and carcinoma occurred in 80.7%, 10.5%, 7.0% and 1.8% of cases, respectively. Of the 24 paediatric patients screened for genetic mutations, two patients were found to carry MEN1 mutations and six were found to carry CDC73 mutations. The mutation rate was 22.2% (4/18) in sporadic patients.ConclusionUnlike adults with PHPT, most paediatric PHPT were symptomatic. Rickets/osteomalacia was more common in paediatric patients than in their adult counterparts. Paediatric PHPT patients can be treated successfully with surgical intervention. Genetic screening of the MEN1 and CDC73 genes for mutations should be recommended in paediatric patients due to a relatively high mutation rate.
How Cross‐Linguistic Differences in the Grammaticalization of Future Time Reference Influence Intertemporal Choices
Authors: Thoma Dieter , Tytus Agnieszka E. 
Published: August 2017

AbstractAccording to Chen's (2013) Linguistic Savings Hypothesis (LSH), our native language affects our economic behavior. We present three studies investigating how cross‐linguistic differences in the grammaticalization of future‐time reference (FTR) affect intertemporal choices. In a series of decision scenarios about finance and health issues, we let speakers of altogether five languages that represent FTR with increasing strength, that is, Chinese, German, Danish, Spanish, and English, choose between hypothetical sooner‐smaller and later‐larger reward options. While the LSH predicts a present‐bias that increases with FTR‐strength, our decision makers preferred later‐larger options and this future‐bias increased with FTR‐strength. In multiple regressions, the FTR‐strength effect persisted when controlled for socioeconomic and cultural differences. We discuss why our findings deviate from the LSH and ask in how far the FTR‐strength effect represents a habitual constitution of linguistic relativity or an instance of online decision framing.
Intra‐operative predictors of postoperative Takotsubo syndrome in liver transplant recipients—An exploratory case‐control study
Authors: Aniskevich Stephen , Chadha Ryan M. , Peiris Prith , Taner Cemal Burcin , Torp Klaus L. , Thomas Colleen S. , Yataco Maria L. , Pai Sher‐Lu 
Published: August 2017

AbstractIntroductionTakotsubo syndrome (TTS), also known as Takotsubo cardiomyopathy or stress‐induced cardiomyopathy, has been described following a variety of surgeries and disease states. The relationship between intra‐operative anesthesia management and the development of this syndrome has never been fully elucidated.ObjectivesThe primary objective of this study was to determine the relationship of multiple intra‐operative factors on the pathogenesis of TTS.MethodsA single‐center retrospective review of all liver transplants performed at Mayo Clinic Florida from January 2005 to December 2014. Patients developing left ventricular dilation and a concomitant decrease in ejection fraction, a negative cardiac catheterization, or stress test within 30 days of transplantation were identified. Cases were matched 2:1 to controls with respect to MELD, age, sex, and indication for transplantation. Our evaluation included liver graft characteristics, intra‐operative medications, and intra‐operative hemodynamic measurements.ResultsWe identified 24 cases of TTS from a pool of 1752 transplants, for an incidence of 1.4%. No statistically significant differences in intra‐operative measures between the two groups were identified (all P ≥ .08).ConclusionOur exploratory, single‐center retrospective review evaluating 46 intra‐operative characteristics found no association with the development of TTS.
Therapeutic inertia in the treatment of hyperglycaemia in patients with type 2 diabetes: A systematic review
Authors: Khunti Kamlesh , Gomes Marilia B. , Pocock Stuart , Shestakova Marina V. , Pintat Stéphane , Fenici Peter , Hammar Niklas , Medina Jesús 
Published: August 2017

AimsTherapeutic inertia, defined as the failure to initiate or intensify therapy in a timely manner according to evidence‐based clinical guidelines, is a key reason for uncontrolled hyperglycaemia in patients with type 2 diabetes. The aims of this systematic review were to identify how therapeutic inertia in the management of hyperglycaemia was measured and to assess its extent over the past decade.Materials and MethodsSystematic searches for articles published from January 1, 2004 to August 1, 2016 were conducted in MEDLINE and Embase. Two researchers independently screened all of the titles and abstracts, and the full texts of publications deemed relevant. Data were extracted by a single researcher using a standardized data extraction form.ResultsThe final selection for the review included 53 articles. Measurements used to assess therapeutic inertia varied across studies, making comparisons difficult. Data from low‐ to middle‐income countries were scarce. In most studies, the median time to treatment intensification after a glycated haemoglobin (HbA1c) measurement above target was more than 1 year (range 0.3 to >7.2 years). Therapeutic inertia increased as the number of antidiabetic drugs rose and decreased with increasing HbA1c levels. Data were mainly available from Western countries. Diversity of inertia measures precluded meta‐analysis.ConclusionsTherapeutic inertia in the management of hyperglycaemia in patients with type 2 diabetes is a major concern. This is well documented in Western countries, but corresponding data are urgently needed in low‐ and middle‐income countries, in view of their high prevalence of type 2 diabetes.
Fibrotic scar model and TGF‐β1 differently modulate action potential firing and voltage‐dependent ion currents in hippocampal neurons in primary culture
Authors: Ondacova Katarina , Moravcikova Lucia , Jurkovicova Dana , Lacinova Lubica 
Published: August 2017

AbstractTraumatic injury of the central nervous system is accompanied by various functional and morphological changes. Animal models of traumatic brain injury are commonly used to investigate changes in behaviour, morphology, in the expression of various proteins around the site of the injury, or the expression of diagnostically important biomarkers. Excitability of a single neuron at, or close to, the site of injury was rarely investigated. Several in vitro models were developed which allow such investigation. In the present work, we employed a fibrotic scar model according to Kimura‐Kuroda and coauthors to analyse altered excitability of rat hippocampal neurons under the conditions mimicking traumatic brain injury. Hippocampal neurons from newborn rats were cultured either on a fibrotic scar model or in the presence of TGF‐β1, a cytokine secreted at a brain injury site that may have both neuroprotective and neurodegenerative function. Fibrotic scar facilitated ability of neonatal hippocampal neurons to fire action potential series by increasing the density of voltage activated sodium and potassium currents. Chondroitin sulphate proteoglycans played substantial role in these effects, as proven by their full reversion after administration of Chondroitinase ABC. In contrast, TGF‐β1 did not contribute to them. An application of TGF‐β1 itself attenuated generation of action potentials, inhibited sodium current and potentiated potassium currents. Main alteration of electrophysiological parameters of neonatal hippocampal neurons caused by a fibrotic scar model is enhanced excitability. TGF‐β1 may have predominantly neuroprotective role in injured rat hippocampus.
Investigation into intraoral approach for nerve block injection at the mental foramen in the horse
Authors: Eckert R. E. , Griffin C. E. , Cohen N. D. , Marx S. 
Published: August 2017

SummaryInvasive dental procedures performed in the standing, sedated horse are facilitated by local and regional anaesthesia. The traditional transcutaneous approach to the mental foramen is used to desensitise the incisive region including the mandibular incisors, but is not well tolerated by many sedated patients. In this study, a new, intraoral needle insertion technique for nerve block at the mental foramen was investigated. In 15 equine cadaver heads and two live horses, computed tomography (CT) was used to verify Tuohy needle placement into each mental foramen using an intraoral technique. Varying volumes of contrast medium (3, 6, 10 mL) were injected into the mandibular canal with and without digital occlusion of the mental foramen. The distance of retrograde flow was measured. Additionally, measurements were taken to determine the position of the mental foramen within the interdental space. Correct placement of Tuohy needles and injection of contrast medium into the mandibular canal using an intraoral approach at the mental foramen was achieved in all injections. Retrograde flow of contrast medium was accomplished with all volumes, regardless of occlusion. Although not statistically significant, the 10 mL group appeared to have a greater distance of flow. The needle insertion technique described here appears to be a potential alternative to traditional transcutaneous approaches to mental nerve block for procedures involving the incisive region. In addition, it was found that 79% of the mandibular canals injected with 10 mL of contrast medium had retrograde flow to the position of PM4, suggesting this method may be a useful alternative technique for nerve block for the more rostrally located cheek teeth. The location of the mental foramen was consistently found in the distal third of the interdental space (approximately 60–80% of the distance between the distal aspect of the lateral corner incisor and the mesial aspect of the second premolar).
Examining the process of performance measurement system design and implementation in two Italian public service organizations
Authors: Bracci Enrico , Maran Laura , Inglis Robert 
Published: August 2017

AbstractIn the last two decades, the adoption of new public management (NPM) practices in the public sector has increased as public sector organizations seek to improve efficiency, effectiveness and public accountability. We present case study findings of a NPM initiative to implement balanced scorecard (BSC) performance measurement systems in two Italian public sector organizations. This study considers the question of whether the BSC development process can be effectively translated into the public sector context. Our findings highlight the importance of aligning the development of performance management systems with a greater understanding of the internal and external environment of public sector organizations. Our results further emphasize the significant role of emergent stakeholders and management culture for the success of NPM performance management initiatives.
Managing diversions in unregulated streams using a modified percent‐of‐flow approach
Authors: Mierau Darren W. , Trush William J. , Rossi Gabriel J. , Carah Jennifer K. , Clifford Matthew O. , Howard Jeanette K. 
Published: August 2017

AbstractIn Mediterranean‐type river systems, naturally low seasonal stream flows are often overexploited, which has implications for managing flows for environmental as well as human needs.Traditional approaches to instream flow management are not well suited to unregulated systems with strong seasonal patterns of water availability and many water diverters, and are challenging to implement in such systems. They often do not protect the full range of variability in the annual hydrograph, require extensive site‐specific data, expensive modelling or both.In contrast, holistic flow management strategies, such as percent‐of‐flow (POF) strategies are designed to protect multiple ecological processes and preserve inter‐annual flow variability. However,POFapproaches typically require real‐time streamflow gauging, and often lack a robust metric relating a diversion rate to ecological processes in the stream.To address these challenges, we present a modified percent‐of‐flow (MPOF) diversion approach where diversions are allocated from a streamflow baseline which is derived from a regional relationship between a conservative streamflow‐exceedance and date. The streamflow baseline remains the same from year to year, and is independent of water‐year type. This approach protects inter‐annual flow variability and provides a predictable daily allowable volume of diversion at any diversion point—supporting efficient water management planning.The allowable diversion rate in theMPOFapproach is based not on a fixed percentage of the ambient streamflow, but rather on a maximum allowable percentage change in riffle crest thalweg depth, an ecologically meaningful, common hydraulic measurement.In this paper, we demonstrate that theMPOFapproach is a holistic approach well suited to manage diversions in unregulated streams typical of California's Mediterranean‐type coastal drainages.
How network structure can affect nitrogen removal by streams
Authors: Helton Ashley M. , Hall Robert O. , Bertuzzo Enrico 
Published: August 2017

Abstract

Streams and rivers can be highly reactive sites for nitrogen (N) transformation and removal. Empirical and model‐based research show how location in a stream network affects rates of N removal. Because the structure of stream networks can vary widely and N cycling in headwater streams may affect N cycling in downstream reaches, we hypothesised that network structure may affect whole stream network processing of N.

We generated three stream networks with the same catchment area but differing shapes, based on optimal channel network theory. We applied a model of nitrate () transport and denitrification, and implemented model scenarios to examine how network shape affects removal with (1) increased loading from the catchment, (2) altered spatial distributions of loading and (3) decreased drainage density (i.e. loss of headwater streams).

For all stream networks, the fraction of total removed decreased with increasing loading from the catchment. Stream networks in narrow catchments removed a higher fraction of , particularly at intermediate loading rates. Network shape also controlled the distribution of removal in small versus large streams, with larger streams removing a higher fraction of the total load in narrower networks.

The effects of network shape on removal when the spatial distribution of loading was altered varied with the magnitude of loading. At low loads, was entirely removed when added to distal parts of the stream network, and about 50% removed when added near the outlet; there was no effect of network shape. At intermediate and high loads, the fraction of total load removed by the narrow stream network was 1.5× higher than the rectangular and square networks when was added to distal parts of the networks. Network shape did not have an effect when load occurred near the outlet, regardless of the magnitude of the load.

The fraction of total removed by the stream network was up to 5% lower when drainage density was reduced from 1.0 to 0.74 km−1, with the least change for the narrow network. Reducing the drainage density also altered the role of small relative to large streams, with the net effect of moving the location of removal downstream.

Overall, effects of network shape contributed up to 20% of the variation in the fraction of removed by stream networks. Network shape was most important at intermediate to high loads and when was loaded to distal parts of the catchment. The narrow network removed more across model scenarios, with elevated removal in larger streams explaining most of the difference. We suggest the shape of the catchment may modulate the degree to which large streams contribute to whole network removal.