bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Dyspnoea-12 and Multidimensional Dyspnoea Profile in people with COPD
Authors: Williams Marie T. , John David , Frith Peter 
Published: December 2016

We directly compared convergent, discriminant and concurrent validity of the Dyspnoea-12 (D-12) and Multidimensional Dyspnoea Profile (MDP) in people with chronic obstructive pulmonary disease.Breathlessness measures (D-12, MDP, visual analogue scales and descriptors) were completed for two focal periods (daily life and end of walk test). Instrument structure (D-12 and MDP item grouping) was assessed with factor analysis. Differences between airflow severity stage and focal periods (ANOVA, t-test and Chi-squared test), associations between D-12 and MDP (r, r2for static pulmonary function, 6-min walk test and self-reported measures of impairment) and individual consistency for comparable items of the D-12 and MDP (McNemar's test) were assessed.In 84 participants (mean±sdage 70±9 years, 47 males, forced expiratory volume in 1 s 48±17% predicted), item groupings were confirmed for both focal periods. Developer-recommended single and subdomain scores were highly correlated, and demonstrated similar convergent, discriminant and concurrent validity. Individual consistency differed between the D-12 and MDP according to item/item groups.At the level of developer-recommended single and subdomain scores, the D-12 and MDP share similar psychometric properties, but these instruments serve different purposes, do not assess the same sensations or emotions and are not interchangeable.
Measurement of tidal breathing flows in infants using impedance pneumography
Authors: Malmberg Leo Pekka , Seppä Ville-Pekka , Kotaniemi-Syrjänen Anne , Malmström Kristiina , Kajosaari Merja , Pelkonen Anna S. , Viik Jari , Mäkelä Mika J. 
Published: December 2016

Tidal breathing flow volume (TBFV) profiles have been used to characterise altered lung function. Impedance pneumography (IP) is a novel option for assessing TBFV curves noninvasively. The aim of this study was to extend the application of IP for infants and to estimate the agreement between IP and direct pneumotachograph (PNT) measurements in assessing tidal airflow and flow-derived indices.Tidal flow profiles were recorded for 1 min simultaneously with PNT and uncalibrated IP at baseline in 44 symptomatic infants, and after methacholine-induced bronchoconstriction in a subgroup (n=20).The agreement expressed as the mean deviation from linearity ranged between 3.9 and 4.3% of tidal peak inspiratory flow, but was associated with specific airway conductance (p=0.002) and maximal flow at functional residual capacity (V′maxFRC) (p=0.004) at baseline. Acute bronchoconstriction induced by methacholine did not significantly affect the agreement of IP with PNT. TBFV indices derived from IP were slightly underestimated compared to PNT, but were equally well repeatable and associated with baselineV′maxFRC(p=0.012 and p=0.013, respectively).TBFV profiles were consistent between IP and PNT in most infants, but the agreement was affected by reduced lung function. TBFV parameters were not interchangeable between IP and PNT, but had a similar association with lung function in infants.
Predictors of mortality in chronic pulmonary aspergillosis
Authors: Lowes David , Al-Shair Khaled , Newton Pippa J. , Morris Julie , Harris Chris , Rautemaa-Richardson Riina , Denning David W. 
Published: December 2016

Chronic pulmonary aspergillosis (CPA) is a chronic progressive infection that destroys lung tissue in non-immunocompromised patients. Contemporary series suggest 50–85% 5-year mortality, with few prognostic factors identified.A cohort of 387 CPA patients referred to the UK's National Aspergillosis Centre from 1992 to June 2012 was studied until June 2015. The impact of objective and subjective variables including age, sex, previous pulmonary conditions, dyspnoea score, quality of life, serum albumin and C-reactive protein and radiological appearances were assessed using Kaplan–Meier curves, log rank tests and Cox proportional hazards modelling. In samples of patients, retrospective review of time from likely onset of CPA to referral and cause of death were also investigated.Survival was 86%, 62% and 47% at 1, 5 and 10 years, respectively. Increased mortality was associated with nontuberculous mycobacterial infection (hazard ratio 2.07, 95% CI 1.22–3.52; p<0.001) and chronic obstructive pulmonary disease (1.57, 1.05–2.36; p=0.029) as well as higher age (1.053, 1.03–1.07 per year; p<0.001), lower albumin (0.92, 0.87–0.96 per g·L−1), lower activity (1.021, 1.01–1.03 per point increase in St George's Respiratory Questionnaire activity domain; p<0.001) and having one, and especially, bilateral aspergillomas (p<0.001).Several factors impact on mortality of CPA, and can be evaluated as tools to assess CPA prognosis.
Psychometric properties of the St George's Respiratory Questionnaire in patients with idiopathic pulmonary fibrosis
Authors: Swigris Jeffrey J. , Esser Dirk , Wilson Hilary , Conoscenti Craig S. , Schmidt Hendrik , Stansen Wibke , Leidy Nancy Kline , Brown Kevin K. 
Published: December 2016

The St George's Respiratory Questionnaire (SGRQ) has been used to measure health-related quality of life (HRQoL) in patients with idiopathic pulmonary fibrosis (IPF).This analysis evaluated the psychometric properties of the SGRQ using data from 428 patients with IPF who participated in a 12-month, randomised, placebo-controlled phase II trial of nintedanib.Internal consistency (Cronbach's α) was 0.91 for SGRQ total and >0.70 for domain scores. Test–retest reliability (intraclass correlation coefficients) was 0.77, 0.77, 0.69 and 0.66 for SGRQ total, activity, impact and symptoms scores, respectively. Construct validity of SGRQ total and domain scores was supported by weak to moderate cross-sectional correlations with the Medical Research Council dyspnoea scale (0.32–0.55), 6-min walk test distance (−0.25– −0.34), percentage predicted forced vital capacity (−0.11– −0.15) and measures of gas exchange (−0.26–0.03). There was some evidence that the SGRQ total score was sensitive to detecting change.The reliability, construct validity and responsiveness of the SGRQ in patients with IPF suggest that this is an acceptable measure of HRQoL in patients with IPF.
Amplified canonical transforming growth factor-β signallingviaheat shock protein 90 in pulmonary fibrosis
Authors: Sibinska Zaneta , Tian Xia , Korfei Martina , Kojonazarov Baktybek , Kolb Janina Susanne , Klepetko Walter , Kosanovic Djuro , Wygrecka Malgorzata , Ghofrani Hossein Ardeschir , Weissmann Norbert , Grimminger Friedrich , Seeger Werner , Guenther Andreas , Schermuly Ralph T. 
Published: December 2016

Interstitial lung fibroblast activation coupled with extracellular matrix production is a pathological signature of idiopathic pulmonary fibrosis (IPF), and is governed by transforming growth factor (TGF)-β/Smad signalling. We sought to define the role of heat shock protein (HSP)90 in profibrotic responses in IPF and to determine the therapeutic effects of HSP90 inhibition in a murine model of pulmonary fibrosis.We investigated the effects of HSP90 inhibitionin vitroby applying 17-AAG (17-allylamino-17-demethoxygeldanamycin) to lung fibroblasts and A549 cells andin vivoby administering 17-DMAG (17-dimethylaminoethylamino-17-demethoxygeldanamycin) to mice with bleomycin-induced pulmonary fibrosis.HSP90 expression was increased in (myo)fibroblasts from fibrotic human and mouse lungs compared with controls. 17-AAG inhibited TGF-β1-induced extracellular matrix production and transdifferentiation of lung fibroblasts and epithelial–mesenchymal transition of A549 cells. The antifibrotic effects were associated with TGF-β receptor disruption and inhibition of Smad2/3 activation. Co-immunoprecipitation revealed that HSP90β interacted with TGF-β receptor II and stabilised TGF-β receptors. Furthermore, 17-DMAG improved lung function and decreased fibrosis and matrix metalloproteinase activity in the lungs of bleomycin-challenged mice.In conclusion, this is the first study to demonstrate that HSP90 inhibition blocks pulmonary fibroblast activation and ameliorates bleomycin-induced pulmonary fibrosis in mice.
Wage rigidities and business cycle fluctuations: a linked employer-employee analysis
Authors: Adamopoulou Effrosyni , Bobbio Emmanuele , De Philippis Marta , Giorgi Federico 
Published: December 2016

Abstract
This paper analyses wage dynamics in Italy in the last 25 years with a special focus on the recent recession. Despite the rather rigid Italian institutional setting, using linked employer-employee data we find that wage rigidities, albeit always present, have been subdued during the recessionary years. Using complementary data, we verify that, although we only observe daily and not hourly wages, overtime hours are not the main mechanism behind this enhanced wage flexibility. We document the presence of a trade-off between wage and employment adjustments: firms historically displaying higher levels of wage rigidities were less able to modify wages but exhibited higher turnover. A higher share of temporary workers, whose contractual relationship may be costlessly terminated and whose wages are therefore more frequently negotiated, served instead as a significant wage flexibility enhancing margin. More broadly, we find that firms of larger dimension, with a higher share of blue collar workers, or belonging to a sector where bonuses represent a large part of annual earnings were the ones displaying a higher level of wage flexibility.

JEL Classification
J31, J33
Frontline Science: Myeloid-derived suppressor cells (MDSCs) facilitate maternal–fetal tolerance in mice
Authors: Ostrand-Rosenberg Suzanne , Sinha Pratima , Figley Chas , Long Ramses , Park DoHwan , Carter Darryl , Clements Virginia K 
Published: December 2016

Abstract
During successful pregnancy, a woman is immunologically tolerant of her genetically and antigenically disparate fetus, a state known as maternal–fetal tolerance. How this state is maintained has puzzled investigators for more than half a century. Diverse, immune and nonimmune mechanisms have been proposed; however, these mechanisms appear to be unrelated and to act independently. A population of immune suppressive cells called myeloid-derived suppressor cells (MDSCs) accumulates in pregnant mice and women. Given the profound immune suppressive function of MDSCs, it has been suggested that this cell population may facilitate successful pregnancy by contributing to maternal–fetal tolerance. We now report that myeloid cells with the characteristics of MDSCs not only accumulate in the circulation and uterus of female mice following mating but also suppress T cell activation and function in pregnant mice. Depletion of cells with the phenotype and function of MDSCs from gestation d 0.5 through d 7.5 resulted in implantation failure, increased T cell activation, and increased T cell infiltration into the uterus, whereas induction of MDSCs restored successful pregnancy and reduced T cell activation. MDSC-mediated suppression during pregnancy was accompanied by the down-regulation of L-selectin on naïve T cells and a reduced ability of naïve T cells to enter lymph nodes and become activated. Because MDSCs regulate many of the immune and nonimmune mechanisms previously attributed to maternal–fetal tolerance, MDSCs may be a unifying mechanism promoting maternal–fetal tolerance, and their induction may facilitate successful pregnancy in women who spontaneously abort or miscarry because of dysfunctional maternal–fetal tolerance.
Rhetoric and Reform in Waiver States
Authors: Grogan Colleen M. , Singer Phillip M. , Jones David K. 
Published: December 2016

Abstract
Seven states have used Section 1115 waivers to expand Medicaid as part of the Affordable Care Act (ACA). While each state pursued a unique plan, there are similarities in the types of changes each state desired to make. Equally important to how a state modified their Medicaid programs is how a state talked about Medicaid and reform. We investigate whether the rhetoric that emerged in waiver states is unique, analyze whether the rhetoric is associated with particular waiver reforms, and consider the implications of our findings for the future of Medicaid policy making. We find that proponents in waiver states have convinced a conservative legislature that their reform is sufficiently innovative that they are not doing a Medicaid expansion, and not building on the traditional Medicaid program. Particularly striking is that none of these reforms are entirely new to the Medicaid program. While not new, the way in which waiver states have been allowed to implement many of the reforms is new and has become stricter. We find an emerging consensus utilized by conservative policy makers in framing the Medicaid expansion. Expansion efforts by conservative policy makers in other states have subsequently pushed this framing far to the right.
Policy Diffusion in Polarized Times: The Case of the Affordable Care Act
Authors: Volden Craig 
Published: December 2016

Abstract
With increasing ideological polarization both within states and across states, policy makers face new challenges in developing and refining policies. This essay explores these challenges in the context of the spread of health policies across the states under the Affordable Care Act, highlighting key arguments and findings from the authors in this Special Issue. I discuss how common mechanisms of policy diffusion, the attributes of policies themselves, and the conditional nature of policy diffusion all play somewhat different roles during polarized times. In addition to new challenges to policy makers, polarization offers new opportunities for experimentation and learning that may be valuable to scholars and practitioners alike.
Miscarriage, stillbirth and neonatal mortality in the extreme preterm birth window of gestation in a limited-resource setting on the Thailand-Myanmar border: A population cohort study
Authors: McGready Rose , Paw Moo Kho , Wiladphaingern Jacher , Min Aung Myat , Carrara Verena I. , Moore Kerryn A. , Pukrittayakamee Sasithon , Nosten François H. 
Published: December 2016

Background: The WHO definition of stillbirth uses 28 weeks’ gestation as the cut-point, but also defines extreme preterm birth as 24 to <28 weeks’ gestation. This presents a problem with the gestational limit of miscarriage, and hence reporting of stillbirth, preterm birth and neonatal death. The objective of this study is to provide a synopsis of the outcome of a population cohort of pregnancies on the Thailand-Myanmar border between 24 to <28 weeks’ gestation. Methods: Records from the Shoklo Malaria Research Unit Antenatal Clinics were reviewed for pregnancy outcomes in the gestational window of 24 to <28 weeks, and each record, including ultrasounds reports, were reviewed to clarify the pregnancy outcome. Pregnancies where there was evidence of fetal demise prior to 24 weeks were classified as miscarriage; those viable at 24 weeks’ gestation and born before 28 weeks were coded as births, and further subdivided into live- and stillbirth. Results: Between 1995 and 2015, in a cohort of 49,931 women, 0.6% (318) of outcomes occurred from 24 to <28 weeks’ gestation, and 35.8% (114) were miscarriages, with confirmatory ultrasound of fetal demise in 45.4% (49/108). Of pregnancies not ending in miscarriage, 37.7% (77/204) were stillborn and of those born alive, neonatal mortality was 98.3% (115/117). One infant survived past the first year of life. Congenital abnormality rate was 12.0% (23/191). Ultrasound was associated with a greater proportion of pregnancy outcome being coded as birth. Conclusion: In this limited-resource setting, pregnancy outcome from 24 to <28 weeks’ gestation included: 0.6% of all outcomes, of which one-third were miscarriages, one-third of births were stillborn and mortality of livebirths approached 100%. In the scale-up to preventable newborns deaths, at least initially, greater benefits will be obtained by focusing on the greater number of viable newborns with a gestation of 28 weeks or more.
Exploring the barriers to exclusive breastfeeding in Ibadan North Local Government Area, Oyo State, Nigeria
Authors: Ohaeri Beatrice M , Bello Salihu Sule 
Published: December 2016

Background:Breastfeeding is a crucial strategy in improving child health and reducing infant mortality, but the majority of women still do not practise exclusive breastfeeding (EBF).Aims:This study aimed to assess the barriers to implementation of EBF among nursing women in Ibadan North, Nigeria.Methods:A cross-sectional design was used. A total of 210 nursing women were selected using a purposive sampling technique, in two health centres in Ibadan North, Nigeria. The study questionnaire had a reliability of 0.77. Data were analysed using descriptive statistics and chi-square test.Findings:The main barriers reported were: occupation (90.00%), insufficient milk (71.43%), spouse's influence (66.19%), influence of extended family (62.38%) and inadequate time (54.76%). Participants with good knowledge of EBF were more likely to practise EBF.Conclusions:This study suggests a need for women to be empowered through informal education on the benefits of EBF. Regular prenatal counselling is advocated, both to enhance informed decision-making and to reduce infant mortality.
Factors increasing vulnerability to sexual violence of adolescent girls in Limuru sub-county, Kenya
Authors: Kimani Eunice , Osero Justus , Akunga Daniel 
Published: December 2016

Aims: The objective of this study was to determine the factors that increase vulnerability to sexual violence of adolescent girls in secondary schools in Limuru sub-county, Kiambu, Kenya. Methods: The study was cross-sectional in nature and collected qualitative and quantitative data on 301 adolescent girls aged 15–19 years. Data collection was achieved through the use of self-administered questionnaires and three focus group discussions. Findings The response rate was 99.67% (300 of 301 questionnaires). Among the respondents, 33% were victims of sexual violence. Factors that showed a significant association with vulnerability to sexual violence against adolescent girls were: alcohol use (OR = 3.4; P = 0.001), forced sex at debut (OR = 62.4;P < 0.001) and family connectedness (OR = 10.6; P = 0.001). Socioeconomic status and age of adolescent girl did not show any significant association. Conclusion: This study found that alcohol use, forced sexual debut and not living with both parents may increase girls' vulnerability to sexual violence. These findings could be used to create targeted interventions to reduce occurrence of sexual violence against adolescent girls.
Report on overweight and obesity among adult Kenyan women
Authors: Gichu Muthoni , Githuku Jane , Kibachio Joseph , Ransom James 
Published: December 2016

Aims: To ascertain the prevalence and describe the determinants of over-nutrition among adult Kenyan women with data from the Kenya Demographic and Health Survey (KDHS) (2008-09). Methods: A representative sample of 5169 women aged 20–49 years was analysed. The dependent variable was body mass index (BMI) with 18.5–24.9 kg/m2 considered normal and > 24.9 kg/m2 overweight and obese. Descriptive statistics and odds ratios were calculated. Results: The mean age was 32.0 ± 8.5 years, mean BMI was 24.2 ± 4.6 kg/m2 and 33.7% of the sample had a BMI > 25 kg/m2. Two thirds of the women lived in rural areas, 87.4% achieved at least primary education, 64.1% were married and 65.6% were working. Key determinants of over-nutrition were age (OR: 2.12, 95% CI: 1.89–2.40), marital status (OR: 1.43, 95% CI: 1.21–1.68) and smoking status (OR: 0.3, 95% CI: 0.17–0.55). Conclusions: Over-nutrition was present among adult Kenyan women in the 2008–09 KDHS. Further investigation of the associated factors attributing to increased BMI may be warranted.
Attempts to strengthen maternal functioning in the postpartum period: A literature review
Authors: Aydın Ruveyde , Barkin Jennifer Lynn , Kukulu Kamile 
Published: December 2016

Objective: This study aims to examine that the effects of home visiting, prenatal education, parent classes, and tele counselling on maternal functioning.Methods: The search process was conducted in PubMed, Scopus, Cochrane and Google Scholar using key words of “motherhood’’, ‘‘maternity functioning’’, ‘‘postpartum’’, ‘‘postpartum care’’, ‘‘home visiting’’, ‘‘prenatal education’’, ‘‘parent classes’’, ‘‘tele counseling’’ and a combination of them English-Turkish language papers were searched between 2000 and 2015 years. All studies relating to subject was included.Results: Discharge occurs shortly after birth in some countries such as the United States and Turkey, women do not receive adequate care, training and counseling and the demands of childrearing often exceed the mother’s expectations.Conclusion: Women should be supported with training programs, home visits, and phone counseling aimed at optimal maternal child health and development.
Multiple Positive Solutions to a Kirchhoff Type Problem Involving a Critical Nonlinearity in ℝ3
Authors: Zhong Xiao-Jing , Tang Chun-Lei 
Published: December 2016

Abstract
In this paper, we investigate a class of Kirchhoff type problems in

ℝ
3

{\mathbb{R}^{3}}

involving a critical nonlinearity, namely,

-

(
1
+
b

∫

ℝ
3

|
∇
u

|
2

d
x
)

△
u
=
λ
f

(
x
)

u
+
|
u

|
4

u
,
u
∈

D

1
,
2

(

ℝ
3

)

,

-\biggl{(}1+b\int_{\mathbb{R}^{3}}\lvert\nabla u|^{2}\,dx\biggr{)}\triangle u=% \lambda f(x)u+|u|^{4}u,\quad u\in D^{1,2}(\mathbb{R}^{3}),

where

b
>
0

{b>0}

,

λ
>

λ
1

{\lambda>\lambda_{1}}

and

λ
1

{\lambda_{1}}

is the principal eigenvalue of

-

△
⁢
u

=

λ
⁢
f
⁢

(
x
)

⁢
u

{-\triangle u=\lambda f(x)u}

,

u
∈

D

1
,
2

⁢

(

ℝ
3

)

{u\in D^{1,2}(\mathbb{R}^{3})}

. We prove that there exists

δ
>
0

{\delta>0}

such that the above problem has at least two positive solutions for

λ
1

<
λ
<

λ
1

+
δ

{\lambda_{1}<\lambda<\lambda_{1}+\delta}

. Furthermore, we obtain the existence of ground state solutions. Our tools are the Nehari manifold and the concentration compactness principle. This paper can be regarded as an extension of Naimen’s work [21].
An existence result for multiple solutions to a Dirichlet problem
Authors: Shokooh Saeid , Afrouzi Ghasem A. , Graef John R. 
Published: December 2016

AbstractThe authors establish the existence of at least three solutions to a quasilinear elliptic problem subject to Dirichlet boundary conditions in a bounded domain inℝN${\mathbb{R}^{N}}$. A critical point result for differentiable functionals is used to prove the results.