bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long‐term outcomes after selective dorsal rhizotomy: a retrospective matched cohort study
Authors: Munger Meghan E , Aldahondo Nanette , Krach Linda E , Novacheck Tom F , Schwartz Michael H 
Published: August 2017

AimTo examine long‐term outcomes of selective dorsal rhizotomy (SDR) 10 to 17 years after surgery.MethodParticipants who underwent SDR had spastic diplegic cerebral palsy (CP), completed baseline gait analysis, and were 16 to 25 years old at follow‐up. Non‐SDR participants (i.e. controls) were matched on important clinical parameters at baseline but did not undergo SDR. All study participants completed six surveys assessing pain, quality of life, participation, function, and mobility. Treatment history for lower extremity surgery and antispasticity injections was tabulated. A subset of each study group returned for three‐dimensional gait analysis, including kinematics, metabolic energy cost, and physical examination. Gait Deviation Index (GDI) was calculated to measure gait quality.ResultsThe study cohort had 24 participants with SDR and 11 without SDR. Of these, 13 patients with SDR (five males, eight females; median [IQR] age 17y 2mo [16y 8mo–17y 9mo]) and eight without SDR (three males, five females; median [IQR] age 19y 2mo [17y 3mo–21y 11mo]) completed baseline and follow‐up gait analysis. Spasticity significantly decreased in those with SDR (p<0.05). Gait Deviation Index improved more in participants without SDR than those with SDR (Δnon‐SDR=12.8 vs ΔSDR=9.1; p=0.01). Compared with the SDR group, participants without SDR underwent significantly more subsequent interventions (p<0.05).InterpretationPatients in both the SDR and non‐SDR groups showed improved gait quality more than 10 years after surgery. Participants without SDR had a larger improvement in gait pathology but underwent significantly more intervention. There were no differences between groups in survey measures. These results suggest differing treatment courses provide similar outcomes into early adulthood.What this paper adds

Selective dorsal rhizotomy (SDR) and non‐SDR groups had significant improvement in gait pathology over time.

The non‐SDR group had significantly better gait compared with the SDR group at follow‐up.

The groups had similar levels of energy cost, pain, and quality of life.

Non‐SDR participants underwent significantly more orthopaedic surgery and antispasticity injections than SDR participants.

Use of a clinically similar control group highlights that different treatment courses may result in similar outcomes into young adulthood.
A population‐based study of communicative participation in preschool children with speech‐language impairments
Authors: Cunningham Barbara Jane , Hanna Steven E , Oddson Bruce , Thomas‐Stonell Nancy , Rosenbaum Peter 
Published: August 2017

AimTo develop statistical models of communicative participation development of preschool children and explore variations by level of function.MethodThis was a secondary analysis of data from a longitudinal study of preschool children with speech and language impairments (n=46 872; age range 18–67mo, mean age [SD] 41.76mo [11.92]; 67% male) accessing publicly funded services in Ontario, Canada. Two measures were used: Focus on the Outcomes of Communication Under Six (FOCUS), measuring changes in communicative participation skills, and the Communication Function Classification System (CFCS), classifying communicative function into one of five levels. We used mixed effects modeling to fit growth curves for children in each CFCS level. Models allowed for variation in initial FOCUS score at 18 months, rate of growth with age, and rate of acceleration/deceleration with age.ResultsStarting FOCUS score (18mo) varied inversely with CFCS level at entry to the program. Growth was initially rapid and then leveled off for children in Levels I to III. Growth was less rapid for children in Level IV, but leveled off, and was slow but continual for children in Level V.InterpretationThis work can help us to move beyond traditional impairment‐based thinking and shows that children can make meaningful communicative changes regardless of their function.
Comparing emergency department presentations among children with cerebral palsy with general childhood presentations: a data linkage study
Authors: Meehan Elaine , Williams Katrina , Reid Susan M , Freed Gary L , Babl Franz E , Sewell Jillian R , Vidmar Suzanna , Donath Susan , Reddihough Dinah S 
Published: August 2017

AimThe aims of this study were to estimate the proportion of emergency department presentations attributable to children with cerebral palsy (CP), investigate the frequency of emergency department presentations in a CP cohort, and compare emergency department presentations among children with CP with those of other children.MethodThis was a retrospective cohort study. The Victorian Cerebral Palsy Register was linked to the Victorian Emergency Minimum Dataset. Data on emergency department presentations for the CP cohort occurring between 2007 and 2014 and population control data were obtained.ResultsThe CP cohort (n=1748) had 7015 emergency department presentations during the 7‐year period, accounting for 0.4% of the 1.69 million age‐specific presentations during that time. The number of annual presentations per 1000 children rose with increasing CP severity. Compared with presentations among the general population, higher proportions of presentations among the CP cohort were preceded by ambulance arrivals (27% vs 8%), triaged as urgent (66% vs 32%), and required hospital admission (38% vs 12%).InterpretationThe marked differences in presentations between the CP cohort and the general population in the proportions that were urgent and required ambulance arrivals and hospital admissions was an important finding. Strategies to ensure appropriate use of services, including encouragement to seek earlier assistance from primary care providers, may prevent problems escalating to the need for urgent care.What this paper adds

Children with cerebral palsy (CP) account for 0.4% of childhood emergency department presentations.

More emergency department presentations among children with CP require ambulance arrival.

More CP emergency department presentations are urgent and require hospital admission.

Traditional emergency department triage scales seem less accurate for this group.
Efficacy and safety of teneligliptin added to canagliflozin monotherapy in Japanese patients with type 2 diabetes mellitus: A multicentre, randomized, double‐blind, placebo‐controlled, parallel‐group comparative study
Authors: Kadowaki Takashi , Inagaki Nobuya , Kondo Kazuoki , Nishimura Kenichi , Kaneko Genki , Maruyama Nobuko , Nakanishi Nobuhiro , Gouda Maki , Iijima Hiroaki , Watanabe Yumi 
Published: August 2017

Dipeptidyl peptidase‐4 (DPP‐4) inhibitors and sodium glucose co‐transporter 2 (SGLT2) inhibitors are frequently used in combination for the treatment of type 2 diabetes mellitus (T2DM). We examined the efficacy and safety of teneligliptin (a DPP‐4 inhibitor) added to canagliflozin (an SGLT2 inhibitor) monotherapy in Japanese patients with poorly controlled T2DM as part of the development of a fixed‐dose combination of teneligliptin and canagliflozin.Japanese patients treated with canagliflozin (100 mg) for ≥12 weeks were randomized to receive add‐on teneligliptin (20 mg; C + T group) or placebo (C + P group) for 24 weeks. The primary endpoint was change in glycated haemoglobin (HbA1c) from baseline to Week 24. The between‐group differences in reductions from baseline to Week 24 were significantly greater in the C + T group for HbA1c (−0.94%; P < .001). The incidence of adverse events was similar in both groups (55.8% and 49.4% in the C + T and C + P groups, respectively). No episodes of hypoglycaemia were reported. Teneligliptin added to ongoing canagliflozin monotherapy improved glycaemic control and was well tolerated in Japanese patients with inadequately controlled T2DM.
Sodium‐glucose cotransporter‐2 inhibition improves incretin sensitivity of pancreatic β‐cells in people with type 2 diabetes
Authors: Ahn Chang Ho , Oh Tae Jung , Kwak Soo Heon , Cho Young Min 
Published: August 2017

AimTo test the hypothesis that dapagliflozin, a sodium‐glucose cotransporter‐2 inhibitor, improves β‐cell responses to incretin hormones (or β‐cell incretin sensitivity) by alleviating glucose toxicity in people with type 2 diabetes mellitus (T2DM).MethodsA total of 19 people with T2DM underwent a 3‐hour hyperglycaemic clamp study with incretin infusion before and after 8‐week treatment with dapagliflozin added to the background treatment. In addition, 10 people with normal glucose tolerance (NGT) underwent a single hyperglycaemic clamp study. The hyperglycaemic clamp was targeted at 15.5 mmol/L for 3 hours, with synthetic glucagon‐like peptide‐1 (GLP‐1) and glucose‐dependent insulinotropic polypeptide (GIP) infusion over a 60‐ to 180‐minute and a 120‐ to 180‐minute period, respectively.ResultsCompared with baseline, the C‐peptide response to GLP‐1 (incremental area under the curve [iAUC] of C‐peptide60‐120 minutes) significantly increased (83.6 ± 42.1 to 106.6 ± 45.7 nmol/L × min; P = .011), and the C‐peptide response to GIP/GLP‐1 (iAUC of C‐peptide120‐180 minutes) tended to increase after dapagliflozin treatment (82.5 ± 58.4 to 101.9 ± 50.3 nmol/L × min; P = .087), whereas both the insulin responses to GLP‐1 and GIP/GLP‐1 increased significantly. First‐phase C‐peptide response, which reflects β‐cell function, significantly increased after dapagliflozin treatment; however, all these improved values in the participants with T2DM were far lower than those in the participants with NGT. In addition, the improvement in insulin responses to hyperglycaemia was correlated with the improvement in insulin responses to incretin infusion.ConclusionsDapagliflozin improved β‐cell responses to incretin hormones as well as glucose during the hyperglycaemic clamp in patients with inadequately controlled T2DM.
Factors associated with polypharmacy in elderly home‐care patients
Authors: Komiya Hitoshi , Umegaki Hiroyuki , Asai Atsushi , Kanda Shigeru , Maeda Keiko , Shimojima Takuya , Nomura Hideki , Kuzuya Masafumi 
Published: August 2017

AbstractAimPolypharmacy, which is often observed in elderly patients, has been associated with several unfavorable outcomes, including an increased risk of potentially inappropriate medications, medication non‐adherence, drug duplication, drug–drug interactions, higher healthcare costs and adverse drug reactions. A significant association between polypharmacy and adverse outcomes among older people living in the community has also been confirmed. A reduction in the number of medications should thus be pursued for many older individuals. Nevertheless, the factors associated with polypharmacy in elderly home‐care patients have not been reported. Here, we investigated those factors in elderly home‐care patients in Japan.MethodsWe used the data of the participants in the Observational Study of Nagoya Elderly with Home Medical investigation. Polypharmacy was defined as the current use of six or more different medications. We carried out univariate and multivariate logistic regression analyses to assess the associations between polypharmacy and each of several factors.ResultsA total of 153 home‐care patients were registered. The mean number of medications used per patient was 5.9, and 51.5% of the patients belonged to the polypharmacy group. The multivariate model showed that the patients’ scores on the Charlson Comorbidity Index and the Mini‐Nutrition Assessment Short Form were inversely associated with polypharmacy, and potentially inappropriate medication was most strongly associated with polypharmacy (odds ratio 4.992).ConclusionsThe present findings showed that polypharmacy was quite common among the elderly home‐care patients, and they suggest that home‐care physicians should prescribe fewer medications in accord with the deterioration of home‐care patients’ general condition. Geriatr Gerontol Int 2018; 18: 33–41.
Chemically strengthened glass by ion exchange: Strength evaluation
Authors: Macrelli Guglielmo 
Published: August 2017

AbstractA linear fracture mechanics model is considered for strength evaluation of glass submitted to ion exchange below glass transition temperature. Former models of the ion exchange process were based on rough zero‐order (constant) and first‐order (linear) approximations of the residual stress field generated by the larger ions invading the glass matrix. In this study, the effective stress field generated by the invading ions is taken into account for strength evaluation. Both stress non‐relaxation approximation and stress relaxation are analyzed and discussed. A comparison of results predicted by the introduced models with experimental data of glass strength before and after ion exchange is presented. The hypothesis of conservation of surface flaws geometry (shape and depth) after ion exchange is critically discussed.
Hypokalaemia Occurring During Insulin‐induced Hypoglycaemia
Authors: Strakosch C. R. , Stiel J. N. , Györy A. Z. 
Published: August 2017

SummaryInsulin‐induced hypoglycaemia was used to test pituitary function in six patients with suspected pituitary deficiency. In each, a fall in serum potassium concentration of from 0·63 to 1·48 mEq/litre (mean fall 1·10 mEq/ litre ± 0·30 SEM) was observed during the two hour period following administration of 0·15 units of insulin per kilogram body weight. In several patients the resulting hypokalaemia was at a level which has been associated with cardiac complications.
Thorotrast‐induced Haemangioendothelial Sarcoma—A Lesson from the Past
Authors: Quinlan M. F. , Scopa J. 
Published: August 2017

SummaryComplications following a carotid arteriogram done in 1947 with Thorotrast are described in a 47‐year‐old man who sub‐sequently died from them in 1970. They included a local cervical granuloma with associated haemangioendothelial sarcoma, chromosome changes characteristic of radiation damage and widespread haemangioendothelial sarcomatous deposits in brain, lung, liver, probably arising from multicentric primary sites in the bone marrow.A survey of the use of Thorotrast as a contrast medium in Australia and New Zealand showed that its use was extremely limited. The principal complications seen have been two cervical granulomas and one hepatoma.
Complement and the Clinician
Authors: Palmer D. G. 
Published: August 2017

SummaryThe estimation of complement in serum, and in other body fluids, particularly synovial fluid, now has an established place in the assessment, prognosis and response to treatment of those diseases associated with immunological phenomena. Some knowledge of the complement sequence itself, the patterns characteristic of various disease processes and the interacting factors which may affect the levels of the various components have been summarised. Disease states closely resembling lupus erythematosus have been associated with genetically determined deficiencies of classic pathway components and deficiencies of terminal sequence components may lead to severe recurrent infections.
Chinese Health Improvement Profile for people with severe mental illness: A cluster‐randomized, controlled trial
Authors: Bressington Daniel , Chien Wai Tong , Mui Jolene , Lam Kar Kei Claire , Mahfoud Ziyad , White Jacquie , Gray Richard 
Published: August 2017

AbstractThe aim of the present study was to establish the feasibility of conducting a full‐scale trial and to estimate the preliminary effect of a Chinese Health Improvement Profile (CHIP) intervention on self‐reported physical well‐being of people with severe mental illness (SMI). The study used a parallel‐group, open‐label, cluster‐randomized, controlled trial (RCT) design. Twelve community psychiatric nurses (CPN) and their corresponding 137 patients with SMI were randomized into the CHIP or treatment‐as‐usual (TAU) groups. After training, the CPN completed the CHIP at baseline and 12 months, and the findings were used to devise an individualized care plan to promote health behaviour change. Patients were assessed at baseline and 6 and 12 months after starting the intervention. There was an observed positive trend of improvement on the physical component subscale of SF12v2 in the CHIP group compared to the TAU group after 12 months, but the difference did not reach statistical significance (P = 0.138). The mental component subscale showed a similar positive trend (P = 0.077). CHIP participants were more satisfied with their physical health care than TAU patients (P = 0.009), and the CPN were positive about the usefulness/acceptability of the intervention. There were significant within‐group improvements in the total numbers of physical health risks, as indicated by the CHIP items (P = 0.005). The findings suggest that it is feasible to conduct a full‐scale RCT of the CHIP in future. The CHIP is an intervention that can be used within routine CPN practice, and could result in small–modest improvements in the physical well‐being of people with SMI.
A sanctuary of safety: A study of how patients with dual diagnosis experience caring conversations
Authors: Priebe Åsa , Wiklund Gustin Lena , Fredriksson Lennart 
Published: August 2017

AbstractThe prevalence of dual diagnosis, that is, the combination of psychiatric illnesses and substance use disorders, is high. As a vast majority of previous research in this context focusses on the effects of different treatment methods, rather than interpersonal issues, the purpose of the present study was to explore and illuminate in what way patients with a dual diagnosis experience conversations with nurses in an outpatient clinic to be caring. Five patients were interviewed regarding their experiences of caring conversations. The analysis and interpretation were inspired by a previously‐used hermeneutical process. These yielded three themes: (i) reciprocity creates safety and communion; (ii) suffering is made visible and understandable; and (iii) self‐esteem is restored. When synthesized, these themes gave rise to a main theme – a sanctuary of safety – where suffering is alleviated and dignity and self‐esteem are restored. It is concluded that the caring conversation contributes to experiences of safeness. In this specific context, safety appears to be more fundamental than trust for patients’ recoveries. The caring conversation also contributes to recovery, as it supports the individual's learning and understanding as a way to cope with problems, which also enables patients to make informed decisions about their own care. The caring conversation contributes to the alleviation of suffering and restoration of dignity and self‐esteem for patients with a dual diagnosis. However, there is a need for further research focussing on how the caring conversation can contribute to psychiatric nurses’ caring expertise.
Downward occupational mobility of baccalaureate‐prepared, internationally educated nurses to licensed practical nurses
Authors: Salami B. , Meherali S. , Covell C. L. 
Published: August 2017

AimThis study explored the experience of baccalaureate‐prepared, internationally educated nurses who work as licensed practical nurses in Canada.Background/IntroductionInternationally educated nurses experience several barriers to workforce integration on arrival in destination countries. Given these barriers, evidence suggests that internationally educated nurses sometimes experience downward occupational mobility and deskilling in destination countries. Some baccalaureate‐prepared, internationally educated nurses work as licensed practical nurses in destination countries, but there is minimal research on this population.MethodsWe used an exploratory transnational feminist qualitative research design. Following ethics approval, a total of 14 baccalaureate‐prepared, internationally educated nurses who currently or recently worked as practical nurses in Canada were interviewed for the study. Data were thematically analysed with the aide of NVivo 11 data software.ResultsOur results revealed four key themes related to the experiences of this group of nurses: they migrate to Canada with hope for a better personal and professional life; they experience barriers to workforce integration as registered nurses and discover an easier path in the licensed practical nurse registration process; they experience deskilling and ambivalent skill recognition; and they feel dissatisfied as a licensed practical nurse in Canada.Discussion/ConclusionThere is a need for policy to support the upward mobility of baccalaureate‐prepared, internationally educated nurses who work as practical nurses.Implications for Nursing PolicyImplications for policymakers include the need to address the barriers to becoming registered nurses, including application processing times and lack of adequate access to educational programmes.
Responsiveness to Different National Interests: Voting Behaviour on Genetically Modified Organisms in the Council of the European Union
Authors: Mühlböck Monika , Tosun Jale 
Published: August 2017

AbstractDoes voting behaviour in the Council of Ministers reflect different national interests? In this article, we explore this question by studying requests for authorization of genetically modified organisms (GMOs). The fact that GMOs constitute a highly contentious issue in the European Union enables us to look underneath the ‘culture of consensus’ which usually characterizes voting behaviour in the Council. We argue that the focus on one issue area can help us to discover more specific voting patterns than those that have previously been found in EU legislative studies. Indeed, based on a dataset comprising all authorization requests voted on in the Council between 2004 and 2014, we find that ministers' voting behaviour is significantly influenced by important national factors such as public opinion, party politics, and structural as well as sectoral interests.
Interpreting the genomic landscape of speciation: a road map for finding barriers to gene flow
Authors: Ravinet M. , Faria R. , Butlin R. K. , Galindo J. , Bierne N. , Rafajlović M. , Noor M. A. F. , Mehlig B. , Westram A. M. 
Published: August 2017

AbstractSpeciation, the evolution of reproductive isolation among populations, is continuous, complex, and involves multiple, interacting barriers. Until it is complete, the effects of this process vary along the genome and can lead to a heterogeneous genomic landscape with peaks and troughs of differentiation and divergence. When gene flow occurs during speciation, barriers restricting gene flow locally in the genome lead to patterns of heterogeneity. However, genomic heterogeneity can also be produced or modified by variation in factors such as background selection and selective sweeps, recombination and mutation rate variation, and heterogeneous gene density. Extracting the effects of gene flow, divergent selection and reproductive isolation from such modifying factors presents a major challenge to speciation genomics. We argue one of the principal aims of the field is to identify the barrier loci involved in limiting gene flow. We first summarize the expected signatures of selection at barrier loci, at the genomic regions linked to them and across the entire genome. We then discuss the modifying factors that complicate the interpretation of the observed genomic landscape. Finally, we end with a road map for future speciation research: a proposal for how to account for these modifying factors and to progress towards understanding the nature of barrier loci. Despite the difficulties of interpreting empirical data, we argue that the availability of promising technical and analytical methods will shed further light on the important roles that gene flow and divergent selection have in shaping the genomic landscape of speciation.