bluuebunny/crossref_metadata_2025_split huggingface dataset:
Distinguishing Features of the Repetitive Nerve Stimulation Test Between Lambert–Eaton Myasthenic Syndrome and Myasthenia Gravis, 50-Year Reappraisal
Authors: Oh Shin J. 
Published: November 2017

Abstract

Objective:
To reappraise the distinguishing features of the repetitive nerve stimulation (RNS) tests in the abductor digiti quinti muscle between myasthenia gravis (MG) and Lambert–Eaton myasthenic syndrome (LEMS) 50 years after the 1965's Lambert seminal paper.

Methods:
The various parameters of the RNS test were compared between 34 patients with LEMS and 140 patients with MG to assess their diagnostic sensitivity.

Results:
RNS test was abnormal in all (100%) patients with LEMS and 76 (54%) patients with MG. The diagnostic hallmark of LEMS, ≥60% increment at high-rate stimulation or postexercise facilitation, was present in 33 (97%) of patients. The diagnostic hallmark of MG, decrement at low-rate stimulation (LRS), was present in 65 (46%) of patients with MG. The most prominent difference in the various parameters of RNS tests was noted between LEMS versus MG and normal controls.

Conclusions:
Distinguishing features of the RNS test in LEMS and MG are confirmed in this direct comparison study: the low compound muscle action potential amplitude, decrement at LRS, and increment at high-rate stimulation or postexercise facilitation for LEMS and normal compound muscle action potential amplitude and decrement at LRS for MG.
Self-efficacy Mediates the Relationship Between Motivation and Physical Activity in Patients With Heart Failure
Authors: Klompstra Leonie , Jaarsma Tiny , Strömberg Anna 
Published: November 2017

Background:
Motivation is necessary in patients with heart failure (HF) who are attempting to become more physically active but may not be sufficient to initiate physical activity. Self-efficacy might explain the relationship between motivation and physical activity.

Objective:
The aim of this study was to examine the role of exercise self-efficacy in the relationship between exercise motivation and physical activity in patients with HF.

Methods:
A total of 100 stable patients with HF (88% in New York Heart Association class II/III; mean age, 67 ± 13 years; 62% men) were studied. Self-efficacy was measured with the Exercise Self-Efficacy Scale; motivation, with the Exercise Motivation Index; and physical activity, with a self-report questionnaire. Logistic regression analyses were made to examine the mediation effect of exercise self-efficacy on the relationship between exercise motivation and physical activity.

Results:
Forty-two percent of the 100 patients reported engaging in less than 60 minutes per week of physical activity. Motivation predicted physical activity (b = 0.58, P < .05), but after controlling for self-efficacy, the relationship between motivation and physical activity was no longer significant (b = 0.76, P = .06), indicating full mediation.

Conclusion:
Motivation to be physically active is important but not sufficient. In addition to a high level of motivation to be physically active, it is important that patients with HF have a high degree of self-efficacy.
A cognitive map of sustainable decision-making in entrepreneurship
Authors: Muñoz Pablo 
Published: November 2017

Purpose
Under what conditions do entrepreneurs make the sustainable decisions they need to develop socially and environmentally responsible new businesses? Explanations of sustainable decision-making have involved various cognitive features; however, it is not yet clear how they play a role in empirical terms and, moreover, how they combine to induce business decisions based on social, environmental and economic considerations. The purpose of this paper is to explore how five cognitive factors combine and causally connect to produce sustainable decision-making in entrepreneurship.

Design/methodology/approach
This study uses fuzzy-set qualitative comparative analysis to examine the decision-making of 37 sustainable entrepreneurs. It focuses on a substantive conception of entrepreneurial behaviour to uncover the cognitive antecedents underlying entrepreneurial decisions that involve the explicit development and implementation of measures, targets and strategies aimed at improving its impact on people and the environment.

Findings
The configurational analysis reveals a typology comprising five combinations of cognitive factors constituting a comprehensive cognitive map of sustainable decision-making in entrepreneurship, namely: purpose-driven, determined; value-based, vacillating; value-based, unintended; single motive, single solution; and purpose-driven, hesitant.

Research limitations/implications
This study demonstrates that no single condition is necessary nor sufficient for triggering decision-making involving social and environmental concerns, revealing five mental models leading to sustainable decision-making. In doing so, this paper responds to recent calls that stress the need for studies capable of uncovering the complex constellation of cognitive factors underlying entrepreneurial sustainable behaviour. Theoretical and practical implications are discussed.

Originality/value
This paper provides a systematic characterization of the cognitive underpinnings of sustainable decision-making and offers a basis for organizing the study of sustainable outcomes and configurations of cognitive antecedents. It reconciles prior efforts aimed at characterizing sustainability decisions in the context of SMEs and new enterprises, challenging current models based on awareness, experience and ethical normative frameworks.
Interface defects detection and quantification on a Si/SiO2 structure
Authors: Elias Rawad , Ziade Pierre , Habchi Roland 
Published: November 2017

Purpose
The purpose of this paper is to investigate and classify the defects on silicon-based power devices under extreme conditions.

Design/methodology/approach
Electrical characterization was performed on MOS devices to study their interface defects. The devices were subjected to a voltage or a current constraint to induce defects, and then measurements were done to detect the effects of those defects. Measurements include current voltage, capacitance and conductance characterization. The Hill–Coleman method was used to calculate the interface states density in each case.

Findings
It was found that most of the defects have energies within the upper band gap of the semiconductor.

Originality value
The method used in this paper allows the determination of any interface defects on a Si/SiO2 structure.
Variation of thermal resistance with input current and ambient temperature in low-power SMD LED
Authors: Raypah Muna E. , M.K. Dheepan , Devarajan Mutharasu , Subramani Shanmugan , Sulaiman Fauziah 
Published: November 2017

PurposeThermal behavior of light-emitting diode (LED) device under different operating conditions must be known to enhance its reliability and efficiency in various applications. The purpose of this study is to report the influence of input current and ambient temperature on thermal resistance of InGaAlP low-power surface-mount device (SMD) LED.Design/methodology/approachThermal parameters of the LED were measured using thermal transient measurement via Thermal Transient Tester (T3Ster). The experimental results were validated using computational fluid dynamics (CFD) software.FindingsAs input current increases from 50 to 90 mA at 25°C, the relative increase in LED package (ΔRthJS) and total thermal resistance (ΔRthJA) is about 10 and 4 per cent, respectively. In addition, at 50 mA and ambient temperature from 25 to 65°C, the ΔRthJSand ΔRthJAare roughly 28 and 22 per cent, respectively. A good agreement between simulation and experiment results of junction temperature.Originality/valueMost of previous studies have focused on thermal management of high-power LEDs. There were no studies on thermal analysis of low-power SMD LED so far. This work will help in predicting the thermal performance of low-power LEDs in solid-state lighting applications.
The use of anti-psychotic and other psychotropic medication in a specialist community service for adults with learning disabilities
Authors: Clare Isabel C.H. , Wade Kelly A. , Bolton Sorcha , Wagner Adam P. , Steven Tatsiana , Holland Anthony J. 
Published: November 2017

Purpose
The purpose of this paper is to examine the extent to which, in the five integrated community teams for adults with learning disabilities (CTLDs) in an English county-wide service, the use of psychotropic medication for service users was based on the presence of an appropriate mental health condition or epilepsy.

Design/methodology/approach
Adult participants were recruited following referral to one of the CTLDs for assessment, treatment and/or support of a possible mental health and/or behavioural need. Data were collected about participant characteristics and psychotropic medication 12 months after recruitment.

Findings
While a total of 42 (78 per cent) of the 54 participants were apparently prescribed regular or PRN (as required) psychotropic medication, only 24 (57 per cent) of these individuals had a recorded past or current mental health condition or epilepsy for which such medicine could be appropriate.

Research limitations/implications
There were several limitations: the sample size was small and its representativeness was uncertain; and data collection was compromised by barriers to explicit knowledge exchange within and across the learning disability service.

Practical implications
While recent guidance about the use of psychotropic medication is welcome, minimising inappropriate use requires more comprehensive person-centred interventions (including crisis management plans), underpinned by imaginative, but feasible, data collection methods and integrated formulations. Investment is needed in developments that support multi-disciplinary and inter-agency working to promote “good practice” by CTLDs in responding to referrals for possible mental health and/or behavioural needs.

Originality/value
Complementing recent large studies of primary care (General Practitioner) records, this is the first examination of the use of psychotropic medication by service users in English CTLDs.
Optimising psychotropic medication use
Authors: Sheehan Rory 
Published: November 2017

Purpose
This commentary accompanies Clare et al.’s study investigating psychotropic drug prescribing for adults with intellectual disability who were referred to specialist community learning disability teams in the east of England. The purpose of this paper is to explore some of the background to psychotropic drug prescribing for people with intellectual disability, review important contextual factors that influence prescribing decisions, and consider how we might make the best use of psychotropic drugs in this group.

Design/methodology/approach
Narrative summary and opinion, supported by reference to recent research literature.

Findings
Psychotropic drug use for people with intellectual disability raises complex issues, not least because of the lack of research evidence that exists on the topic. Psychotropic drugs can be an important part of treatment for people with mental illness but further research is needed to support prescribing for challenging behaviour. Medication optimisation is a framework within which individual preferences and values are considered alongside the evidence base and clinical judgement in order to inform safe, effective, and collaborative management decisions.

Practical implications
Prescribing decisions should be individualised and reviewed regularly, incorporating evidence from patients and carers. Improving the use of psychotropic medication requires concerted action, adequate social support, and the provision of alternative, non-pharmacological interventions that are acceptable and effective.

Originality/value
This paper reviews some of the current concerns about the use of psychotropic drugs and opens up new avenues of discussion.
Bioelectrical Impedance as a Technique for Estimating Postmortem Interval,,
Authors: Hansen Eriek S. , Baigent Christiane , Reck Sophia I. , Connor Melissa 
Published: November 2017

AbstractEstimation of postmortem interval (PMI) is a critical component of death investigation. A cadaver can be hypothesized to be a resistor–capacitor (RC) circuit the impedance (Z) of which changes in a quantifiable manner as the cadaver decomposes. This hypothesis was tested using bioelectrical impedance analysis (BIA) equipment to apply a current with a fixed amplitude at a single frequency to four cadavers over time and measuring two components of Z, resistance (R) and reactance (Xc). Quadratic regression analysis between Z and accumulated degree days (ADD) showed a statistically significant parabolic relationship. The parabolic relationship poses an initial challenge to the use of the method, and additional research is needed to address this issue. However, the results of the reported research support the hypothesis that Z measured using BIA has a relationship to PMI.
Pharmacokinetics of concentrated naloxone nasal spray for opioid overdose reversal: Phase I healthy volunteer study
Authors: McDonald Rebecca , Lorch Ulrike , Woodward Jo , Bosse Björn , Dooner Helen , Mundin Gill , Smith Kevin , Strang John 
Published: November 2017

AbstractBackground and AimsTake‐home naloxone can prevent death from heroin/opioid overdose, but pre‐provision is difficult because naloxone is usually given by injection. Non‐injectable alternatives, including naloxone nasal sprays, are currently being developed. To be effective, the intranasal (i.n.) spray dose must be adequate but not excessive, and early absorption must be comparable to intramuscular (i.m.) injection. We report on the pharmacokinetics (PK) of a specially produced concentrated novel nasal spray. The specific aims were to: (1) estimate PK profiles of i.n. naloxone, (2) compare early systemic exposure with i.n. versus i.m. naloxone and (3) estimate i.n. bioavailability.DesignOpen‐label, randomized, five‐way cross‐over PK study.SettingClinical trials facility (Croydon, UK).ParticipantsThirty‐eight healthy volunteers (age 20–54 years; 11 female).Intervention and comparatorThree doses of i.n. (1 mg/0.1 ml, 2 mg/0.1 ml, 4 mg/0.2 ml) versus 0.4 mg i.m. (reference) and 0.4 mg intravenous (i.v.) naloxone.MeasurementsRegular blood samples were taken, with high‐frequency sampling during the first 15 minutes to capture early systemic exposure. PK parameters were determined from plasma naloxone concentrations. Exploratory analyses involved simulation of repeat administration.FindingsMean peak concentration (Cmax) values for 1 mg (1.51 ng/ml), 2 mg (2.87 ng/ml) and 4 mg (6.02 ng/ml) i.n. exceeded 0.4 mg i.m. (1.27 ng/ml) naloxone. All three i.n. doses rapidly achieved plasma levels > 50% of peak concentrations (T50%) by 10 minutes, peaking at 15–30 minutes (Tmax). For comparison, the i.m. reference reached Tmax at 10 minutes. Mean bioavailability was 47–51% for i.n. relative to i.m. naloxone. Simulation of repeat dosing (2 × 2 mg i.n. versus 5 × 0.4 mg i.m. doses) at 3‐minute intervals showed that comparable plasma naloxone concentrations would be anticipated.ConclusionsConcentrated 2 mg intranasal naloxone is well‐absorbed and provides early exposure comparable to 0.4 mg intramuscular naloxone, following the 0.4 mg intramuscular curve closely in the first 10 minutes post‐dosing and maintaining blood levels above twice the intramuscular reference for the next 2 hours.
Invertebrate biodiversity in apple orchards: agrichemical sprays as explanatory variables for inter‐orchard community differences
Authors: Malone Louise A. , Burgess Elisabeth P. J. , Barraclough Emma I. , Poulton Joanne , Todd Jacqui H. 
Published: November 2017

Abstract

Invertebrates are important providers of ecosystem services to orchards and the orchards may benefit where there is greater biodiversity. Previous research has shown that apple orchards using organic or integrated pest management support different invertebrate communities, as can different orchards within the same management system.
In the present study, we examined the potential for agrichemical usage to explain inter‐orchard invertebrate community differences in 10 New Zealand apple orchards under integrated pest management.
Multiple regression models were used to examine relationships between spray diary data and invertebrates collected by branch tapping, pitfall and sticky traps in 2011/2012. Insecticides, fungicides, plant growth regulators and fertilizers were used as explanatory variables in these models and the most parsimonious models were identified.
Plant growth regulators were significant in most of the models for inter‐orchard variability in total invertebrate diversity. Insecticides featured strongly in models explaining pest assemblages, although not so strongly for models for their natural enemies. Fungicide and fertilizer use featured in models explaining communities of decomposers and fungivores.
The results generated several hypotheses about the impacts of specific agrichemicals on invertebrate biodiversity, which, if tested, could establish the feasibility of customizing spray schedules to meet both biodiversity and production goals.
The impact of mental health comorbidities on adherence to buprenorphine: A claims based analysis
Authors: Litz Megan , Leslie Douglas 
Published: November 2017

Background and ObjectivesPrevious research has been inconclusive about whether opioid‐dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base.MethodsWe used MarketScan® data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder‐related ICD‐9 code who had been prescribed buprenorphine (n = 2947). Medication adherence was defined using the Medication Possession Ratio ≥.8 (MPR) and logistic regression was used to examine the association between medication adherence and mental health diagnoses, which included Alzheimer's/dementia, schizophrenia, other psychosis, major depressive disorder/bipolar disorder (MDDBP), anxiety disorder, personality disorder, and mental health disorder not elsewhere specified (NOS).ResultsOf the 2947 patients included in our analysis, the most common diagnoses were anxiety disorder: n = 648 (22.0%), MDDBP: n = 467 (15.9%), and mental health disorder NOS: n = 959 (32.5%). Patients diagnosed with MDDBP were significantly less likely to adhere to opioid pharmacotherapy (OR = .805, 95%CI = .651, .994) than patients without MDDBP.Conclusions and Scientific SignificanceThe presence of a psychiatric comorbidity can significantly affect adherence to buprenorphine. These trends illustrate the need for clinicians treating opioid use disorder with buprenorphine to screen for psychiatric disorders and monitor their medication adherence. There may also be opportunities to design interventions to help this vulnerable population adhere to buprenorphine and other forms of opioid pharmacotherapy. (Am J Addict 2017;26:859–863)
Testosterone replacement in transgenic sickle cell mice controls priapic activity and upregulates PDE5 expression and eNOS activity in the penis
Authors: Musicki B. , Karakus S. , Akakpo W. , Silva F. H. , Liu J. , Chen H. , Zirkin B. R. , Burnett A. L. 
Published: November 2017

AbstractSickle cell disease (SCD)‐associated priapism is characterized by decreased nitric oxide (NO) signaling and downregulated phosphodiesterase (PDE)5 protein expression and activity in the penis. Priapism is also associated with testosterone deficiency, but molecular mechanisms underlying testosterone effects in the penis in SCD are not known. Given the critical role of androgens in erection physiology and NO synthase (NOS)/PDE5 expression, we hypothesized that testosterone replacement to eugonadal testosterone levels reduces priapism by reversing impaired endothelial (e)NOS activity and molecular abnormalities involving PDE5. Adult male transgenic Berkeley sickle cell (Sickle) and wild‐type (WT) mice were implanted with testosterone pellets, which release 1.2 μg testosterone/day for 21 days, or vehicle. After 21 days, animals underwent erectile function assessment followed by collection of blood for serum testosterone measurements, penes for molecular analysis, and seminal vesicles as testosterone‐responsive tissue. Serum testosterone levels were measured by radioimmunoassay; protein expressions of PDE5, α‐smooth muscle actin, eNOS and nNOS, and phosphorylation of PDE5 at Ser‐92, eNOS at Ser‐1177, neuronal (n) NOS at Ser‐1412, and Akt at Ser‐473 were measured by Western blot in penile tissue. Testosterone treatment reversed downregulated serum testosterone levels and increased (p < 0.05) the weight of seminal vesicles in Sickle mice to levels comparable to that of WT mice, indicating restored testosterone levels in Sickle mice. Testosterone treatment reduced (p < 0.05) prolonged detumescence in Sickle mice and normalized downregulated P‐PDE5 (Ser‐92), PDE5, P‐eNOS (Ser‐1177), and P‐Akt (Ser‐473) protein expressions in the Sickle mouse penis. Testosterone treatment did not affect P‐nNOS (Ser‐1412), eNOS, nNOS, or α‐smooth muscle actin protein expressions in the Sickle mouse penis. In conclusion, in the mouse model of human SCD, increasing testosterone to eugonadal levels reduced priapic activity and reversed impaired Akt/eNOS activity and PDE5 protein expression in the penis.
Expression of oestrogen receptors (GPER, ESR1, ESR2) in human ductuli efferentes and proximal epididymis
Authors: Rago V. , Romeo F. , Giordano F. , Malivindi R. , Pezzi V. , Casaburi I. , Carpino A. 
Published: November 2017

SummaryOestrogen targeting in the human genital ducts is still not well‐known. In fact, to date, the localization of oestrogen receptors, ESR1 and ESR2, is controversial and the presence of the membrane oestrogen receptor GPER (G protein‐coupled oestrogen receptor) is unexplored. This study has investigated the expression of GPER, ESR1, ESR2 in human ductuli efferentes and proximal caput epididymis by immunohistochemistry and Western blot analysis. Furthermore, the presence of PELP1 (proline–glutamic acid–leucine‐rich protein 1), a co‐regulator of the oestrogen receptors, was also evaluated. In ductuli efferentes, GPER and ESR1 were clearly localized in all epithelial cells, while ESR2 was evidenced only in ciliated cells. Conversely, the epithelial cells of proximal caput epididymis revealed moderate GPER immunoreactivity, the absence of ERS1 and the occasional presence of ESR2. Furthermore, PELP1 was observed in ciliated cells of ductuli efferentes and in principal cells of proximal caput epididymis. Therefore, this study firstly demonstrated the expression of GPER in human male genital ducts, revealing a new mediator of oestrogen action in these anatomical sites. ESR1 and ESR2 were differentially localized in the two genital tracts together with PELP1, but cell sites of ERs and their co‐regulator were not homogeneous. So, a different regional/cellular association of GPER with the classical oestrogen receptors was highlighted, suggesting that oestrogen action could be mediated by GPER, ESR1, ESR2 in ductuli efferentes, while by GPER and, occasionally by ESR2, in proximal caput epididymis. This study suggests that the specific oestrogen‐mediated functions in human genital ducts might result from the different local interactions of oestrogens with oestrogen receptors and their co‐regulators.