bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caregivers’ interactions with health care services – Mediator of stress or added strain? Experiences and perceptions of informal caregivers of people with dementia – A qualitative study
Authors: Laparidou Despina , Middlemass Jo , Karran Terence , Siriwardena A Niroshan 
Published: February 2018

Background There are an estimated 46.8 million people worldwide living with dementia in 2015, being cared for usually by family members or friends (informal caregivers). The challenges faced by informal caregivers often lead to increased levels of stress, burden and risk of care-recipient institutionalisation. Aim The overarching aim of this study was to explore the experiences and perceptions of informal caregivers of people with dementia when interacting with the health care system, and whether the support received acted as a mediator of caregiver stress. The secondary aim was to investigate healthcare professionals’ views and current practice regarding people with dementia and their interactions with informal caregivers. Method We employed a qualitative research design, using focus groups and one face-to-face interview with a purposive sample of informal caregivers and healthcare professionals in Lincolnshire, UK. Data were collected between March and July 2015. We used the stress-process model of stress in caregivers as a theoretical framework. Results We interviewed 18 caregivers and 17 healthcare professionals. Five themes, mapped to the stress-process in caregivers’ model, captured the main challenges faced by caregivers and the type of support they wanted from health care services. Primary stressors included the challenge of diagnosing dementia; caregivers’ needs and expectations of an in-depth knowledge and understanding of dementia from healthcare professionals; and need for carer education. Secondary role strain included lack of support and mismatch of communication and expectations. Caregiver involvement in monitoring care and disease was a potential mediator tool. Conclusions Fragmentation of dementia care services, lack of training for healthcare professionals and the dearth of information for caregivers means health care services are only partially fulfilling a support role. In turn, lack of support may be intensifying caregiver stress leading to worsening in their health and well-being; thus, potentially increasing the risk of institutionalisation of their care-recipient.
Court rulings involving individuals with dementia in Israel: A qualitative perspective
Authors: Doron Israel (Issi) , Werner Perla , Spanier Benny , Lazar Ori 
Published: February 2018

Background Individuals with dementia may appear before the courts in different roles. Despite the growing interest in the rights of older persons with dementia, relatively little empirical data exist regarding their actual interactions and experiences in court. Methods This study used a qualitative, textual analysis methodology. A total of 281 Israeli legal court cases, which addressed issues relating to dementia, were analyzed. Results Four key themes were found in the legal texts: (1) The legal construction of dementia and its relationships to old age; (2) The importance of procedural justice; (3) The implications and outcomes of the legal process; and (4) The legal implications to the society as a whole. Conclusions The legal narratives, which surround legal cases that deal with dementia in Israel, reveal an internal tension between stigmatic and anti-stigmatic narratives. This complex reality raises the need for further research and for a clearer judicial policy.
The Role of Musk in Relieving the Neurodegenerative Changes Induced After Exposure to Chronic Stress
Authors: Abd El Wahab Manal Galal , Ali Soad Shaker , Ayuob Nasra Naeim 
Published: February 2018

Objective: This study aimed to evaluate the effect induced by musk on Alzheimer’s disease—such as neurodegenerative changes in mice exposed to chronic unpredictable mild stress (CUMS). Material and Methods: Forty male Swiss albino mice were divided into 4 groups (n = 10); control, CUMS, CUMS + fluoxetine, CUMS + musk. At the end of the experiment, behavior of the mice was assessed. Serum corticosterone level, hippocampal protein level of the glucocorticoid receptors, and brain-derived neurotropic factor were also assessed. Hippocampus was histopathologically examined. Results: Musk improved depressive status induced after exposure to CUMS as evidenced by the forced swimming and open field tests and improved the short-term memory as evidenced by the elevated plus maze test. Musk reduced both corticosterone levels and the hippocampal neurodegenerative changes observed after exposure to CUMS. These improvements were comparable to those induced by fluoxetine. Conclusion: Musk alleviated the memory impairment and neurodegenerative changes induced after exposure to the chronic stress.
Multimodal magnetic resonance imaging to identify stroke onset within 6 h in patients with large vessel occlusions
Authors: Wouters Anke , Dupont Patrick , Christensen Soren , Norrving Bo , Laage Rico , Thomalla Götz , Kemp Stephanie , Lansberg Maarten , Thijs Vincent , Albers Gregory W , Lemmens Robin 
Published: February 2018

Introduction Mechanical thrombectomy within 6 h after stroke onset improves the outcome in patients with large vessel occlusions. The aim of our study was to establish a model based on diffusion weighted and perfusion weighted imaging to provide an accurate prediction for the 6 h time-window in patients with unknown time of stroke onset. Patients and methods A predictive model was designed based on data from the DEFUSE 2 study and validated in a subgroup of patients with large vessel occlusions from the AXIS 2 trial. Results We constructed the model in 91 patients from DEFUSE 2. The following parameters were independently associated with <6 h time-window and included in the model: interquartile range and median relative diffusion weighted imaging, hypoperfusion intensity ratio, core volume and the interaction between median relative diffusion weighted imaging and hypoperfusion intensity ratio as predictors of the 6 h time-window. The area under the curve was 0.80 with a positive predictive value of 0.90 (95%CI 0.79–0.96). In the validation cohort (N = 90), the area under the curve was 0.73 ( P for difference = 0.4) with a positive predictive value of 0.85 (95%CI 0.69–0.95). Discussion After validation in a larger independent dataset the model can be considered to select patients for endovascular treatment in whom stroke onset is unknown. Conclusion In patients with large vessel occlusion and unknown time of stroke onset an automated multivariate imaging model is able to select patients who are likely within the 6 h time-window.
Statistical analysis plan for the ‘Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2 (RIGHT-2)’
Authors: Scutt Polly , Appleton Jason P , Dixon Mark , Woodhouse Lisa J , Sprigg Nikola , Wardlaw Joanna M , Montgomery Alan A , Pocock Stuart , Bath Philip M 
Published: February 2018

Rationale: Glyceryl trinitrate, a nitric oxide donor, is a candidate treatment for acute stroke; it lowers blood pressure, does not alter cerebral blood flow or platelet function and is neuroprotective in experimental stroke. The ongoing rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 trial aims to assess the safety and efficacy of paramedic-delivered glyceryl trinitrate in patients with ultra-acute stroke. Aims and design: The rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 trial is a multicentre UK-based prospective randomised sham-controlled outcome-blinded parallel-group trial in patients with presumed stroke who present to the ambulance service following a 999 emergency call. The primary outcome is the modified Rankin scale measured by central telephone follow-up at 90 days. Results This paper describes the statistical analysis plan for the rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 trial and was developed prior to unblinding to treatment allocation. The statistical analysis plan includes details of methods for analyses and unpopulated tables and figures to be included in the primary and other secondary publications. Discussion Statistical analysis plan details what analyses will be done prior to unblinding to treatment allocation to avoid bias in the findings. Rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 trial will determine whether glyceryl trinitrate administered ultra-acutely can improve outcome after stroke. The rapid intervention with glyceryl trinitrate in hypertensive stroke trial-2 trial is registered as ISRCTN26986053.
Synergistic role of HSP90α and HSP90β to promote myofibroblast persistence in lung fibrosis
Authors: Bellaye Pierre-Simon , Shimbori Chiko , Yanagihara Toyoshi , Carlson David A. , Hughes Philip , Upagupta Chandak , Sato Seidai , Wheildon Nolan , Haystead Timothy , Ask Kjetil , Kolb Martin 
Published: February 2018

Idiopathic pulmonary fibrosis (IPF) is a progressive disease of the lung parenchyma, causing significant morbidity through worsening dyspnoea and overall functional decline. IPF is characterised by apoptosis-resistant myofibroblasts, which are a major source for the excessive production of extracellular matrix (ECM) overtaking normal lung tissue. We sought to study the role of heat shock protein (HSP) isoforms HSP90α and HSP90β, whose distinct roles in lung fibrogenesis remain elusive.We determined the level of circulating HSP90α in IPF patients (n=31) and age-matched healthy controls (n=9) by ELISA. The release of HSP90α and HSP90β was evaluatedin vitroin primary IPF and control lung fibroblasts andex vivoafter mechanical stretch on fibrotic lung slices from rats receiving adenovector-mediated transforming growth factor-β1.We demonstrate that circulating HSP90α is upregulated in IPF patients in correlation with disease severity. The release of HSP90α is enhanced by the increase in mechanical stress of the fibrotic ECM. This increase in extracellular HSP90α signals through low-density lipoprotein receptor-related protein 1 (LRP1) to promote myofibroblast differentiation and persistence. In parallel, we demonstrate that the intracellular form of HSP90β stabilises LRP1, thus amplifying HSP90α extracellular action.We believe that the specific inhibition of extracellular HSP90α is a promising therapeutic strategy to reduce pro-fibrotic signalling in IPF.
Social deprivation and prognosis in Scottish patients with pulmonary arterial hypertension
Authors: Pellino Katherine , Kerridge Simon , Church Colin , Peacock Andrew J. , Crowe Timothy , Jayasekera Geeshath , Johnson Martin K. , MacKenzie Alison M. 
Published: February 2018

Several demographic and clinical factors have prognostic significance in idiopathic pulmonary arterial hypertension (IPAH). Studies in China and the USA have suggested an association between low socioeconomic status and reduced survival. The impact of social deprivation on IPAH survival in the UK is not known.280 patients with IPAH and hereditary PAH (HPAH) attending the Scottish Pulmonary Vascular Unit (Glasgow, UK) were assigned to social deprivation quintiles using the Scottish Index of Multiple Deprivation database. The association between survival and social deprivation quintile was assessed using Cox proportional hazards regression analysis.The distribution of IPAH/HPAH patients was more socially deprived than would be expected based on Scottish citizenry as a whole (Chi-squared 16.16, p=0.003), suggesting referral and access to care is not impeded by socioeconomic status. Univariate analysis demonstrated no significant association between social deprivation and survival (p=0.81), and this association failed to reach significance with inclusion of time, sex and age as covariates in the model (p=0.23). There were no statistically significant correlations between social deprivation and baseline clinical variables of prognostic importance except for age, sex and quality of life.Social deprivation is not a significant referral barrier or prognostic factor for IPAH and HPAH in Scotland.
Effects of continuous positive airway pressure therapy on left ventricular diastolic function: a randomised, sham-controlled clinical trial
Authors: Shim Chi Young , Kim Darae , Park Sungha , Lee Chan Joo , Cho Hyung-Ju , Ha Jong-Won , Cho Yang-Je , Hong Geu-Ru 
Published: February 2018

Continuous positive airway pressure (CPAP) therapy may decrease left ventricular (LV) loads and improve myocardial oxygenation. In this study, we investigated the effect of CPAP on LV diastolic function compared with sham treatment in patients with severe obstructive sleep apnoea (OSA).This 3-month prospective single-centre randomised sham-controlled trial analysed 52 patients with severe OSA. Patients were randomly assigned (1:1) to receive either CPAP or sham treatment for 3 months. The main investigator and patients were masked to the trial randomisation. The primary end-point was change of early diastolic mitral annular (e′) velocity over the 3-month period. Secondary end-points were pulse wave velocity (PWV), 24-h ambulatory blood pressure (BP) and variables of ventricular-vascular coupling at 3 months.After 3 months of follow-up, CPAP treatment significantly increased the e′ velocity, and was greater than the sham treatment (0.65±1.70versus−0.61±1.85 cm·s−1, p=0.014). The PWV, 24-h mean diastolic BP, night-time diastolic BP, arterial elastance index and ventricular-vascular coupling index after 3 months of follow-up decreased significantly in the CPAP group.In patients with severe OSA, CPAP treatment for 3 months improved LV diastolic function more than sham treatment, and was accompanied by improvements in arterial stiffness and ventricular-vascular coupling.
Mindfulness-based cognitive therapy in COPD: a cluster randomised controlled trial
Authors: Farver-Vestergaard Ingeborg , O'Toole Mia S. , O'Connor Maja , Løkke Anders , Bendstrup Elisabeth , Basdeo Sharee A. , Cox Donal J. , Dunne Pádraic J. , Ruggeri Kai , Early Frances , Zachariae Robert 
Published: February 2018

A considerable proportion of patients with chronic obstructive pulmonary disease (COPD) entering pulmonary rehabilitation (PR) report psychological distress, which is often accompanied by poor physical health status. Mindfulness-based cognitive therapy (MBCT) has been shown to improve psychological and physical outcomes in other chronic diseases. We therefore evaluated the efficacy of MBCT as an add-on to a standard PR programme in COPD.COPD patients eligible for PR were cluster randomised to receive either an 8-week, group-based MBCT programme as an add-on to an 8-week PR programme (n=39), or PR alone (n=45). The primary outcomes of psychological distress and physical health status impairment were measured with the Hospital Anxiety and Depression Scale (HADS) and the COPD Assessment Test (CAT) before randomisation (T1), mid- (T2) and post-intervention (T3), and at 3 (T4) and 6 (T5) months’ follow-up .A statistically significant time×arm effect was found for the HADS (Cohen'sd=0.62, 95% CIs (d)=0.18–1.06, p=0.010). The treatment effect on the CAT failed to reach statistical significance (d=0.42, 95% CIs (d)=−0.06–0.90, p=0.061).MBCT showed a statistically significant and durable effect on psychological distress, indicating that MBCT may be an efficacious add-on to standard PR programmes in COPD.
“Past Echoes of Cruelty and Nonsense” in Stevie Smith
Authors: Gargaillo Florian 
Published: February 2018

AbstractIn a review of T. S. Eliot’s Murder in the Cathedral, Stevie Smith lamented that “so many writers of these times, which need courage and the power of criticism, and coolness, should find their chief delight in terrifying themselves and their readers with past echoes of cruelty and nonsense.” Paradoxically, those twin nouns—“cruelty and nonsense”—have often been used to describe her own poetry. This essay examines Smith’s allusions to Eliot, Algernon Swinburne, and John Keats and demonstrates that such “past echoes” helped her weigh the risk of dwelling on cruelty to the point of morbidity against that of finding too much pleasure in the cruel and absurd. More broadly, Smith’s allusiveness presents a significant alternative to Harold Bloom’s anxiety of influence. Her attitude toward her predecessors is not agonistic but playful, elusive, and polyvalent. She writes through the poetry of the past to work out problems of ethics and aesthetics that were of great importance to her.
Evaluation of periprostatic neurovascular fibers before and after radical prostatectomy by means of 1.5 T MRI diffusion tensor imaging
Authors: Di Paola Valerio , Cybulski Adam , Belluardo Salvatore , Cavicchioli Francesca , Manfredi Riccardo , Pozzi Mucelli Roberto 
Published: February 2018

Objective:
To evaluate if diffusion tensor imaging (DTI) is able to detect changes of periprostatic neurovascular fibers (PNFs) before and after radical prostatectomy (RP), and if these changes are related to post-surgical urinary incontinence and erectile dysfunction.

Methods:
22 patients (mean age 62.6 years) with biopsy-proven prostate cancer underwent 1.5 T DTI before and after RP. The number, fractional anisotropy (FA) values and length of PNFs before and after RP were compared using Student’s t-test. Each patient filled out two questionnaires before and after RP, one for the evaluation of urinary continence (ICIQ-SF) and one for the evaluation of erectile function (IIEF-5). The ratios of the number, FA values and length of PNFs before and after RP (DTI B-A RATIOs) and the ratios between the scores obtained before and after RP for both ICIQ-SF and IIEF-2 (ICIQ-SF B-A RATIOs and IIEF-2 B-A RATIOs) were calculated to perform the Kendall’s τ-test between them.

Results:
There was a statistically significant decrease of the number of PNFs after RP at base, midgland, and apex (p &lt; 0.01) and of FA values at midgland (p &lt; 0.05), with positive statistically significant correlation between the DTI B-A RATIOs of the number of PNFs and IIEF-2 B-A RATIOs (p &lt; 0.05, ρ = 0.47).

Conclusion:
DTI was able to detect that the decrease of the number of the PNFs after RP was statistically related to the post-surgical erectile dysfunction (p &lt; 0.05).

Advances in knowledge:
This work demonstrates that: (1) 1.5 T MRI DTI is able to detect the decrease of the number and of the FA of PNFs after prostatectomy; (2) the decrease of the number of PNFs after prostatectomy is related with the post-surgical erectile dysfunction; (3) 1.5 T MRI DTI has demonstrated to be a reproducible technique in detecting the changes of the PNFs induced by RP, with high interobserver agreement.
Equine influenza
Authors: BOUNTOURI (Μ. ΜΠΟΥΝΤΟΥΡΗ) M. , FRAGKIADAKI (Ε. ΦΡΑΓΚΙΑΔΑΚΗ) E. , DAFIS (Β. ΝΤΑΦΗΣ) V. , XYLOURI (Ε. ΞΥΛΟΥΡΗ) E. 
Published: February 2018

Equine Influenza (ΕΙ) is an acute, highly contagious, respiratory disease of equine. The causative agent of EI infections is a type A influenza virus, classified into the family Orthomyxovirìdae. Up to today two subtypes of EI are known, subtype 1 (H7N7) and subtype 2 (H3N8). Subtype 1 has not been isolated since 1977 and is presumed that has been replaced by the subtype 2, which is the causative agent of many recent outbreaks. Antigenic drift of H3N8 viruses resulted in the divergence of strains into two distinct evolutionary lineages, which co-circulate. The high morbidity of equine influenza disease was demonstrated in all resent widespread outbreaks all over the world. On the other hand, the mortality rate of influenza disease in equids is generally low, unless secondary bacterial infections occurred. Devastating economic loss of the disease in breeding and race animals reinforced the importance of vaccination. Despite the extensive use of vaccines, outbreaks of equine influenza continue to occur. In 2003 there were widespread outbreaks of equine influenza among un vaccinates and regularly vaccinated horses in Europe and later all over the world, even in regions that rarely report equine influenza outbreaks. However, studies have shown that vaccination does not prevent transmission and on the other hand multiple booster doses could result to paralysis of the immune system. Furthermore, all these developments including transmission to swine and dogs, shows the unpredictable evolutionary pathways the equine influenza virus follows. In conclusion, influenza surveillance and research should go on and provide useful tools to better evaluate when vaccine strains should be updated.
Impact of a porcine reproductive and respiratory syndrome inactivated vaccine on the health and semen traits of boars
Authors: PAPATSIROS (Β. ΠΑΠΑΤΣΙΡΟΣ) V. G. , ALEXOPOULOS (Κ. ΑΛΕΞΟΠΟΥΛΟΣ) C. , BOSCOS (Κ. ΜΠΟΣΚΟΣ) C. , KYRIAKIS (Σ.Κ. ΚΥΡΙΑΚΗΣ) S. C. 
Published: February 2018

The aim of this study was to investigate the effects of a commercial European Porcine Reproductive and Respiratory Syndrome (PRRS) - inactivated vaccine on health status, semen characteristics and semen fertilizing capacity in vivo of boars. In a farrow to finish farm that suffered from chronic course of PRRS, 7 donor boars (1.1-2.2 years old) were initially twice vaccinated, with a 4 weeks interval. At the same time, all gilts / sows of the herd were, also, vaccinated. Boars were monitored for abnormal clinical signs 24 h prior to 15 days after each vaccination. Ejaculates were collected 24 h prior, 24 h after and 15 days after each vaccination and the semen characteristics were evaluated. A total of 305 sows were inseminated twice with the collected semen 2 weeks prior up to 6 weeks after the 1st vaccination. No systemic clinical signs and significant differences in semen characteristics, except of sperm viability, were noticed. After the 1st vaccination, sperm viability increased, but this was probably due to the increase of the age of 7 boars during the trial and not due to the vaccination. All semen characteristics were decreased 24h after each vaccination, but they were not lower than the value of accepted criteria semen quality. No change was noticed in sow's fertility parameters, apart from the farrowing rate, that was not, however, of clinical importance. In conclusion, the use of a PRRSV - inactivated vaccine in boars is safe and has not negative effects on health status and their semen characteristics neither on fertilizing capacity in vivo.