bluuebunny/crossref_metadata_2025_split huggingface dataset:
Finding the Right Assessment Measures for Young People with Intellectual Disabilities Who Display Harmful Sexual Behaviour
Authors: Malovic A. , Murphy G. , Coulton S. 
Published: November 2016

BackgroundPrevious studies and national reports have all noted that a significant proportion of the young people who display harmful sexual behaviours have intellectual disabilities. However, research on the topic has been scarce. This study presents a systematic review of the literature relating to clinical instruments specifically developed or adapted for adolescents with intellectual disabilities who display harmful sexual behaviours.MethodAn electronic search of databases was completed for published articles in English from the earliest possible date to the end of 2013.ResultsNo published articles met the full search criteria. This confirmed the lack of published clinical measures, apart from two risk assessment instruments.ConclusionsGiven the lack of measures, it is recommended that the focus of future research needs to be on developing or adapting instruments that will offer researchers’ and clinicians’ empirical as well as clinical data on this all‐too‐often‐overlooked population of vulnerable youth.
The Role of Law in EU Foreign Policy‐making: Legal Integrity, Legal Spillover, and the EU Policy of Differentiation towards Israel
Authors: Müller Patrick , Slominski Peter 
Published: November 2016

AbstractLittle systematic effort has been made to examine the role of law and its implications for EU foreign policy‐making. Addressing this research gap, we identify key legal dynamics that operate in supranational policies, but have increasingly led to legal ‘spillovers’, both institutionally and discursively, into the Common Foreign and Security Policy. We illustrate the relevance of these dynamics for the case of EU–Israeli relations. Since the late 1990s, legal inconsistencies in EU–Israeli co‐operation have been addressed by the Commission via soft law, by various MEPs via parliamentary questions, and by the European Court of Justice (ECJ). Simultaneously, external actors like NGOs and corporations have used the EU's legal infrastructure to confront the EU with the fact that its de facto relations have not lived up its de jure position. Over time and also as a consequence of the Lisbon Treaty, even the Council found it difficult to ignore non‐compliance with its own legal position.
Melanomas vs. nevi in high‐risk patients under long‐term monitoring with digital dermatoscopy: do melanomas and nevi already differ at baseline?
Authors: Tschandl P. , Hofmann L. , Fink C. , Kittler H. , Haenssle H. A. 
Published: November 2016

AbstractBackgroundWhat lesions to select for a most efficient dermatoscopic monitoring of patients with multiple nevi remains an unresolved issue.ObjectiveTo compare the grade of atypia of melanomas and nevi of the same patient at baseline.MethodsProspective observational study using 236 dermatoscopic baseline images (59 quartets from 59 patients, each including one melanoma detected during follow‐up and three nevi). Dermatologists (n = 26) were asked to assess the ‘grade of dermatoscopic atypia’ on a numerical scale and to identify the melanomas.ResultsOn average, each dermatologist identified 24 of 59 melanomas (40%, range: 11–37). The number of correct picks was greater for dermatologists with moderate (mean: 28) or high (mean: 28) experience compared to beginners (mean 17; P < 0.001). In three of the 59 sets, none of the 26 dermatologists identified the melanoma. The mean grade of dermatoscopic atypia was 2.5 for nevi (95% CI: 2.4–2.6) and 3.0 for melanomas (95% CI: 2.9–3.1, P < 0.001).LimitationsRating dermatologists were informed that each quartet of images included one melanoma creating substantial deviation from a real‐life situation.ConclusionA significant proportion of melanomas detected during follow‐up cannot be differentiated from nevi at baseline. This necessitates the additional inclusion of less atypical lesions for monitoring.
Cyclosporine A for severe atopic dermatitis in children. efficacy and safety in a retrospective study of 63 patients
Authors: Hernández‐Martín A. , Noguera‐Morel L. , Bernardino‐Cuesta B. , Torrelo A. , Pérez‐Martin M.A. , Aparicio‐López C. , de Lucas‐Collantes C. 
Published: November 2016

AbstractBackgroundCyclosporine A (CSA) is an immunosuppressant agent widely used in severe atopic dermatitis (AD). However, experience in children is limited.ObjectivesTo assess the efficacy and adverse events of CSA therapy in children.MethodsRetrospective study of children with severe AD treated with CSA between January 2009 and December 2015.ResultsData from 63 patients were collected. Mean age at the beginning of treatment was 8.4 years (±3.6). The median starting dose was 4.27 (±0.61) mg/kg/day. After 4 weeks of treatment, the outcome was excellent in 35% of cases, good in 29% and poor in 36% of the patients. The response was better in patients without eosinophilia (P < 0.05). The median duration of treatment was 4.6 months (range 1.5–21.6). Side‐effects were frequent but mild, being more common in patients after longer treatment periods (P < 0.05). Mean time of follow‐up was 19.4 months (±12.7). Prolonged remission (>6 months) was observed in 13 patients (20%).LimitsThis is a retrospective review. The follow‐up period is limited.ConclusionsOur data confirm that CSA is efficacious and acts rapidly in the majority of children with severe AD. CSA therapy can provide sustained remission in some patients. CSA seems to be well tolerated in children, but strict monitoring is mandatory.
Substantial reduction in hospital stay of children and adolescents with diabetic ketoacidosis after implementation of Clinical Practice Guidelines in a university hospital in Saudi Arabia
Authors: Al Nemri Abdulrahman , Amer Yasser Sami , Gasim Hala , Osman Mohamed Elfaki , Aleyadhy Ayman , AL Otaibi Hessah , Iqbal Shaikh Mohammed , Aljurayyan Nasir Abdullah , Assiri Asaad M. , Babiker Amir , Mohamed Sarar 
Published: November 2016

AbstractRationale, aims and objectivesWe aimed to determine the effect of Clinical Practice Guideline (CPG) implementation on length of hospital stay of children and adolescents with diabetic ketoacidosis (DKA).MethodsThis was a 6‐year (2008‐2014) case‐control retrospective study conducted at King Khalid University Hospital, Riyadh, that compared patients with DKA managed using CPG with those treated before CPG implementation.ResultsThere were 63 episodes of DKA in 41 patients managed using CPG compared with 40 episodes in 33 patients treated before implementation of CPG. Baseline characteristics of the 2 groups were similar (age, sex, newly diagnosed patients, recurrent DKA, DKA severity, and mean glycosylated hemoglobin). The mean length of hospital stay (±SD) was 68.6 ± 53.1 hours after implementation of CPG compared with 107.4 ± 65.6 hours before implementation (P < .001). The reduction in length of hospital stay equals to 1700 bed days saved per year per 1000 patients.ConclusionsImplementation of CPG for DKA decreased the length of hospital stay.
Prognostic durability of liver fibrosis tests and improvement in predictive performance for mortality by combining tests
Authors: Bertrais Sandrine , Boursier Jérôme , Ducancelle Alexandra , Oberti Frédéric , Fouchard‐Hubert Isabelle , Moal Valérie , Calès Paul 
Published: November 2016

AbstractBackground and AimThere is currently no recommended time interval between noninvasive fibrosis measurements for monitoring chronic liver diseases. We determined how long a single liver fibrosis evaluation may accurately predict mortality, and assessed whether combining tests improves prognostic performance.MethodsWe included 1559 patients with chronic liver disease and available baseline liver stiffness measurement (LSM) by Fibroscan, aspartate aminotransferase to platelet ratio index (APRI), FIB‐4, Hepascore, and FibroMeterV2G.ResultsMedian follow‐up was 2.8 years during which 262 (16.8%) patients died, with 115 liver‐related deaths. All fibrosis tests were able to predict mortality, although APRI (and FIB‐4 for liver‐related mortality) showed lower overall discriminative ability than the other tests (differences in Harrell's C‐index: P < 0.050). According to time‐dependent AUROCs, the time period with optimal predictive performance was 2–3 years in patients with no/mild fibrosis, 1 year in patients with significant fibrosis, and <6 months in cirrhotic patients even in those with a model of end‐stage liver disease (MELD) score <15. Patients were then randomly split in training/testing sets. In the training set, blood tests and LSM were independent predictors of all‐cause mortality. The best‐fit multivariate model included age, sex, LSM, and FibroMeterV2G with C‐index = 0.834 (95% confidence interval, 0.803–0.862). The prognostic model for liver‐related mortality included the same covariates with C‐index = 0.868 (0.831–0.902). In the testing set, the multivariate models had higher prognostic accuracy than FibroMeterV2G or LSM alone for all‐cause mortality and FibroMeterV2G alone for liver‐related mortality.ConclusionsThe prognostic durability of a single baseline fibrosis evaluation depends on the liver fibrosis level. Combining LSM with a blood fibrosis test improves mortality risk assessment.
The Effect of Silica and Prepolymer Nanoparticles on the Mechanical Properties of Denture Base Acrylic Resin
Authors: Cevik Pinar , Yildirim‐Bicer Arzu Zeynep 
Published: November 2016

AbstractPurposeTo evaluate how hydrophobic nanoparticle silica and prepolymer affect the flexural strength, surface hardness, surface roughness, and resilience of a denture base acrylic resin.Materials and MethodsA total of 40 denture base acrylic resin specimens with dimensions 65 × 10 × 3 mm3 were fabricated in this study. Specimens were divided into five experimental groups (n = 8) according to surface‐treated silica and prepolymer concentration incorporated into the acrylic resin (weight %) prior to polymerization: G1 acted as control, no fillers were used in this group. G2: 1 wt% 12 nm silica nanoparticles; G3: 5 wt% 12 nm silica nanoparticles; G4: 1 wt% 12 nm prepolymer nanoparticles; G5: 5 wt% 12 nm prepolymer nanoparticles were added into the acrylic mixture. Acrylic specimens were polymerized according to the manufacturer's instructions. Three‐point bending test was performed to evaluate the flexural strength and the resilience of the specimens. Then, a digital profilometer was used to determine the surface roughness of the specimens. Surface hardness was conducted by a digital Shore D hardness testing machine. Surface analysis of one specimen in each group was performed with a scanning electron microscopy (SEM) to observe the fracture surfaces of specimens. ANOVA and Tukey tests were used for the statistical analysis (p < 0.05).ResultsStatistical analysis revealed significant differences among the groups. All groups showed poor flexural strength as compared with the control (p < 0.05). Regarding resilience, silica 5% showed the highest value whereas silica 1% showed the lowest value. Regarding Shore D hardness, silica 1% had the lowest hardness whereas polymer addition did not significantly influence the hardness of the acrylic resin (p < 0.05). Furthermore, silica 1% presented the highest roughness as compared with the other groups (p < 0.05). SEM images indicated some porosity and voids on fracture surfaces.ConclusionsBoth the silica and prepolymer incorporation into acrylic resin adversely affected the flexural strength of the acrylic resin compared to control group. In all concentrations, prepolymer incorporation resulted in increased flexural strength of acrylic resins compared to silica addition. The greater concentrations of the fillers resulted in increased mechanical properties of the acrylic resin.
Impact of inflammation and oxidative stress on carotid intima‐media thickness in obstructive sleep apnea patients without metabolic syndrome
Authors: Chang Ya‐Ting , Lin Hsin‐Ching , Chang Wen‐Neng , Tsai Nai‐Wen , Huang Chih‐Cheng , Wang Hung‐Chen , Kung Chia‐Te , Su Yu‐Jih , Lin Wei‐Che , Cheng Ben‐Chung , Su Chih‐Min , Chen Ting‐Yao , Chiang Yi‐Fang , Lu Cheng‐Hsien 
Published: November 2016

SummaryObstructive sleep apnea (OSA) increases the risk of cardiovascular diseases, and carotid intima‐media thickness (IMT) is a good indicator of the severity of atherosclerotic disease. This study tested the hypothesis that inflammation and oxidative stress determined carotid IMT in patients with OSA. The carotid IMT, mean systolic and diastolic pressure (night and morning) were significantly higher and the level of thiols and high‐density lipoprotein were significantly lower in our 121 OSA patients than in 27 controls (P < 0.05). The apnea/hypopnea index was correlated positively with E‐selectin (r = 0.222, P = 0.014), total cholesterol (r = 0.185, P = 0.042), low‐density lipoprotein (r = 0.264, P = 0.003) and HbA1c levels (r = 0.304, P = 0.001), but inversely with high‐density lipoprotein level (r = −0.203, P = 0.025) in the 121 patients with OSA. In OSA subjects, multiple linear regression analysis revealed that age, systolic blood pressure and intercellular cell adhesion molecule‐1 level associated independently with carotid IMT. Besides both age and systolic blood pressure, our study demonstrated that intercellular cell adhesion molecule‐1 level was associated significantly with carotid IMT in those patients who had OSA but without metabolic syndrome.
Risk of empyema in patients with chronic liver disease and cirrhosis: A nationwide, population‐based cohort study
Authors: Shen Te‐Chun , Chen Chia‐Hung , Lai Hsueh‐Chou , Lin Cheng‐Li , Tu Chih‐Yen , Hsia Te‐Chun , Shih Chuen‐Ming , Hsu Wu‐Huei , Sung Fung‐Chang 
Published: November 2016

AbstractBackgroundEmpyema is an important complication for patients with chronic liver disease and cirrhosis (CLDC). However, no study has investigated this relationship by using a population‐based cohort study.MethodsWe used the National Health Insurance Research Data of Taiwan to identify a cohort of 76 027 CLDC patients newly diagnosed in 2000‐2010 and a comparison cohort without CLDC of same size matched by age, gender and the year of diagnosis. The occurrence of empyema was monitored until the end of 2011. The hazard ratios (HRs) of empyema were estimated using the Cox model.ResultsThe overall incidence of empyema was 66% greater in the CLDC group than in the non‐CLDC group (3.85 vs 2.32/10 000 person‐years, P<.001), with an adjusted HR of 1.54 (95% confidence interval [CI]=1.24‐1.90). Compared with those without CLDC, adjusted HRs of empyema were 4.96 (95% CI=3.40‐7.24) for patients with cirrhosis and 4.75 (95% CI=3.11‐7.24) for patients with alcoholic CLDC. Further analyses revealed significant adjusted HRs of empyema among CLDC patients with ascites (5.76, 95% CI=4.13‐8.04) and with gastrointestinal haemorrhage (1.60, 95% CI=1.03‐2.48), compared to those without the respective disorders. Analyses using propensity score matched CLDC and non‐CLDC cohorts revealed similar results.ConclusionThe present study shows that CLDC patients have an increased risk of empyema. These patients need timely monitor for the risk of empyema, particularly for those with comorbid cirrhosis, alcoholic disorder, gastrointestinal haemorrhage and ascites.
Empowering women to breastfeed: Does the Baby Friendly Initiative make a difference?
Authors: Groleau Danielle , Pizarro Katherine W. , Molino Luisa , Gray‐Donald Katherine , Semenic Sonia 
Published: November 2016

AbstractThe Baby‐Friendly Hospital Initiative (BFI) is currently presented worldwide as the gold standard model of care for promoting and supporting breastfeeding. However, there is a lack of understanding about the ways in which health services, including the BFI, address the cultural change from a disembodied practice (formula feeding) to an embodied one (breastfeeding) in contexts where formula feeding is the norm. We used a qualitative case study methodology to compare the embodied experience of breastfeeding and the maternal experience of breastfeeding promotion and support services between mothers receiving care from institutions with low and high levels of BFI implementation in Québec, Canada. A total of 11 focus groups were conducted with mothers from six institutions–three with high and three with low levels of BFI implementation. We found the flexible approach to breastfeeding duration, characteristic of BFI services in our study, helped to avoid maternal guilt and shame; the shift to focusing on potential barriers and strategies for overcoming them empowered women to negotiate changes in infant feeding with others and self by addressing the embodied experience of a practice that may not feel natural at the beginning. Findings have implications for the concept of habitus and the construction of the breastfeeding body; we suggest that habitus can change if agents are provided with discursive tools to negotiate this embodied change. Implications for BFI services include the need to implement the 10 steps in a flexible, family‐centred way that focuses on empowering women rather than simply reaching outcomes.
Effect of tailored dietary guidance for pregnant women on nutritional status: A double‐cohort study
Authors: Haruna Megumi , Shiraishi Mie , Matsuzaki Masayo , Yatsuki Yuko , Yeo SeonAe 
Published: November 2016

AbstractThis double cohort study aimed to evaluate the effect of tailored dietary guidance for pregnant women on dietary intake, nutritional status, and infant birth weight. Healthy pregnant women were recruited at an antenatal clinic during two phases over 2 years. The historical controls were analyzed a year prior to the intervention group. In both groups, data were collected at 19–26 gestational weeks (baseline) and at 34–37 gestational weeks (outcome measurement). The intervention included the following: (a) assessments of maternal dietary nutritional intake using the brief self‐administered diet history questionnaire, (b) individual feedback based on the assessments of maternal nutritional status, (c) tailored guidance for a healthy diet, (d) original cooking recipes, and (e) goal sharing. Mann–Whitney U test was used to compare the outcome data between the groups. Of the 378 eligible women, 309 women had follow‐up questionnaire data. Blood samples were obtained from 202 women. Despite a lack of improvement in reported dietary intake, plasma eicosapentaenoic acid (p = .002), docosahexaenoic acid (p < .001), arachidonic acid (p < .001), and dihomo‐gamma‐linolenic acid (p < .001) concentrations as well as maternal weight gain (p = .019) were significantly higher in the intervention group. However, serum folate (p = .031) concentration was significantly lower in the intervention group, and there were no significant differences between the groups in 25‐hydroxy vitamin D levels, blood count, average birth weight, and rate of low birth weight infants. Assessment‐based tailored guidance individualized to maternal dietary intake might partially contribute to improved nutrition in pregnant women.
Effect of iron supplementation during lactation on maternal iron status and oxidative stress: A randomized controlled trial
Authors: Jorgensen Josh M. , Yang Zhenyu , Lönnerdal Bo , Chantry Caroline J. , Dewey Kathryn G. 
Published: November 2016

AbstractWe examined the effect of iron‐containing prenatal vitamin–mineral supplements taken postpartum on biomarkers of iron status and oxidative stress. Lactating women (n = 114) were randomly assigned to consume daily one iron‐free prenatal vitamin–mineral supplement plus either 27 mg of iron or placebo for approximately 3.5 months. The placebo group took the tablets between meals, while those given iron took the tablets either with (Fe‐W) or between meals (Fe‐B). Blood and urine samples were collected before and after the supplementation period to analyze hemoglobin (Hb), ferritin, hepcidin, transferrin saturation (TfSat), total plasma iron, and biomarkers of oxidative stress (isoprostane and 8‐hydroxy‐2‐deoxyguanosine (8‐OHdG)) and inflammation (C‐reactive protein (CRP) and alpha‐1‐acid glycoprotein (AGP)). There was a trend toward a greater change in Hb among women in the Fe‐B group compared to placebo (+2.5 vs. −3.7 g/L, respectively, p = 0.063). When the iron groups were combined, there was a greater change in Hb (+1.4 g/L) compared to placebo (p = 0.010). There were trends toward greater changes in TfSat (p = 0.087) and total plasma iron (p = 0.065) in the iron groups compared to placebo, yet no significant differences between the three groups in change in hepcidin (p = 0.291), isoprostane (p = 0.319), or 8‐OHdG (p = 0.659), nor in change in ferritin among those with elevated CRP at baseline (60% of women; p = 0.946); among those without elevated CRP (40% of women), ferritin increased more in the iron groups compared to placebo (p = 0.001). Iron consumption during lactation moderately increased iron status, particularly among women without elevated CRP, and increased Hb, but did not significantly increase oxidative stress.
A web app for population viability and harvesting analyses
Authors: GETZ WAYNE M. , MUELLERKLEIN OLIVER C. , SALTER RICHARD M. , CARLSON COLIN J. , LYONS ANDREW J. , SEIDEL DANA P. 
Published: November 2016

AbstractPopulation viability analysis (PVA) is used to assess the probability that a biological population will persist for a specified period of time. Such models are typically cast as Markov processes that may include age, stage, sex and metapopulation structures, density‐dependence and ecological interaction processes. They may also include harvesting, stocking, and thresholds that trigger interventions. Here we present a PVA web app that includes extensible user‐selected options. Specifically, this PVA web app allows for the specification of one to ten age classes, one or two sexes, single population or metapopulation configurations with 2 or 3 subpopulations, as well as density‐dependent settings for inducing region‐specific carrying capacities. Movement among subpopulations can be influenced by age, metapopulation connectivity, and attractivity of regions based on the relative fitness of the youngest age classes in each region. Simulations can be carried out deterministically or stochastically, with a user‐specified combination of demographic and environmental processes. This PVA web app is freely available athttp://www.numerusinc.com/webapps/pvafor running directly on any browser and device. It is easily modified by users familiar with the NovaModeler Software Platform.
On the pathogenesis of mTOR inhibitor‐associated stomatitis (mIAS)—studies using an organotypic model of the oral mucosa
Authors: Sonis S , Andreotta PW , Lyng G 
Published: November 2016

ObjectivemTOR inhibitor treatment of solid cancers is associated with mTOR inhibitor‐associated stomatitis (mIAS) a common, significant, dose‐limiting toxicity, with aphthous‐like lesions. Our objective was to assess the utility of a new organotypic model in defining mIAS’ pathogenesis.Materials and methodsThe effect of everolimus on organotypic human oral mucosa was studied. Sterile specimens were assessed 24 and 48 h after exposure to varying concentrations of everolimus. Morphologic changes and measures of apoptosis, proliferation, and levels of six Th1 and Th2 cytokines were studied.ResultsFollowing a 24‐h incubation, concentrations of 500 ng ml−1 of everolimus resulted in histological changes consistent with epithelial injury, disorganization and pre‐ or early apoptosis, increased TUNEL‐positive staining (P < 0.05) and reduced PCNA‐positive staining cells (P < 0.001) and increased levels of IL‐6 (P < 0.0001), IL‐8 (P < 0.01), and IFN‐γ (P < 0.09).ConclusionsEverolimus elicited epithelial damage manifest by morphologic changes, increased apoptosis, and decreased proliferation with concurrent release of keratinocyte‐derived pro‐inflammatory cytokines in the absence of bacteria. The extent of the effect was concentration and time dependent. These results suggest that mIAS is likely initiated by direct epithelial injury, independent of the microbiome. Keratinocyte cytokine release could likely play a role in accelerating an inflammatory infiltrate.