bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the medium-term impact of a home-visiting programme on child maltreatment in England: protocol for a routine data linkage study
Authors: Lugg-Widger Fiona V , Cannings-John Rebecca , Channon Sue , Fitzsimmons Deborah , Hood Kerenza , Jones Kerina H , Kemp Alison , Kenkre Joyce , Longo Mirella , McEwan Kirsten , Moody Gwenllian , Owen-Jones Eleri , Sanders Julia , Segrott Jeremy , Robling Michael 
Published: July 2017

IntroductionChild maltreatment involves acts of omission (neglect) or commission (abuse) often by caregivers that results in potential or actual harm to a child. The Building Blocks trial (ISRCTN23019866) assessed the short-term impact of an intensive programme of antenatal and postnatal visiting by specially trained nurses to support young pregnant women in England. The Building Blocks: 2–6 Study will assess the medium-term impacts of the programme for mothers and children (n=1562), through the linkage of routinely collected data to the trial data, with a particular emphasis on the programme’s impact on preventing child maltreatment.Methods and analysisWe have developed a bespoke model of data linkage whereby outcome data for the trial cohort will be retrieved by linked anonymous data abstraction from NHS Digital, Office for National Statistics and the Department for Education’s National Pupil Database. Participants will be given reasonable opportunity to opt out of this study prior to data transfer. The information centres will match participants to the information held in their databases using standard identifiers and send extracts to a third-party safe haven. The study will have 80% power to detect a 4% difference (4%vs8%) for the binary primary outcome of child in need status (from birth to key stage 1) at a two-sided 5% alpha level by following up 602 children in each trial arm. Analysis will be by intention to treat using logistic multilevel modelling. A cost-and-consequences analysis will extend the time frame of the economic analysis from the original trial.Ethics and disseminationThe study protocol has been approved by the National Health Service Wales Research Ethics Committee and the Health Research Authority’s Confidentiality Advisory Group. Methods of innovative study design and findings will be disseminated through peer-reviewed journals and conferences; results will be of interest to clinical and policy stakeholders in the UK.Trial registration numberISRCTN23019866.
Sociodemographic differences in women’s experience of early labour care: a mixed methods study
Authors: Henderson Jane , Redshaw Maggie 
Published: July 2017

ObjectivesTo explore women’s experiences of early labour care focusing on sociodemographic differences, and to examine the effect of antenatal education, using mixed methods.SettingEngland, 2014.ParticipantsWomen who completed postal questionnaires about their experience of maternity care, including questions about antenatal education, early labour and sociodemographic factors, included space for free-text comments.Outcome measuresWorries about labour, contact with midwives in early labour and subsequent care.MethodsThis study was based on secondary analysis of a national maternity survey carried out in England in 2014. Quantitative data were analysed using descriptive statistics and binary logistic regression; qualitative data were analysed using a thematic content analytic approach.ResultsCompleted questionnaires were received from 4578 women (47% response rate). There were significant differences by sociodemographic factors, particularly ethnicity, in women’s worries about early labour. Compared with white women, women from black or minority ethnic groups had an adjusted OR of 1.93 (95% CI 1.56 to 2.39) of feeling worried about not knowing when labour would start. Among women who contacted a midwife at the start of labour, 84% perceived their advice as appropriate, more in older and multiparous women. Overall, 64% of women were asked to come to the hospital at this time, more in multiparous women (adjusted OR 1.63, 95% CI 1.35 to 1.96). Those who did not have access to antenatal education experienced greater worry about early labour. Five themes emerged from the qualitative analysis: ‘Differentiating between early and active labour’, ‘Staff attitudes’, ‘Not being allowed…’, ‘Previous labours’ and ‘Perceived consequences for women’.ConclusionThese findings reinforce the importance of providing reassurance to women in early labour, taking care that women do not feel neglected or dismissed. In particular, primiparous and ethnic minority women reported greater worry about early labour and require additional reassurance.
Evaluating the predictive strength of the LACE index in identifying patients at high risk of hospital readmission following an inpatient episode: a retrospective cohort study
Authors: Damery Sarah , Combes Gill 
Published: July 2017

ObjectiveTo assess how well the LACE index and its constituent elements predict 30-day hospital readmission, and to determine whether other combinations of clinical or sociodemographic variables may enhance prognostic capability.DesignRetrospective cohort study with split sample design for model validation.SettingOne large hospital Trust in the West Midlands.ParticipantsAll alive-discharge adult inpatient episodes between 1 January 2013 and 31 December 2014.Data sourcesAnonymised data for each inpatient episode were obtained from the hospital information system. These included age at index admission, gender, ethnicity, admission/discharge date, length of stay, treatment specialty, admission type and source, discharge destination, comorbidities, number of accident and emergency (A&E) visits in the 6 months before the index admission and whether a patient was readmitted within 30 days of index discharge.Outcome measuresClinical and patient characteristics of readmission versus non-readmission episodes, proportion of readmission episodes at each LACE score, regression modelling of variables associated with readmission to assess the effectiveness of LACE and other variable combinations to predict 30-day readmission.ResultsThe training cohort included data on 91 922 patient episodes. Increasing LACE score and each of its individual components were independent predictors of readmission (area under the receiver operating characteristic curve (AUC) 0.773; 95% CI 0.768 to 0.779 for LACE; AUC 0.806; 95% CI 0.801 to 0.812 for the four LACE components). A LACE score of 11 was most effective at distinguishing between higher and lower risk patients. However, only 25% of readmission episodes occurred in the higher scoring group. A model combining A&E visits and hospital episodes per patient in the previous year was more effective at predicting readmission (AUC 0.815; 95% CI 0.810 to 0.819).ConclusionsAlthough LACE shows good discriminatory power in statistical terms, it may have little added value over and above clinical judgement in predicting a patient’s risk of hospital readmission.
Accuracy and precision of venous pressure measurements of endovascular microcatheters in the setting of dural venous sinus stenosis
Authors: Avery Michael B , Sambrano Sheryl , Khader Eliyas Javed , Eesa Muneer , Mitha Alim P 
Published: July 2017

IntroductionDural venous sinus stenosis (DVSS) may lead to increased intracranial pressure, sometimes requiring a stent if a high pressure gradient exists. Many neuroendovascular physicians use microcatheters to measure gradients, yet there are no studies comparing the accuracies and precisions of modern day microcatheters. We examined pressure recordings from five commonly used microcatheters in an experimental DVSS model.MethodsUsing a programmable pump, dynamic flow was established in a closed circuit mimicking the venous sinus waveform. Microcatheters with 150 cm effective lengths were connected proximally to pressure transducers. Mean recording pressures were compared with a high fidelity microcatheter (HFM) in several configurations including no stenosis, proximal to a focal stenosis, and distal to a focal stenosis in opposing orientations.ResultsAll microcatheters recorded lower pressures than the HFM. Three of the five microcatheters successfully met intracranial pressure monitoring device standards in all conditions, while one did not meet standards in any configuration. The performance of the final microcatheter was variable, with inaccuracies occurring in unrestricted flow. All microcatheters demonstrated relatively high precision, but with variable accuracies. The larger diameter microcatheters displayed the least damping and therefore the greatest accuracies. Of the three smaller microcatheters, dimensions did not predict performance, suggesting that microcatheter construction may also play a role in pressure accuracy.ConclusionThe use of microcatheters to record dural venous sinus pressures must be done with an understanding of the inherent limitations and inaccuracies, especially if clinical decisions are made from the results.
Use of a next-generation multi-durometer long guide sheath for triaxial access in flow diversion: experience in 95 consecutive cases
Authors: Lin Li-Mei , Bender Matthew T , Colby Geoffrey P , Beaty Narlin B , Jiang Bowen , Campos Jessica K , Huang Judy , Tamargo Rafael J , Coon Alexander L 
Published: July 2017

BackgroundIntracranial access techniques in modern neurointerventions have shifted towards more robust access platforms. The long guide sheath is one of the building blocks of triaxial systems used in intracranial embolizations. Here we present our experience with the AXS Infinity LS long sheath in the triaxial platform for the implantation of the Pipeline embolization device (PED).MethodsWe retrospectively identified patients who underwent PED Flex treatment with the AXS Infinity LS at a single institution. Procedural data collected included parent artery tortuosity, patient demographics, vasodilator use, aneurysm characteristics, equipment utilized, and catheter-related complications.ResultsA total of 95 cases were completed using the AXS Infinity LS for the triaxial platform foundation in PED Flex treatment of cerebral aneurysms. Mean patient age was 56.2±12.2 years (range 21–86). Average aneurysm size was 6.9±6.2 mm (range 1–38). There were 89 anterior circulation cases (94%) and 6 posterior circulation cases (6%). Significant cervical ICA tortuosity was present in 11/89 (12%) and moderate to severe cavernous ICA tortuosity was present in 29/89 (33%). Mean fluoroscopy time was 40.0±19.8 min. In 14/95 cases (15%), vasospasm prophylaxis or treatment with intra-arterial verapamil infusion was performed. Catheter access-related complications included asymptomatic iatrogenic dissection in one case (1%) from the distal intracranial catheter and groin hematoma in one case (1%). No parent vessel wall abnormalities were visualized in the region of the Infinity long sheath on final control angiography in all 95 cases.ConclusionThe AXS Infinity LS is the newest long guide sheath available for modern neurointerventional procedures. We have shown its utility in augmenting the triaxial access platform in PED Flex cases by providing enhanced distal tip trackability with added support in the aortic arch and proximal great vessels.
Role of P-glycoprotein on CD69+CD4+cells in the pathogenesis of proliferative lupus nephritis and non-responsiveness to immunosuppressive therapy
Authors: Tsujimura Shizuyo , Adachi Tomoko , Saito Kazuyoshi , Tanaka Yoshiya 
Published: July 2017

IntroductionP-glycoprotein (P-gp) expression on activated lymphocytes in systemic lupus erythematosus (SLE) plays a role in active efflux of intracellular drugs, resulting in drug resistance. The role of P-gp-expressing lymphocytes in the pathogenesis of SLE remains unclear. The aim of this study was to determine the importance of P-gp+CD4+cells in organ manifestations in refractory SLE.MethodsThe proportion of P-gp+CD4+cells was determined by flow cytometry in peripheral blood of patients with SLE (n=116) and healthy adults (n=10). Renal biopsy specimens were examined by immunohistochemistry for P-gp expression.ResultsCD69 is a marker of CD4 cell activation. The proportion of both P-gp-expressing CD4+cells and CD69-expressing CD4+cells in peripheral blood was higher in SLE than control. The proportion of P-gp+CD69+CD4+cells correlated with Systemic Lupus Erythematosus Disease Activity Index and was higher in poor responders to corticosteroids. Furthermore, the proportion of P-gp+CD69+CD4+cells was significantly higher in proliferative lupus nephritis (LN) with poor response to corticosteroids. The efficacy of immunosuppressive therapy depended on the regulation of the proportion of P-gp+CD69+CD4+cells. Marked accumulation of P-gp+CD4+cells in renal interstitial tissue and high proportion of peripheral P-gp+CD69+CD4+cells were noted in patients with proliferative LN.ConclusionsThe results showed high proportion of P-gp+CD69+CD4+cells in peripheral blood and their accumulation in renal tissue in patients with proliferative LN refractory to CS therapy, suggesting that P-gp expression on activated CD4+T cells is a potentially useful marker for refractoriness to treatment and a novel target for treatment.
Dipeptidyl Peptidase‐4 Regulates Hematopoietic Stem Cell Activation in Response to Chronic Stress
Authors: Zhu Enbo , Hu Lina , Wu Hongxian , Piao Limei , Zhao Guangxian , Inoue Aiko , Kim Weon , Yu Chenglin , Xu Wenhu , Bando Yasuko K. , Li Xiang , Lei Yanna , Hao Chang‐Ning , Takeshita Kyosuke , Kim Woo‐Shik , Okumura Kenji , Murohara Toyoaki , Kuzuya Masafumi , Cheng Xian Wu 
Published: July 2017

Background

DPP4 (Dipeptidyl peptidase‐4)‐GLP‐1 (glucagon‐like peptide‐1) and its receptor (
GLP
‐1R) axis has been involved in several intracellular signaling pathways. The Adrβ3 (β3‐adrenergic receptor)/
CXCL
12 (C‐X‐C motif chemokine 12) signal was required for the hematopoiesis. We investigated the novel molecular requirements between
DPP
4‐
GLP
‐1/
GLP
‐1 and Adrβ3/CXCL12 signals in bone marrow (
BM
) hematopoietic stem cell (
HSC
) activation in response to chronic stress.

Methods and Results

Male 8‐week‐old mice were subjected to 4‐week intermittent restrain stress and orally treated with vehicle or the
DPP
4 inhibitor anagliptin (30 mg/kg per day). Control mice were left undisturbed. The stress increased the blood and brain
DPP
4 levels, the plasma epinephrine and norepinephrine levels, and the
BM
niche cell Adrβ3 expression, and it decreased the plasma
GLP
‐1 levels and the brain
GLP
‐1R and
BM CXCL
12 expressions. These changes were reversed by
DPP
4 inhibition. The stress activated
BM
sca‐1
high
c‐Kit
high
CD
48
low
CD
150
high
HSC
proliferation, giving rise to high levels of blood leukocytes and monocytes. The stress‐activated
HSC
proliferation was reversed by
DPP
4 depletion and by
GLP
‐1R activation. Finally, the selective pharmacological blocking of Adrβ3 mitigated
HSC
activation, accompanied by an improvement of
CXCL
12 gene expression in
BM
niche cells in response to chronic stress.

Conclusions

These findings suggest that
DPP
4 can regulate chronic stress‐induced
BM HSC
activation and inflammatory cell production via an Adrβ3/
CXCL
12‐dependent mechanism that is mediated by the
GLP
‐1/
GLP
‐1R axis, suggesting that the
DPP
4 inhibition or the
GLP
‐1R stimulation may have applications for treating inflammatory diseases.
Trinity - The consummated covenant: Theses on the doctrine of the trinitarian God
Authors: Schoonenberg P.J.A.M. 
Published: July 2017

In 1971 Herder and Herder of New York published my book The Christ,1 which under the heading 'God and man, or God in man?' contains a study of Jesus Christ as God and man. This study implies a doctrine of the Trinity, although one more intimated than articulated. In Dietrich Wiederkehr's grandiose 'Design for a systematic Christology,'2 this doctrine of the Trinity was implicitly contested. It also occasioned Jean Galot to speak of a Christology 'en dessous de l'arianisme' (beneath Arianism).3 Recently, in a report in Herder Korrespondenz,4 this conception of the Trinity was judged less consequent than that of Karl Rahner, although I think I am carrying on Rahner's trinitarian thinking. Although I am preparing a longer work on the Trinity, it seems opportune to present my views provisionally in thesis form, so that a judgment can be formed about them. I am grateful to the editors of SR for providing this opportunity. The text was first published in German in the Swiss periodical Orientierung, 31 May 1973. It was translated by Dr Robert C. Ware and afterwards modified by me.
The Informal Patient in England and Wales
Authors: Andoh Benjamin 
Published: July 2017

The informal status of a patient is a very important topic because the vast majority of mental patients in hospital are informal. The origins of the status are traced to the Royal Commissions of 1924–6 and 1954–7 which recommended voluntary admissions and informal admissions, respectively. It is pointed out, inter alia, that it is only generally true to say the informal patient has consented to admission and cannot be treated without his or her consent because exceptionally he or she can be given such treatment, e.g. on the grounds of necessity, as held by the House of Lords in R v Bournewood Community and Mental Health Trust (1998) and that today there are two types of informal patients: those who can, and do, consent to admission, and those who cannot consent to admission, but do not show willingness to leave hospital. It is argued that there is only a power under the Mental Health Act 1983 to admit patients informally. Finally, the informal patient's consent to admission, consent to treatment, other rights, leaving hospital, and how his or her position can be improved are looked at.
A Case of Serial Homicide by Injection of Succinylcholine
Authors: Maeda H , Fujita M Q , Zhu B-L , Ishidam K , Oritani S , Tsuchihashi H , Nishikawa M , Izumi M , Matsumoto F 
Published: July 2017

The abstract of this paper was presented at the 14th Meeting of the International Association of Forensic Sciences, Tokyo in 1996. We report a bizarre criminal case of suspected serial homicide by injection of a muscle relaxant (succinylcholine). Five victims were found buried in a rural area. In two victims showing moderate decomposition (about three months after death), intense pulmonary oedema with pleural effusion was observed. Evidence of a puncture site was found in one of the victims. Succinylcholine could not be detected in the victims, but was identified in a syringe found near the corpses. The 40-mg ampule dose of succinylcholine administered intramuscularly to the victims, possibly causing prolonged apnea, was considered to be at least around the minimum lethal dose, although the combined effect of the sedation with hypnotics also used was not negligible.
Overdose of Parstelin (Tranylcypromine)
Authors: Griffiths G. J. 
Published: July 2017

A case of overdose of Parstelin is described. The post-mortem findings, the forensic laboratory report, the discussion of the case, and the treatment in such a case of overdose are considered. In the correspondence column of the British Medical Journal, MacCaig and Edmondson (1969) describe a case of a fit young man of 25 years who took 25 tablets of Parstelin and died 36 hours later. A similar case is described here.
The Resistance of Human Skin to Compressive Cutting
Authors: Careless C. M. , Acland P. R. 
Published: July 2017

Tests to examine the resistance to cutting of several samples of post-mortem human skin have been conducted. The strength of the tissue is compared to that of a commonly used skin simulation, chamois leather. Several effects are noted relating to the physical behaviour of skin and skin simulations in sharp edge contacts likely to produce tissue damage. Particular reference is made to the minor trauma suffered as a consequence of head to windscreen contact in road traffic accidents.
Firearm Fatalities in Jordan
Authors: Abu Al Ragheb Sameeh Y. 
Published: July 2017

During the 8-year period from 1973 through 1980 there were 221 firearm deaths autopsied and investigated by both departments of Forensic Medicine in Amman, Jordan. Although restrictions for legal possession of firearms are minimal, more illegal arms are possessed. Fifty-one per cent of such deaths were homicides, 31 per cent accidents and 18 per cent suicides, with a sharp increase in the incidence of homicides and accidents over the years. Firearms rank as the fourth cause of death of all cases of unnatural death, and homicidal firearm deaths constitute 29 per cent of all homicides in general. All assailants and 80 per cent of the victims were males. Females were most commonly the victims of homicide. Police and armed forces comprise 20 per cent of the subjects studied and most of the fatalities involved children and young adults.
GC-MS Identification of MIC Trimer: A Constituent of Tank Residue in Preserved Autopsy Blood of Bhopal Gas Victims
Authors: Chandra Heeresh , Rao G J , Saraf A K , Sharma V K , Jadhav R K , Sriramachari S 
Published: July 2017

Based on the external and internal findings of Bhopal gas disaster victims, it was apparent that the gases and particulate matter came out as an aerosol. This was possibly the pyrolysed, reformulated, reconjugated suspension of constituents of the tank E-610 of Union Carbide India Limited, Bhopal, while it was claimed to be methyl isocyanate (MIC) only. It was postulated by the manufacturer of MIC, that the material inhaled by the victims of the Bhopal gas disaster does not cross the lung barrier (UCC press conference on 14th December 1984). It was observed that the more the victims ran, the more aerosol they inhaled and the fatalities were observed in such victims. The tissues, which were preserved in the deep freeze, were randomly selected and analysed by GC coupled with MS (ITD) Finnigan MAT, UK. 14 out of 34 autopsy cases showed MIC trimer peak in extracts of blood. This was one of the constituents of the aerosol and was also located in the tank residue, thereby proving that the trimer had passed the lung barrier
The Criminal Procedure (Insanity and Unfitness to Plead) Act, 1991
Authors: Dolan M C , Campbell A A 
Published: July 2017

Procedures relating to Insanity and Fitness to Plead are reviewed with special emphasis on the problems encountered with previous legislation. The introduction of the new Criminal Procedure (Insanity and Unfitness to Plead) Act 1991, on 1 January 1992, offered greater discretion in the disposal of these defendants, but fell short of many of the recommendations made by those advocating reform. As yet, too few cases have passed through the courts to highlight particular deficiencies in the unreformed parts of the Act, but the benefits are already apparent. Finally, some of the potential pitfalls of supervision and treatment orders and other disposals are discussed and an insanity case, dealt with under the new legislation, is presented.
Age Estimation by Chinese Permanent Teeth with Image Analysis
Authors: Xiaohu Xu , Jiazhen Zhu , Philipsen H P , Pang K M 
Published: July 2017

A total of 567 human teeth except third molars were studied to estimate age, using a combined method of multiple regression analysis of data from a scoring system, direct measurements with image analyser, and logarithmic transformation. As a result, the standard errors of estimate were 4.8–5.4 years in the working sample, and 2.9–5.4 years in the control sample respectively, by using a single tooth. By testing the formulae on forensic autopsy cases in Guang Dong and Guang Xi, (People's Republic of China), it is demonstrated that the standard error of estimate is 3.7 and 2.6 years respectively for any single tooth (incisor, canine, premolar or molar) except the third molar. Age determination from multiple teeth of the same individual has also been studied. As a result, according to the different age grouping, the standard errors of estimate ranged from 0.8 to 2.6 years (2 teeth from the same individual) and 0.6 to 2.3 years (3 teeth from the same individual). It is concluded that the method presented here is helpful in improving the accuracy of age determination from teeth.