bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of unregulated care providers in managing heart failure patients in long‐term care facilities
Authors: Heckman George A , Boscart Veronique M , D'Elia Teresa , Kaasalainen Sharon , McAiney Carrie , Kelley Mary Lou , Stolee Paul , Strachan Patricia , McKelvie Robert S 
Published: May 2016

Aims and objectivesHeart failure is a complex syndrome in which abnormal heart function results in clinical symptoms and signs of low cardiac output and/or pulmonary or systemic congestion. Heart failure is common among long‐term care residents, and is associated with significant morbidity and acute care utilisation. Heart failure guidelines endorse standard therapies, yet long‐term care residents are less likely to receive recommended treatments. The objective of this study is to understand the perceptions and potential role of unregulated care providers in contributing to better heart failure management among long‐term care residents.DesignFocus group interviews.MethodsThis qualitative study employed focus groups to explore perceptions from 24 unregulated care providers in three Ontario, Canada long‐term care homes, about barriers to the optimal management of heart failure.ResultsThree overarching concepts emerged characterising unregulated care providers’ experiences in caring for residents with heart failure in long‐term care: (1) the complexity of providing heart failure care in a long‐term care setting, (2) striving for resident‐centred decision making and (3) unregulated care providers role enactment nested within an interprofessional team in long‐term care. These concepts reflect the complex interplay between individual unregulated care providers and residents, and heart failure‐related, socio‐cultural and organisational factors that influence heart failure care processes in the long‐term care system.ConclusionsOptimising the management of heart failure in long‐term care is contingent on greater engagement of unregulated care providers as active partners in the interprofessional care team. Interventions to improve heart failure management in long‐term care must ensure that appropriate education is provided to all long‐term care staff, including unregulated care providers, and in a manner that fosters greater and more effective interprofessional collaboration.Relevance to clinical practiceActive and collaborative engagement unregulated care providers has the potential to improve the management of heart failure in long‐term care residents.
Invasive cervical cancer accompanied by IgG4‐related disease
Authors: Mizuno Rin , Yamanishi Yukio , Uda Satoko , Terashima Tsuyoshi , Higashi Tatsuya , Higuchi Toshihiro 
Published: May 2016

AbstractIgG4‐related disease (IgG4‐RD) is a systemic disease that affects multiple organs and generates nodules or thickening. Discriminating these diseases from malignancy is important because glucocorticoid treatment is effective for patients with IgG4‐RD. Coexistence of IgG4‐RD with various malignant diseases has been reported, but there are few reports with regard to gynecologic malignant diseases. We encountered a case of invasive cervical cancer stage IIB accompanied by IgG4‐RD. The patient was a 46‐year‐old woman. On pelvic magnetic resonance imaging, fluorodeoxyglucose‐positron emission tomography and computed tomography, systemic multiple lymph node swelling was seen, including in the neck and the mediastinum in addition to uterine cervix. Diagnosis (and hence, appropriate treatment choice) was achieved on pathology of the submandibular gland and uterus, and analysis of serum IgG4. IgG4‐RD should be suspected in patients presenting with malignancy and unusual multiple lymph node swelling.
The formation, function and regulation of amyloids: insights from structural biology
Authors: Landreh M. , Sawaya M. R. , Hipp M. S. , Eisenberg D. S. , Wüthrich K. , Hartl F. U. 
Published: May 2016

AbstractAmyloid diseases are characterized by the accumulation of insoluble, β‐strand‐rich aggregates. The underlying structural conversions are closely associated with cellular toxicity, but can also drive the formation of functional protein assemblies. In recent years, studies in the field of structural studies have revealed astonishing insights into the origins, mechanisms and implications of amyloid formation. Notably, high‐resolution crystal structures of peptides in amyloid‐like fibrils and prefibrillar oligomers have become available despite their challenging chemical nature. Nuclear magnetic resonance spectroscopy has revealed that dynamic local polymorphisms in the benign form of the prion protein affect the transformation into amyloid fibrils and the transmissibility of prion diseases. Studies of the structures and interactions of chaperone proteins help us to understand how the cellular proteostasis network is able to recognize different stages of aberrant protein folding and prevent aggregation. In this review, we will focus on recent developments that connect the different aspects of amyloid biology and discuss how understanding the process of amyloid formation and the associated defence mechanisms can reveal targets for pharmacological intervention that may become the first steps towards clinically viable treatment strategies.
Autotaxin interacts with lipoprotein(a) and oxidized phospholipids in predicting the risk of calcific aortic valve stenosis in patients with coronary artery disease
Authors: Nsaibia M. J. , Mahmut A. , Boulanger M.‐C. , Arsenault B. J. , Bouchareb R. , Simard S. , Witztum J. L. , Clavel M.‐A. , Pibarot P. , Bossé Y. , Tsimikas S. , Mathieu P. 
Published: May 2016

AbstractBackgroundStudies have shown that lipoprotein(a) [Lp(a)], an important carrier of oxidized phospholipids, is causally related to calcific aortic valve stenosis (CAVS). Recently, we found that Lp(a) mediates the development of CAVS through autotaxin (ATX).ObjectiveTo determine the predictive value of circulating ATX mass and activity for CAVS.MethodsWe performed a case‐control study in 300 patients with coronary artery disease (CAD). Patients with CAVS plus CAD (cases, n = 150) were age‐ and gender‐matched (1 : 1) to patients with CAD without aortic valve disease (controls, n = 150). ATX mass and enzymatic activity and levels of Lp(a) and oxidized phospholipids on apolipoprotein B‐100 (OxPL‐apoB) were determined in fasting plasma samples.ResultsCompared to patients with CAD alone, ATX mass (P < 0.0001), ATX activity (P = 0.05), Lp(a) (P = 0.003) and OxPL‐apoB (P < 0.0001) levels were elevated in those with CAVS. After adjustment, we found that ATX mass (OR 1.06, 95% CI 1.03–1.10 per 10 ng mL−1, P = 0.001) and ATX activity (OR 1.57, 95% CI 1.14–2.17 per 10 RFU min−1, P = 0.005) were independently associated with CAVS. ATX activity interacted with Lp(a) (P = 0.004) and OxPL‐apoB (P = 0.001) on CAVS risk. After adjustment, compared to patients with low ATX activity (dichotomized at the median value) and low Lp(a) (<50 mg dL−1) or OxPL‐apoB (<2.02 nmol L−1, median) levels (referent), patients with both higher ATX activity (≥84 RFU min−1) and Lp(a) (≥50 mg dL−1) (OR 3.46, 95% CI 1.40–8.58, P = 0.007) or OxPL‐apoB (≥2.02 nmol L−1, median) (OR 5.48, 95% CI 2.45–12.27, P < 0.0001) had an elevated risk of CAVS.ConclusionAutotaxin is a novel and independent predictor of CAVS in patients with CAD.
On the Development of Perfectionism: The Longitudinal Role of Academic Achievement and Academic Efficacy
Authors: Damian Lavinia E. , Stoeber Joachim , Negru‐Subtirica Oana , Băban Adriana 
Published: May 2016

AbstractObjectiveAlthough perfectionism is a prominent personality disposition, only a few longitudinal studies have investigated how perfectionism develops. Theoretical models and qualitative studies have posited that academic success is a developmental antecedent of perfectionism. Yet, quantitative studies tend to interpret the cross‐sectional relationships as academic success being an outcome of perfectionism. In light of these gaps in the literature, the present study was the first to investigate the longitudinal relationships between perfectionistic strivings, perfectionistic concerns, academic achievement, and academic efficacy by examining academic success as an antecedent of perfectionism.MethodThe study examined 487 adolescents (aged 12–19 years, 54% female) using a cross‐lagged longitudinal design with three time points spaced 4–5 months apart.ResultsResults showed that academic achievement predicted relative increases in both perfectionistic strivings and perfectionistic concerns, even when including academic efficacy. In addition, academic efficacy predicted relative increases in perfectionistic strivings.ConclusionsThis is the first study to show that academic achievement is a common factor in the development of perfectionistic strivings and perfectionistic concerns, whereas academic efficacy plays a role only in the development of perfectionistic strivings. Implications of the findings for the development of perfectionism are discussed.
Mother–Adolescent Proficiency in a Common Language Facilitates Socialization Among Mexican‐Origin Families
Authors: Schofield Thomas J. , Conger Rand D. , Robins Richard W. , Coltrane Scott , Parke Ross D. 
Published: May 2016

The primary goal of this study was to test how mother and adolescent proficiency in a common language moderates the link from parenting to adolescent development. A sample of Mexican‐origin fifth‐grade adolescents (N = 674, 50% female) was measured longitudinally on self‐control and aggression. Mothers were rated on observed positive discipline, warmth, and harsh discipline. Positive discipline and warm parenting predicted increases in self‐control and decreases in aggression, but only among mother–adolescent dyads who were proficient in a common language. Harsh parenting predicted decreases in self‐control and increases in aggression, but only among dyads who were not proficient in a common language. Similar results were found in a conceptual replication among a second sample of 167 Mexican‐origin adolescents.
The Dynamics of Pharmaceutical Regulation and R&D Investments
Authors: LEVAGGI ROSELLA , MORETTO MICHELE , PERTILE PAOLO 
Published: May 2016

AbstractThe paper uses a real option approach to investigate the properties of two widely used schemes of regulating the reimbursement of new pharmaceutical products: standard cost‐effectiveness thresholds and performance‐based risk‐sharing agreements. The use of the latter has been quickly spreading and often criticized in recent times. The results show that the exact definition of the risk‐sharing agreement is key in determining its economic effects. In particular, despite the concerns expressed by some authors, the incentive for a firm to invest in R&D may be the same or even greater than under cost‐effectiveness thresholds. The greater flexibility on the timing of commercialization allowed by risk‐sharing schemes plays a key role, by increasing the value of the option to invest in R&D under uncertainty. Under this scheme, a higher value for the firm is associated with earlier access to innovations for patients. The price for this is less value for money for the insurer at the time of adoption of the innovation.
Does the Cost Paradox Preclude Technological Progress under Imperfect Competition?
Authors: AMIR RABAH , HALMENSCHLAGER CHRISTINE , KNAUFF MALGORZATA 
Published: May 2016

AbstractWe consider a two‐stage model of R&D/Cournot competition with isoelastic demand satisfying the cost paradox (i.e., that equilibrium profits increase with unit cost). The R&D process has a binary structure, with spillover effects. We provide a negative answer to the question in the title: Under noncooperative R&D, firms will conduct R&D for a broad parameter range, despite the presence of the cost paradox, as a result of being caught in a prisoner's dilemma. A second‐best social planner is shown to have a higher propensity for R&D than the noncooperative scenario. However, if firms engaged in any of the known R&D cooperation scenarios, the answer to the question in the title would become affirmative. It follows that R&D cooperation leads to lower producer and consumer surpluses. This constitutes a major departure from the conclusions of the standard R&D model. Therefore, R&D cooperation in such environments should not receive favorable antitrust treatment.
The Welfare and Employment Effects of Centralized Public Sector Wage Bargaining
Authors: CARDULLO GABRIELE 
Published: May 2016

AbstractIn many countries, the government pays almost identical nominal wages to workers living in regions with notable economic disparities. By developing a two‐region general equilibrium model with endogenous migration and search frictions in the labor market, I study the differences in terms of unemployment, real wages, and welfare between a regional wage bargaining process and a national one in the public sector. Adopting the latter makes residents in the poorer region better off and residents of the richer region worse off. Private sector employment decreases in the poorer region and it increases in the richer one. Under some conditions, the unemployment rate in the poorer region soars.
Physical Properties and Rheological Behavior of Pseudofruits of Hovenia dulcis Thunb. In Different Maturity Stages
Authors: Maieves Helayne Aparecida , Bosmuler Züge Luana Caroline , Scheer Agnes De Paula , Ribani Rosemary Hoffmann , Morales Patricia , Sánchez‐Mata María Cortes 
Published: May 2016

AbstractThe study of physical properties of the pulp of exotic fruit products and its rheological behavior can contribute to improve their quality for food uses. The aim of this study was to evaluate color, thickness, acidity, texture, rheological behavior in pseudofruits (peduncles) of Hovenia dulcis in different stages of maturation. The experimental rheological data were adjusted for models of Ostwald‐de Waele and Herschel‐Bulkley. Through maturation process of H. dulcis pseudofruits, parallel to the increase in size, a decrease in texture occurs. The softening is closely associated with ripening, reaching its apex in the stadium Hd04, when the peduncle is fully mature and already in full senescence period in Hd05 stage. The appearance of flow curves indicates a non‐Newtonian behavior pseudo‐plastic, which is proven when adjusted to the models. From their physicochemical characteristics (color, thickness, pH and acidity and texture) Hd04 and Hd05 are the most suitable stages for human consumption of H. dulcis pseudofruits, for either fresh consumption or the elaboration of manufactured products. All these results are important to define processing conditions, and thus facilitate and increase the use of H. dulcis pulp in the food industry.Practical StatementIn this work, we studied Hovenia dulcis Thunb. peduncles (pseudofruits), a crop is gaining interest in Brazil, and presents great potencial for food uses, as well as like an ingredient in dietary supplemets or nutraceuticals. To our knowledge, this product had been scarcely studied. This work present a study on the evolution of the product through maturation regarding its physicochemical parameters. Data about color, thickness, acidity, texture and rheology behavior are presented. Flow curves reflect non‐Newtonian pseudoplastic behavior (Ostwald‐de Waelle model) and principal components analysis well describes physicochemical properties through maturation of pseudofruits. These results would permit a better handling and selection of the optimal prime matter for industrial purposes.
Comparison of Transpulmonary Thermodilution and Calibrated Pulse Contour Analysis with Pulmonary Artery Thermodilution Cardiac Output Measurements in Anesthetized Dogs
Authors: Garofalo N.A. , Teixeira‐Neto F.J. , Rodrigues J.C. , Cerejo S.A. , Aguiar A.J.A. , Becerra‐Velásquez D.R. 
Published: May 2016

BackgroundTranspulmonary thermodilution (TPTDCO) and calibrated pulse contour analysis (PCACO) are alternatives to pulmonary artery thermodilution cardiac output (PATDCO) measurement.HypothesisTen mL of ice‐cold thermal indicator (TI10) would improve the agreement and trending ability between TPTDCO and PATDCO compared to 5 mL of indicator (TI5) (Phase‐1). The agreement and TA between PCACO and PATDCO would be poor during changes in systemic vascular resistance (SVR) (Phase‐2).AnimalsEight clinically normal dogs (20.8–31.5 kg).MethodsProspective, experimental study. Simultaneous TPTDCO and PATDCO (averaged from 3 repetitions) using TI5 and TI10 were obtained during isoflurane anesthesia combined or not with remifentanil or dobutamine (Phase‐1). Triplicate PCACO and PATDCO measurements were recorded during phenylephrine‐induced vasoconstriction and nitroprusside‐induced vasodilation (Phase‐2).ResultsMean bias (limits of agreement: LOA) (L/min), percentage bias (PB), and percentage error (PE) were 0.62 (−0.11 to 1.35), 16%, and 19% for TI5; and 0.33 (−0.25 to 0.91), 9%, and 16% for TI10. Mean bias (LOA), PB, and PE were 0.22 (−0.63 to 1.07), 6%, and 23% during phenylephrine; and 2.12 (0.70–3.55), 43%, and 29% during nitroprusside. Mean angular bias (radial LOA) values were 2° (−10° to 14°) and −1° (−9° to 6°) for TI5 and TI10, respectively (Phase‐1), and 38° (5°–71°) (Phase‐2).Conclusions and Clinical ImportanceAlthough TI10 slightly improves the agreement and trending ability between TPTDCO and PATDCO in comparison to TI5, both volumes can be used for TPTDCO in replacement of PATDCO. Vasodilation worsens the agreement between PCACO and PATDCO. Because of PCACO's poor agreement and trending ability with PATDCO during SVR changes, this method has limited clinical application.
Staff views about psychosocial aspects of recovery in psychosis: A systematic review
Authors: Morera Tirma , Pratt Daniel , Bucci Sandra 
Published: May 2016

PurposeMental health services remain largely set up to improve patient outcomes through symptom alleviation, but patient views of recovery are broader than symptom remission. Clinicians influence the nature of treatment patients received, but their views about recovery remain poorly understood. The aim of this study was to systematically review the literature examining staff views about psychosocial aspects of recovery in psychosis.MethodWe systematically searched the PsycInfo, EMBASE, MEDLINE, and CINAHL databases. Of the 6,225 articles identified, 15 met inclusion criteria for review.ResultsThe studies reviewed showed a relatively inconsistent picture. Although there was evidence of staff endorsing psychosocial views of recovery, the majority of studies suggested staff endorsed biomedical models of recovery in psychosis and emphasized the importance of pharmacological, over psychosocial, and interventions.ConclusionsThe reviewed studies showed that biomedical views about recovery prevail among multidisciplinary mental health staff, despite recent advancements in patients’ broader conceptualization of recovery. Clinical implications are discussed.Practitioner points

The psychosocial model of recovery has become widely accepted and now underpins most international recovery policies.

Despite a dearth in research, existing studies indicate that mental health staff subscribe to biomedical models of recovery in psychosis, with more emphasis on pharmacological, over psychosocial, and interventions.

Robust research targeting staff views about recovery in psychosis is needed.
Alliance rupture and repair processes and therapeutic change in youth with borderline personality disorder
Authors: Gersh Elon , Hulbert Carol A. , McKechnie Ben , Ramadan Reem , Worotniuk Tamara , Chanen Andrew M. 
Published: May 2016

ObjectivesThis study aimed to investigate alliance rupture and repair processes in psychotherapy for youth with borderline personality disorder. It sought to examine whether alliance processes differ between treatments, across the phases of therapy, and what associations these processes might have with therapeutic outcomes.DesignThe study involves repeated measurement of both process and outcome measures. Hypotheses were addressed using within‐ and between‐subjects analyses.MethodsForty‐four people, aged 15–24, with a diagnosis of BPD were randomized to receive either 16 sessions of Cognitive Analytic Therapy (CAT) or a supportive treatment known as Befriending. In addition to pre‐post outcome assessments, alliance processes were rated using the observer‐based Rupture Resolution Rating Scale.ResultsResults indicated that CAT and Befriending did not differ in terms of number of ruptures, although CAT was associated with more stages of rupture resolution. Examination of alliance processes across time pointed to increasing ruptures, more frequent confrontation ruptures and increasing rupture resolution, suggesting increased volatility, directness and productivity in the therapeutic process across time. Contrary to hypotheses, there was no consistent link between alliance processes and outcome. However, two specific phases were significant. Early treatment ruptures were associated with poor outcome whereas greater late treatment resolution was associated with better outcomes.ConclusionsThis study suggests that alliance processes can differ across treatments and the phases of therapy in psychotherapy for youth with BPD. Alliance ruptures are more likely to be problematic early in therapy but later in therapy, they appear to be opportunities for therapeutic growth.Practitioner points

Alliance ruptures are more likely than not to occur in any given session with a young person with Borderline Personality Disorder.

Early in therapy, withdrawal type ruptures are more frequent, whereas late in therapy, confrontation ruptures are more frequent.

Late in therapy, alliance ruptures should be viewed as opportunities for therapeutic change, rather than barriers to good outcomes.
Outcomes after discontinuation of routine use of transanastomotic biliary stents in pediatric liver transplantation at a single site
Authors: Valentino Pamela L. , Jonas Maureen M. , Lee Christine K. , Kim Heung B. , Vakili Khashayar , Elisofon Scott A. 
Published: May 2016

AbstractRoutine use of transanastomotic biliary stents (RTBS) for biliary reconstruction in liver transplantation (LT) is controversial, with conflicting outcomes in adult randomized trials. Pediatric literature contains limited data. This study is a retrospective review of 99 patients who underwent first LT (2005–2014). In 2011, RTBS was discontinued at our center. This study describes biliary complications following LT with and without RTBS. 56 (56%) patients had RTBS. Median age at LT was 1.9 yr (IQR 0.7, 8.6); 55% were female. Most common indication for LT was biliary atresia (36%). Most common biliary reconstruction was Roux‐en‐Y choledochojejunostomy (75% with RTBS, 58% without RTBS, p = 0.09). Biliary complications (strictures, bile leaks, surgical revision) occurred in 23% without significant difference between groups (20% with RTBS, 28% without RTBS, p = 0.33). Patients with RTBS had routine cholangiography via the tube at 6–8 wk; thus, significantly more patients with RTBS had cholangiograms (91% vs. 19%, p < 0.0001). There was no difference in the number of patients who required therapeutic intervention via endoscopic or percutaneous transhepatic cholangiography (11% with RTBS, 19% no RTBS, p = 0.26). Routine use of RTBS for biliary reconstruction in pediatric LT may not be necessary, and possibly associated with need for costlier, invasive imaging without improvement in outcomes.