bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estrogen-Related Receptor γ Plays a Key Role in Vascular Calcification Through the Upregulation of BMP2 Expression
Authors: Kim Ji-Hyun , Choi Yeon-Kyung , Do Ji-Yeon , Choi Young-Keun , Ha Chae-Myeong , Lee Sun Joo , Jeon Jae-Han , Lee Won-Kee , Choi Hueng-Sik , Park Keun-Gyu , Lee In-Kyu 
Published: September 2015

Objective—
Vascular calcification which refers to ectopic mineralization in vascular cells is associated with several conditions, such as chronic kidney disease, atherosclerosis, and diabetes mellitus. Estrogen-related receptor (ERR)γ is a member of the orphan nuclear receptor superfamily, which plays diverse roles in regulating homeostatic and metabolic processes. However, the role of ERRγ in vascular calcification has not been investigated to date. The aim of the present study was to examine the role of ERRγ in vascular calcification.

Approach and Results—
Vascular calcification was induced by treating rat aortic vascular smooth muscle cells with calcification medium. ERRγ expression in vascular smooth muscle cells was induced during calcification medium–induced vascular calcification. Adenovirus-mediated overexpression of ERRγ in vascular smooth muscle cells resulted in the upregulation of the expression of osteogenic genes, including runt-related transcription factor 2, osteopontin, and Msx2, and the downregulation of α-smooth muscle actin. Adenovirus-mediated overexpression of ERRγ induced bone morphogenetic protein 2 (BMP2) expression, leading to increased phosphorylation of the intracellular BMP2 effector proteins SMAD1/5/8. Collectively, these data suggested that ERRγ promotes dedifferentiation of vascular smooth muscle cells to an osteogenic phenotype during the vascular calcification process. Inhibition of endogenous ERRγ expression or activity using a specific siRNA or the selective inverse agonist GSK5182 attenuated vascular calcification and osteogenic gene expression in vitro and in vivo.

Conclusions—
The present results indicate that ERRγ plays a key role in vascular calcification by upregulating the BMP2 signaling pathway, suggesting that inhibition of ERRγ is a potential therapeutic strategy for the prevention of vascular calcification.
Utility of Screening for Cerebral Vasospasm Using Digital Subtraction Angiography
Authors: Arias Eric J. , Vajapey Sravya , Reynolds Matthew R. , Chicoine Michael R. , Rich Keith M. , Dacey Ralph G. , Dorward Ian G. , Derdeyn Colin P. , Moran Christopher J. , Cross DeWitte T. , Zipfel Gregory J. , Dhar Rajat 
Published: September 2015

Background and Purpose—
Cerebral arterial vasospasm (CVS) is a common complication of aneurysmal subarachnoid hemorrhage strongly associated with neurological deterioration and delayed cerebral ischemia (DCI). The utility of screening for CVS as a surrogate for early detection of DCI, especially in patients without clinical signs of DCI, remains uncertain.

Methods—
We performed a retrospective analysis of 116 aneurysmal subarachnoid hemorrhage patients who underwent screening digital subtraction angiography to determine the association of significant CVS and subsequent development of DCI. Patients were stratified into 3 groups: (1) no symptoms of DCI before screening, (2) ≥1 episodes of suspected DCI symptoms before screening, and (3) unable to detect symptoms because of poor examination.

Results—

Patients asymptomatic before screening had significantly lower rates of CVS (18%) compared with those with transient symptoms of DCI (60%;
P
<0.0001). None of the 79 asymptomatic patients developed DCI after screening, regardless of digital subtraction angiography findings, compared with 56% of those with symptoms (
P
<0.0001). Presence of CVS was significantly associated with DCI in those with transient symptoms and in those whose examinations did not permit clear assessment (odds ratio 16.0, 95% confidence interval 2.2–118.3,
P
=0.003).

Conclusions—
Patients asymptomatic before screening have low rates of CVS and seem to be at negligible risk of developing DCI. Routine screening of asymptomatic patients seems to have little utility. Screening may still be considered in patients with possible symptoms of DCI or those with examinations too poor to clinically detect symptoms because finding CVS may be useful for risk stratification and guiding management.
Midlife Alcohol Consumption and the Risk of Stroke in the Atherosclerosis Risk in Communities Study
Authors: Jones Sara B. , Loehr Laura , Avery Christy L. , Gottesman Rebecca F. , Wruck Lisa , Shahar Eyal , Rosamond Wayne D. 
Published: September 2015

Background and Purpose—
Alcohol consumption is common in the United States and may confer beneficial cardiovascular effects at light-to-moderate doses. The alcohol–stroke relationship remains debated. We estimated the relationship between midlife, self-reported alcohol consumption and ischemic stroke and intracerebral hemorrhage (ICH) in a biracial cohort.

Methods—
We examined 12 433 never and current drinkers in the Atherosclerosis Risk in Communities study, aged 45 to 64 years at baseline. Participants self-reported usual drinks per week of beer, wine, and liquor at baseline. We used multivariate Cox proportional hazards regression to assess the association of current alcohol consumption relative to lifetime abstention with incident ischemic stroke and ICH and modification by sex–race group. We modeled alcohol intake with quadratic splines to further assess dose–response relationships.

Results—
One third of participants self-reported abstention, 39% and 24%, respectively, consumed ≤3 and 4 to 17 drinks/wk, and only 5% reported heavier drinking. There were 773 ischemic strokes and 81 ICH over follow-up (median ≈22.6 years). For ischemic stroke, light and moderate alcohol consumption were not associated with incidence (hazard ratios, 0.98; 95% CI, 0.79–1.21; 1.06, 0.84–1.34), whereas heavier drinking was associated with a 31% increased rate relative to abstention (hazard ratios, 1.31; 95% CI, 0.92–1.86). For ICH, moderate-to-heavy (hazard ratios, 1.99; 95% CI, 1.07–3.70), but not light, consumption increased incidence.

Conclusions—
Self-reported light-to-moderate alcohol consumption at midlife was not associated with reduced stroke risk compared with abstention over 20 years of follow-up in the Atherosclerosis Risk in Communities study. Heavier consumption increased the risk for both outcomes as did moderate intake for ICH.
Decentralization of the French welfare state: from ‘big bang’ to ‘muddling through’
Authors: Reiter Renate , Kuhlmann Sabine 
Published: September 2015

This article analyses the decentralization of the French welfare state focusing on the transfer of the Revenu minimum d’insertion (RMI) welfare benefit to the departments in 2003 and 2004. We map and explain the effects of the reform on the system and performance of the subnational provision of welfare tasks. To evaluate the impact of decentralization on the RMI-related action of the departments, we carry out a qualitative document analysis and use data from two case studies. The RMI decentralization offers an exemplary insight into the incremental implementation of French decentralization. We find many unintended effects in terms of the performance and outcome of the subnational welfare provision. This is traced back to the combining of institutional and policy reforms and the inadequate translation of high political expectations into an inadequate action programme both resulting in excessive demands on the local actors. Points for practitioners The decentralization of public tasks is associated with high expectations in terms of the effects on the performance of public services and public governance on the subnational levels. For an in-depth measure the range of administrative performance and political systems effects should be taken into account. We propose a five-dimensional scheme allowing for the determination of decentralization effects on the resource input to and the operative output of subnational public services, on the horizontal coordination between subnational task holders and the affected non-public stakeholders, on the vertical intergovernmental coordination, and on the democratic accountability of subnational authorities.
Special-purpose authorities: a welcomed alien to decentralization in Lebanon?
Authors: AbouAssi Khaldoun , Bowman Ann O'M. 
Published: September 2015

Countries in transition face numerous political and economic challenges often exacerbated by persistent corruption and internecine religious conflict. In Lebanon, existing local governments have proven ineffective at providing many public services, especially those with spillover effects and externalities. This article proposes a structural change: the introduction of special-purpose local authorities to provide a single service transcending the boundaries of individual local governments. This proposal promises an innovative and practical solution to some existing problems; moreover, it will disentangle some of the complexities in the social and political milieus of a country typified by intense conflict. Points for practitioners This article proposes a policy recommendation to address one of the many challenges facing decentralization in Lebanon. Existing local governments have proven ineffective at providing many public services, especially those with spillover effects and externalities. Special-purpose local authorities are introduced as an innovative and practical solution to some existing problems; an approach that will disentangle some of the complexities in the social and political milieus of a country typified by intense conflict. The article provides certain decision points that are useful for policy makers and practitioners as they consider possible resolutions to existing challenges, potential implementation obstacles, and mitigating factors.
Introducing simulation-based education to healthcare professionals: exploring the challenge of integrating theory into educational practice
Authors: Katoue Maram G , Iblagh Nadia , Somerville Susan , Ker Jean 
Published: September 2015

Background Introducing simulation-based education to the curricular programme of healthcare professionals can be challenging. This study explored the early experiences of healthcare professionals in the use of simulation. This was in the context of the Kuwait–Scotland transformational health innovation network programme. Methods Two cohorts of healthcare professionals undertook a simulation module as part of faculty development programme in Kuwait. Participants’ initial perceptions of simulators were gathered using a structured questionnaire in the clinical skills centre. Their subsequent ability to demonstrate the application of simulation was evaluated through analyses of the video-recordings of teaching sessions they undertook and written reflections of their experiences of using simulation. Results In theory, participants were able to identify simulators’ classification and fidelity. They also recognised some of the challenges of using simulators. In their teaching sessions, most participants focused on using part-task trainers to teach procedural skills. In their written reflections, they did not articulate a justification for their choice of simulator or its limitations. Conclusion This study demonstrated a theory-to-practice gap in the early use of simulation by healthcare educators. The findings highlight the need for deliberate practice and adequate mentorship for educators to develop confidence and competence in the use of simulation as part of their educational practice.
Views of medical students: what, when and how do they want statistics taught?
Authors: Fielding S , Poobalan A , Prescott GJ , Marais D , Aucott L 
Published: September 2015

Background A key skill for a practising clinician is being able to do research, understand the statistical analyses and interpret results in the medical literature. Basic statistics has become essential within medical education, but when, what and in which format is uncertain. Methods To inform curriculum design/development we undertook a quantitative survey of fifth year medical students and followed them up with a series of focus groups to obtain their opinions as to what statistics teaching they want, when and how. Results A total of 145 students undertook the survey and five focus groups were held with between 3 and 9 participants each. Previous statistical training varied and students recognised their knowledge was inadequate and keen to see additional training implemented. Students were aware of the importance of statistics to their future careers, but apprehensive about learning. Face-to-face teaching supported by online resources was popular. Focus groups indicated the need for statistical training early in their degree and highlighted their lack of confidence and inconsistencies in support. Conclusion The study found that the students see the importance of statistics training in the medical curriculum but that timing and mode of delivery are key. The findings have informed the design of a new course to be implemented in the third undergraduate year. Teaching will be based around published studies aiming to equip students with the basics required with additional resources available through a virtual learning environment.
An update of the UK’s test reference year: The implications of a revised climate on building design
Authors: Eames ME , Ramallo-Gonzalez AP , Wood MJ 
Published: September 2015

Average weather years have been used around the world for testing buildings to ascertain their likely energy use using thermal modelling software. In the UK, the Test Reference Years which are in current use were released in 2006 but generally consisted of data from 1983 to 2004. In this work, revised test reference years will be proposed which are based on a new climatic period from 1984 to 2013. The differences between the two years will be highlighted and the implications for building design will be discussed. Practical application: Test Reference years are integral to building design to assess the performance of buildings at design stage. Specifically, they are used to assess energy use in buildings as well as for compliance purposes with Part L of the Building Regulations.
The correlation analysis of tumor necrosis factor-alpha-308G/A polymorphism and venous thromboembolism risk: A meta-analysis
Authors: Gao Quangen , Zhang Peijin , Wang Wei , Ma He , Tong Yue , Zhang Jing , Lu Zhaojun 
Published: September 2015

Objective Venous thromboembolism is a common complex disorder, being the resultant of gene–gene and gene–environment interactions. Tumor necrosis factor-alpha is a proinflammatory cytokine which has been implicated in venous thromboembolism risk. A promoter 308G/A polymorphism in the tumor necrosis factor-alpha gene has been suggested to modulate the risk for venous thromboembolism. However, the published findings remain inconsistent. Methods In this study, we conducted a meta-analysis of all available data regarding this issue. Eligible studies were identified through search of Pubmed, EBSCO Medline, Web of Science, and China National Knowledge Infrastructure (CNKI, Chinese) databases up to June 2014. Pooled Odd ratios (ORs) with 95% confidence intervals were applied to estimating the strength of the genetic association in the random-effects model or fixed-effects model. Results A total of 10 studies involving 1999 venous thromboembolism cases and 2166 controls were included in this meta-analysis to evaluate the association between tumor necrosis factor-alpha-308G/A polymorphism and venous thromboembolism risk. Overall, no significantly increased risk venous thromboembolism was observed in all comparison models when all studies were pooled into the meta-analysis. However, in stratified analyses by ethnicity, there was a pronounced association with venous thromboembolism risk among West Asians in three genetic models (A vs. G: OR = 1.82, 95%CI = 1.13–2.94; GA vs. GG: OR = 1.82, 95%CI = 1.08–3.06; AA/GA vs. GG: OR = 1.88, 95%CI = 1.12–3.16). When stratifying by source of controls, no significant result was detected in all genetic models. Conclusion This meta-analysis demonstrates that tumor necrosis factor-alpha 308G/A polymorphism may contribute to susceptibility to venous thromboembolism among West Asians. Studies are needed to ascertain these findings in larger samples and different racial groups.
Sensory interventions to support the wellbeing of people with dementia: A critical review
Authors: Haigh Judith , Mytton Carol 
Published: September 2015

Introduction Promoting the wellbeing of people with dementia is central to current social policies. To address the psychological impact of dementia, sensory stimulation is one approach practised by occupational therapists. This article will critically review the primary research that tests the link between sensory interventions and wellbeing for people with dementia. This research is inspired by theory relating to person-centred care and sensory processing. Method A literature search was conducted using electronic databases for health and social care. Nine papers were identified that met the inclusion criteria. These were critically appraised to identify the quality of the evidence available, and to collate emerging themes from their results. Results Although the studies appraised varied widely in the quality of their methodologies, some significant results and themes were found that do link sensory stimulation with emotional wellbeing and occupational engagement. Two distinctly different methods of intervention were documented in the evidence base. Most studies tested the impact of session based interventions in specific environments. One large scale randomised controlled trial implemented sensory care plans that were embedded in the lived environment of participants. This approach is more congruent with sensory processing theory and occupational science theories than time-bound sessions of sensory stimulation. Conclusion Attending to the sensory needs of people with dementia can positively affect their emotional wellbeing and their ability to engage in occupations. This can be incorporated into the reasoning and interventions of occupational therapists when supporting this client group.
A systematic review of professional reasoning literature in occupational therapy
Authors: Unsworth Carolyn , Baker Anne 
Published: September 2015

Introduction Over the past 33 years, theoretical and empirical articles have been published on professional reasoning in occupational therapy. This systematic review sought to answer two questions: (1) What is the nature and volume of professional reasoning literature; and (2) What do we know about the development of professional reasoning in students through literature exploring novice and expert differences? Method A systematic review of the peer-reviewed literature with narrative and critical analysis. Findings A total of 140 articles were classified into six topic areas: what is professional reasoning, ethics and moral reasoning?, methods of studying professional reasoning, novice–expert differences, professional reasoning of assistants, and advancing specific fields of practice using professional reasoning. Of these, 68% included analysis of data, and the remainder were discussions. Fourteen articles examining novice–expert differences were critiqued but only eight were rated as strong. Research findings prompt the need for reflection, extended fieldwork, and development of protocols to facilitate reasoning. Conclusion This is the first systematic review of the professional reasoning literature, and provides a foundation for more detailed critiques of specific topics to be undertaken. While research strengths have been identified, gaps include the use of standardised measures of professional reasoning and identification of educational approaches that promote professional reasoning.
The association between measures of visual perception, visual-motor integration, and in-hand manipulation skills of school-age children and their manuscript handwriting speed
Authors: Brown Ted , Link Julia 
Published: September 2015

Introduction The aim of this study was to investigate whether measures of visual perception, visual-motor integration, and in-hand manipulation skills of school-age children were associated with their manuscript handwriting speed. Method A convenience sample of 39 typically developing Australian students aged six to eight years completed the Beery–Buktenica Developmental Test of Visual-Motor Integration – 6th edition (DTVMI), the Developmental Test of Visual Perception – 3rd edition (DTVP-3), the Test of In-Hand Manipulation – Revised (TIHM-R), and the Handwriting Speed Test (HST). Spearman rho correlations and multi-linear regression analyses were completed to analyze the data. Results Significant correlations were found between visual perception, visual-motor integration, and in-hand manipulation skills and total letters written and total letters per minute. Regression analyses indicated that, when modeled together, the DTVP-3 eye–hand coordination and visual closure subscales and the TIHM-R were significant predictors of total letters written accounting for 25.5% of the variance. The DTVP-3 copying and visual closure subscales and the TIHM-R were predictive of total letters written per minute, with the TIHM-R making a significant unique contribution of 9.1% to the total variance of 26%. Conclusion Visual perception abilities, specifically visual closure skills, plus in-hand manipulation skills appear to be significant predictors of children’s printing speed and need to be assessed and potentially targeted for skill remediation when working with school-age children who present with manuscript handwriting difficulties.