bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antihypertensive Drug Use, Blood Pressure Variability, and Incident Stroke Risk in Older Adults
Authors: Tully Phillip J. , Debette Stephanie , Dartigues Jean-François , Helmer Catherine , Artero Sylvaine , Tzourio Christophe 
Published: March 2016

Background and Purpose—
The aim was to determine the association between antihypertensive drug class and incident stroke controlling for long-term blood pressure (BP) variability (BPV) in people aged ≥65 years.

Methods—

The sample included 5951 participants (median age 74 years, 60% women) taking at least 1 drug for hypertension (3727/5951) or with systolic BP >140 mm Hg or diastolic BP >90 mm Hg. Participants were evaluated for incident fatal and nonfatal stroke to 12 years follow-up. BPV was calculated with the coefficient of variation method and regressed against 9 antihypertensive drug classes (BPV
reg
). Hazard models were used to determine hazard ratios for incident stroke risk attributable to drug class, adjusted for BP, BPV
reg
, covariates, and delayed entry bias.

Results—

There were 273 incident strokes over a median of 9.1 years (interquartile range 6.4–10.4). Stroke risk was generally not reduced by BP-lowering drugs. Angiotensin receptor blockers (hazard ratio 1.56; 95% confidence interval 1.06–2.28;
P
=0.02) and β-blockers (hazard ratio 1.41; 95% confidence interval 1.03–1.92;
P
=0.03) were associated with an increased total stroke risk. Angiotensin receptor blockers and β-blockers were also associated with ischemic strokes after adjustment for systolic BPV. Diastolic BPV was associated with stroke risk in analyses stratified by systolic BP 140 to 160 mm Hg (per 0.10 increase in coefficient of variation, hazard ratio 1.59; 95% confidence interval 1.05–2.40;
P
=0.03).

Conclusions—
The angiotensin receptor blocker and β-blocker drug classes were associated with incident stroke and ischemic stroke in older adults. BPV was generally not associated with incident stroke.
Is the Danube crested newt Triturus dobrogicus polytypic? A review and new nuclear DNA data
Authors: Wielstra Ben , Vörös Judit , Arntzen Jan W. 
Published: March 2016

The Danube crested newtTriturus dobrogicushas been proposed to comprise two subspecies:T. d. dobrogicusandT. d. macrosoma. Uncertainty exists in the literature over their distribution and diagnosability. We conduct a multilocus phylogeographical survey and review published data to determine whether a two taxon treatment is warranted. Newly produced and published nuclear DNA data suggest intraspecific variation in the Pannonian Plain part of the range, but with extensive genetic admixture, whereas mitochondrial DNA data shows a lack of geographical structuring inT. dobrogicusaltogether. None of the studied morphological characters suggest the presence of two geographical groups inT. dobrogicusunequivocally. Although Danube Delta newts do have relatively short bodies compared to the remainder of the range (the Pannonian and Lower Danube Plains and the Dnepr Delta), we argue that this finding can be explained by phenotypic plasticity – particularly in light of the incongruent evolutionary scenario suggested by genetic data. We conclude that the total body of evidence does not support the two subspecies hypothesis and recommend thatT. dobrogicusis treated as a monotypic species.
Karawajew’s ant type specimens (Hymenoptera, Formicidae) in the National Museum of Natural History of the National Academy of Sciences of Ukraine
Authors: MARTYNOV ALEXANDER V. , RADCHENKO ALEXANDER G. 
Published: March 2016

The collection of W.A. Karawajew is one of the richest and most famous ant collections of the World. Much of this collection consists of dry mounted specimens, including types of about 550 taxa, housed in the Shmalhausen Institute of Zoology of the National Academy of Sciences of Ukraine (Kiev). Nevertheless, we located a considerable part of Karawajew’s collection, containing about 25,000 specimens in alcohol, that is preserved in the National Museum of Natural History of the National Academy of Sciences of Ukraine (Kiev). The latter material was recently examined and we found types of 24 taxa. This type material was partly mounted, re-ordered and catalogued. In this paper we present a catalogue of these type specimens housed in the National Museum of Natural History.
Mainstreaming migrant integration? A critical analysis of a new trend in integration governance
Authors: Scholten Peter , Collett Elizabeth , Petrovic Milica 
Published: March 2016

In the academic literature, mainstreaming is conceptualized as a shift in policy focus (from specific to generic), as well as in governance (from state-centric to poly-centric). Whereas mainstreaming has been applied in various areas, such as gender, disability and environment, a more recent application concerns migrant integration, which has so far been under-studied in academic circles. This article provides a critical analysis of mainstreaming as a supposed ‘trend’ in migrant integration policies. It provides a conceptual discussion of what mainstreaming might mean in the field of migrant integration in an effort to connect the concept of mainstreaming as used in other fields to the literature on migrant integration, and notably the emerging concept of interculturalism. Following this, it provides an empirical analysis of shifts in integration governance and policy in Denmark, France, Germany and the UK in an effort to explain whether mainstreaming, as conceptualized, is taking place. The article concludes that mainstreaming as a concept in the field of migrant integration can only partially explain policy developments. There is, indeed, a clear trend towards more poly-centric governance and towards generic policies. However, such policies rarely involve efforts to create a generic awareness of migration-related diversity, and are often overshadowed by broader national narratives on migrant integration, and pre-existing governance structures. However, the existence of an explicit pursuit of replacement strategies at the local level suggests that mainstreaming approaches may be a way of circumventing these national narratives and governance structures. Points for practitioners Potential degenerative effects of target group constructions can be averted by proxy strategies that are defined area- or needs-based rather than group-based. Mainstreaming also demands poly-centric governance structures that allow for horizontal (interdepartmental, multi-actor) and vertical (multi-level) coordination mechanisms to avert policy decoupling. Mainstreaming does not mean total group-blindness; mainstreaming works best when combined with knowledge of and sensitivity to these groups, while preventing formalizing target group constructions. Mainstreaming is not just an option, but also a necessity, for policies in super-diverse cities, where group distinctions can no longer be made.
Society, Environment, Vulnerability, and Climate Change in Latin America
Authors: Rojas Hernández Jorge 
Published: March 2016

Historically, Latin American social development has been diverse and heterogeneous. It depends on the use of natural resources (with greater or less added value and productive diversity), the influence of social movements, the role of political parties, the level of education, and the prevailing culture. Inequality and social exclusion are still prevalent in most Latin American countries. Poverty and environmental deterioration tend to be correlated. Therefore strategies for mitigation of and adaptation to climate change must consider measures for overcoming poverty and reducing inequality. El desarrollo social en América Latina es históricamente muy diverso y heterogéneo. Depende del uso de los recursos naturales — con mayor o menor valor agregado y diversidad productiva —, de la influencia de los movimientos sociales, del papel de los partidos políticos, del nivel educacional alcanzado y del tipo de cultura imperante en las diferentes sociedades. Aún persiste la desigualdad y altos índices de exclusión social en la mayoría de los países latinoamericanos. Pobreza y deterioro del medio ambiente suelen correlacionarse. Los pobres por lo general viven en territorios degradados y vulnerables. Las estrategias de mitigación y adaptación al cambio climático deben, en consecuencia, contemplar medidas de superación de la pobreza y disminución de los niveles de desigualdad social y ambiental.
The efficacy of early initiated, supervised, progressive resistance training compared to unsupervised, home-based exercise after unicompartmental knee arthroplasty: a single-blinded randomized controlled trial
Authors: Jørgensen Peter B , Bogh Søren B , Kierkegaard Signe , Sørensen Henrik , Odgaard Anders , Søballe Kjeld , Mechlenburg Inger 
Published: March 2016

Objective: To examine if supervised progressive resistance training was superior to home-based exercise in rehabilitation after unicompartmental knee arthroplasty. Design: Single blinded, randomized clinical trial. Setting: Surgery, progressive resistance training and testing was carried out at Aarhus University Hospital and home-based exercise was carried out in the home of the patient. Subjects: Fifty five patients were randomized to either progressive resistance training or home-based exercise. Intervention: Patients were randomized to either progressive resistance training (home based exercise five days/week and progressive resistance training two days/week) or control group (home based exercise seven days/week). Main measures: Preoperative assessment, 10-week (primary endpoint) and one-year follow-up were performed for leg extension power, spatiotemporal gait parameters and knee injury and osteoarthritis outcome score (KOOS). Results: Forty patients (73%) completed 1-year follow-up. Patients in the progressive resistance training group participated in average 11 of 16 training sessions. Leg extension power increased from baseline to 10-week follow-up in progressive resistance training group (progressive resistance training: 0.28 W/kg, P= 0.01, control group: 0.01 W/kg, P=0.93) with no between-group difference. Walking speed and KOOS scores increased from baseline to 10-week follow-up in both groups with no between-group difference (six minutes walk test P=0.63, KOOS P>0.29). Conclusions: Progressive resistance training two days/week combined with home based exercise five days/week was not superior to home based exercise seven days/week in improving leg extension power of the operated leg.
How Often Do Individuals with Major Depression Receive Minimally Adequate Treatment? A Population-Based, Data Linkage Study
Authors: Puyat Joseph H. , Kazanjian Arminee , Goldner Elliot M. , Wong Hubert 
Published: March 2016

Objective: Depression is usually treated with antidepressants, psychotherapy, or both. In this study, we examined the extent to which individuals with depression receive minimally adequate treatment with regard to the use of antidepressants and psychotherapy. Method: Using population-based administrative data, we identified individuals with inpatient or outpatient diagnoses of depression and tracked their use of publicly funded mental health services within a 12-month period. We used mixed-effects logistic regression to assess the influence of patient-level characteristics and physician-level variations on the receipt of minimally adequate treatment. Results: A total of 108 101 individuals, predominantly women (65%) and urban residents (89%), were diagnosed with depression in 2010–2011. Of these, 13% received minimally adequate counseling/psychotherapy with higher proportions observed among men, younger individuals, and urban residents. In contrast, there were more who received minimally adequate antidepressant therapy (48%), with women, older individuals, and rural residents having the highest proportions. Overall, about 53% received either type of treatment, and the pattern of use was similar to that of antidepressant therapy. Mixed-effects logistic regression results indicate that these factors remain independent predictors of the receipt of minimally adequate depression care. Significant practice variations also exist, which determine patients’ receipt of minimally adequate care, particularly with respect to counseling or psychotherapy. Conclusions: Only about half of those with depression receive either minimally adequate counseling/psychotherapy or minimally adequate antidepressant therapy. Disparities also persist, affecting mostly men and younger individuals. A multifactorial approach is needed to improve access to and reduce variations in receipt of minimally adequate depression care.
A therapeutic delivery system for chronic osteomyelitis via a multi-drug implant based on three-dimensional printing technology
Authors: Wu Weigang , Ye Chenyi , Zheng Qixin , Wu Gui , Cheng Zhaohui 
Published: March 2016

Chronic osteomyelitis is difficult to be cured and often relapses, which presents to be a great challenge to clinicians. We conducted this original study to explore the efficiency of therapeutic alliance for chronic osteomyelitis by a multi-drug implant based on three-dimensional printing technology. We designed and fabricated preciously a multi-drug implant with a multi-layered concentric cylinder construction by three-dimensional (3D) printing technology. Levofloxacin and tobramycin were incorporated into the drug implant in a specific sequence. The drug release property of the drug implant was assayed in vitro. We also developed an animal model of chronic osteomyelitis to estimate the effect of the 3D printed multi-drug implant. The results showed that the multi-drug implant had a sustained and programmed drug release property. Levofloxacin and tobramycin which were released from the multi-drug implant worked in tandem to enhance pharmacodynamic action which was similar to a tumor chemotherapy program and were sufficient to treat chronic osteomyelitis. These findings imply that the administration of 3D printed multi-drug implant would be a potential therapeutic method for chronic osteomyelitis. Further studies are required.
Medical leadership in the 21st century
Authors: Bhugra Dinesh , Ventriglio Antonio 
Published: March 2016

Objective: Psychiatry as a discipline and as a profession stands at the cusp of major challenges in many areas including social, biological and psychological spheres. The practice of psychiatry is affected by ideologically driven policies by politicians, and the continuing long-lasting impact of the global economic downturn along with new developments in health care delivery. Changing biological factors include better understanding of brain structures and functioning and potential developments in psychopharmacogenomics. Social changes facing psychiatry include globalisation and rapid urbanisation. Psychological changes include therapies without therapists and the impact of social media and the information age. The current paper explores these challenges and the opportunities for psychiatrists to provide leadership in a number of settings. Conclusion: Leadership skills are essential skills for psychiatrists, and enable an individual to plan and deliver services, and also help them to lead not only clinical teams but organisations and institutions. Psychiatrists are best placed because of the breadth of the training they undergo and their communication skills. Leadership is markedly different from managerial skills, although there may be a small degree of overlap.
Quantifying the benefits of peer support for people with dementia: A Social Return on Investment (SROI) study
Authors: Willis Elizabeth , Semple Amy C , de Waal Hugo 
Published: March 2016

Objective Peer support for people with dementia and carers is routinely advocated in national strategies and policy as a post-diagnostic intervention. However there is limited evidence to demonstrate the value these groups offer. This study looked at three dementia peer support groups in South London to evaluate what outcomes they produce and how much social value they create in relation to the cost of investment. Methods A Social Return on Investment (SROI) analysis was undertaken, which involves collecting data on the inputs, outputs and outcomes of an intervention, which are put into a formula, the end result being a SROI ratio showing how much social value is created per £1 of investment. Results Findings showed the three groups created social value ranging from £1.17 to £5.18 for every pound (£) of investment, dependent on the design and structure of the group. Key outcomes for people with dementia were mental stimulation and a reduction in loneliness and isolation. Carers reported a reduction in stress and burden of care. Volunteers cited an increased knowledge of dementia. Conclusions This study has shown that peer groups for people with dementia produce a social value greater than the cost of investment which provides encouraging evidence for those looking to commission, invest, set up or evaluate peer support groups for people with dementia and carers. Beyond the SROI ratio, this study has shown these groups create beneficial outcomes not only for the group members but also more widely for their carers and the group volunteers.
Early transcriptional events in the udder and teat after intra-mammary Escherichia coli and Staphylococcus aureus challenge
Authors: Petzl Wolfram , Günther Juliane , Mühlbauer Katharina , Seyfert Hans-Martin , Schuberth Hans-Joachim , Hussen Jamal , Sauter-Louis Carola , Hafner-Marx Angela , Zerbe Holm 
Published: March 2016

Intra-mammary bacterial infections can result in harmful clinical mastitis or subclinical mastitis with persistent infections. Research during the last decades closely examined the pathophysiology of inflamed udders. Initial events after pathogen perception but before the onset of mastitis have not been examined in vivo. The objective of this study was to develop a mastitis model in cows by monitoring initial transcriptional pathogen-specific host response before clinical signs occur. We applied a short-term infection model to analyse transcripts encoding chemokines, cytokines and antimicrobial molecules in the teat cistern (TC) and lobulo-alveolar parenchyma (LP) up to 3 h after challenge with E. and Staphylococcus aureus. Both pathogens elicited an immune reaction by 1 h after challenge. Escherichia coli induced all analysed factors ( CCL20, CXCL8, TNF, IL6, IL12B, IL10, LAP, S100A9); however, S. aureus failed to induce IL12B, IL10, LAP and S100A9 expression. The E. coli-induced up-regulation was 25–105 times greater than that after S. aureus challenge. Almost all the responses were restricted to the TC. The short-term mastitis model demonstrates that a divergent pathogen-specific response is generated during the first h. It confirms that the first transcripts are generated in the TC prior to a response in the LP.
"Modified Adductor Sling Technique"- a surgical therapy for patellar instability in children and adolescents
Authors: Alm Lena , Frosch Karl-Heinz , Preiss Achim , Heitmann Maximilian , Akoto Ralph 
Published: March 2016

Aims and Objectives: Due to open femoral physis, the therapy of patellar instability in children and adolescents is challenging. We developed a surgical technique, modified form of the "Adductor-Sling-Technique" by Sillanpää which offers a surgical treatment to avoid damage to the femoral physis. The purpose of this study is to determine whether there is a benefit in the clinical outcome for patients operated by the "modified Adductor Sling Technique" in comparison to patients with other surgical procedures. Materials and Methods: Twenty "modified Adductor Sling" reconstructions in 19 patients (age 11-24) were included in the study until now, 15 patients with open physis and 4 patients with closed physis with special indications. Since 2010 "modified Adductor Sling" reconstruction was performed by looping the gracilis tendon around the adductor magnus tendon and attaching it at the medial facette of the patella. Clinical outcome was retrospectively evaluated at a mean follow-up period of 1.3 years (range 0.5-3.6). The evaluation also included Lysholm Score, Kujala Score and DGU score. Statistical analysis was performed using IBM®SPSS®Statistics Version 21. A P value less than 0.5 was considered significant. Results: The average age at the time of operation was 14.9 years (range 11.2-24.3). Recurrent dislocation occurred in 4 out of 20 cases (20%). It was noticeable that out of those 4 patients 2 patients had a lateral release in addition to the "modified Adductor Sling Technique" due to lateral hyperpression. No other patients had a lateral release in our patient population. Also, out of those 4 patients 3 patients had an additional maltracking of the patella, caused by a high TTTG, severe trochlea dysplasia or additional axial deformity. The overall Kujala Score was 87 (range 46-100) points, in patients without re-dislocation it was 94 (range 46-100) points. The overall Lysholm Score was 85 (range 39-100) points, in the group without re-dislocation 90 (range 39-100) points. The mean TTTG was 16,59 (range 11,7-21,4) mm, in the group without re-dislocation it was 16,24 (range 11,7-21,4) mm. There was no significant difference between the patients with or without re-dislocation(p=0,312). Conclusion: The "modified Adductor Sling Technique" offers relevant clinical improvements in knee function and pain. An advantage is the avoidance of damaging the femoral physis. Our Hypothesis of less recurrent dislocation rates could not be confirmed. The re-dislocation rate was even higher than in MPFL reconstruction using femoral fixation in adults. Patients with patellar instabilities without maltracking (no severe trochlea dysplasia, no axial deformity, moderately elevated TTTG) and open physis benefit from the "modified Adductor Sling Technique". This technique is not recommended in patients with patellar instability and additional maltracking.
The use of a radiolucent triangle in knee surgery
Authors: Bauchspieß Felix , Gahr Ralf 
Published: March 2016

Aims and Objectives: There is a variety of different approaches in knee surgery of fractures, injuries of ligaments and knee osteotomy. Materials and Methods: The radiolucent triangle by Innomed®, designed by Stuart E. Fromm, is a very useful tool that helps with the positioning of the femur and tibia during knee surgery. Results: The radiolucent Triangle by Innomed® is available in three different sizes and offers a great variety of possible applications. It is useful for knee positioning in injuries of ligaments such as MCL or LCL but also in complex ligament injuries. Furthermore, it allows an easy access in knee osteotomy. It also provides a very comfortable positioning of the leg in arthroscopic fracture treatment of the tibial head especially when lifting the bone fragments. Using the Triangle in minimal invasive procedures such as MIPO with LISS or LCP-DF or distal femoral nail (DFN) one will find it very helpful that the leg almost rotates "automatically" in the right position. Conclusion: The Fromm Triangle by Innomed® offers a great variety of possible applications and improves the management during operative procedures in knee surgery.