bluuebunny/crossref_metadata_2025_split huggingface dataset:
Síndrome do desconforto respiratório agudo
Authors: Galhardo Fabíola Paula Lovetro , Martinez José Antônio Baddini 
Published: June 2014

A Síndrome do Desconforto Respiratório Agudo (SDRA) é um quadro de insuficiência respiratória aguda, devido a intensa resposta inflamatória pulmonar, que ocorre frente a agentes agressores diversos. A agressão pulmonar pode ser local, como nas pneumonias ou aspiração gástrica, ou pode ocorrer por via sistêmica, como, por exemplo, nas septicemias. Apesar de o edema pulmonar por alteração da permeabilidade alveolocapilar ser uma das principais características de suas fases iniciais, na fase proliferativa da síndrome, o acúmulo de diferentes tipos celulares pode levar à deposição de matriz extracelular e à fibrose. Não existe tratamento específico para a SDRA, e as medidas terapêuticas atuais baseiam-se no suporte ventilatório e no tratamento da condição desencadeadora. Um número expressivo de doentes com quadro de remodelamento e proliferação fibrótica pulmonar podem beneficiar-se do uso de esteróides em altas doses. Apesar de ter sido observada redução da mortalidade associada à SDRA,nos últimos anos, devido, basicamente, à melhoria do cuidado intensivo e a novas estratégias ventilatórias, a mortalidade ainda é alta, situando-se em torno de 40%.
Jovens que tentam suicídio e narcisismo destrutivo
Authors: Cassorla Roosevelt M.S 
Published: June 2014

Modelo do Estudo: O trabalho visa apresentar resultados de investigações anteriores do autor referentes a modelos compreensivos para o comportamento suicida. Comentários: No primeiro modelo discute-se a “história natural de jovens que tentam suicídio”, que implica num mundo interno sentido como esvaziado, estimulando a busca de relações simbióticas, que quando ameaçam desfazer-se levam a risco de desestruturação e fantasias de busca da plenitude com a morte. No segundo, “narcisismo destrutivo” mostra-se como autoexigências cruéis, quando não satisfeitas, levam a sensação de fracasso e loucura, o ato suicida parecendo ser uma saída. Finalmente discutem-se esses modelos em relação ao maior risco suicida em médicos e estudantes de medicina.
.
Cardiac Fibroblast Glycogen Synthase Kinase-3β Regulates Ventricular Remodeling and Dysfunction in Ischemic Heart
Authors: Lal Hind , Ahmad Firdos , Zhou Jibin , Yu Justine E. , Vagnozzi Ronald J. , Guo Yuanjun , Yu Daohai , Tsai Emily J. , Woodgett James , Gao Erhe , Force Thomas 
Published: June 2014

Background—
Myocardial infarction–induced remodeling includes chamber dilatation, contractile dysfunction, and fibrosis. Of these, fibrosis is the least understood. After myocardial infarction, activated cardiac fibroblasts deposit extracellular matrix. Current therapies to prevent fibrosis are inadequate, and new molecular targets are needed.

Methods and Results—
Herein we report that glycogen synthase kinase-3β (GSK-3β) is phosphorylated (inhibited) in fibrotic tissues from ischemic human and mouse heart. Using 2 fibroblast-specific GSK-3β knockout mouse models, we show that deletion of GSK-3β in cardiac fibroblasts leads to fibrogenesis, left ventricular dysfunction, and excessive scarring in the ischemic heart. Deletion of GSK-3β induces a profibrotic myofibroblast phenotype in isolated cardiac fibroblasts, in post–myocardial infarction hearts, and in mouse embryonic fibroblasts deleted for GSK-3β. Mechanistically, GSK-3β inhibits profibrotic transforming growth factor-β1/SMAD-3 signaling via interactions with SMAD-3. Moreover, deletion of GSK-3β resulted in the significant increase of SMAD-3 transcriptional activity. This pathway is central to the pathology because a small-molecule inhibitor of SMAD-3 largely prevented fibrosis and limited left ventricular remodeling.

Conclusions—
These studies support targeting GSK-3β in myocardial fibrotic disorders and establish critical roles of cardiac fibroblasts in remodeling and ventricular dysfunction.
Psychometric Evaluation of the Care Transition Measure in TRACE‐CORE: Do We Need a Better Measure?
Authors: Anatchkova Milena D. , Barysauskas Constance M. , Kinney Rebecca L. , Kiefe Catarina I. , Ash Arlene S. , Lombardini Lisa , Allison Jeroan J. 
Published: June 2014

Background

The quality of transitional care is associated with important health outcomes such as rehospitalization and costs. The widely used Care Transitions Measure (
CTM
‐15) was developed with a classic test theory approach; its short version (
CTM
‐3) was included in the
CAHPS
Hospital Survey. We conducted a psychometric evaluation of both measures and explored whether item response theory (
IRT
) could produce a more precise measure.

Methods and Results

As part of the Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education, 1545 participants were interviewed during an acute coronary syndrome hospitalization, providing information on general health status (
Short Form
‐36),
CTM
‐15, health utilization, and care process questions at 1 month postdischarge. We used classic and IRT analyses and compared the measurement precision of
CTM
‐15–,
CTM
‐3–, and
CTM
‐
IRT
–based score using relative validity.

Participants were 79% non‐Hispanic white and 67% male, with an average age of 62 years. The
CTM
‐15 had good internal consistency (Cronbach's α=0.95) but demonstrated acquiescence bias (8.7% participants responded “Strongly agree” and 19% responded “Agree” to all items) and limited score variability. These problems were more pronounced for the
CTM
‐3. The
CTM
‐15 differentiated between patient groups defined by self‐reported health status, health care utilization, and care transition process indicators. Differences between groups were small (2 to 3 points). There was no gain in measurement precision from
IRT
scoring. The
CTM
‐3 was not significantly lower for patients reporting rehospitalization or emergency department visits.

Conclusion

We identified psychometric challenges of the
CTM
, which may limit its value in research and practice. These results are in line with emerging evidence of gaps in the validity of the measure.
Right Reason in Plato and Aristotle: On the Meaning of Logos
Authors: Moss Jessica 
Published: June 2014

AbstractSomething Aristotle calls ‘rightlogos’ plays a crucial role in his theory of virtue. But the meaning of ‘logos’ in this context is notoriously contested. I argue against the standard translation ‘reason’, and—drawing on parallels with Plato’s work, especially theLaws—in favor of its being used to denote what transforms an inferior epistemic state into a superior one: an explanatory account. Thus Aristotelianphronēsis, like his and Plato’stechnēandepistēmē, is a matter of grasping explanatory accounts: in this case, accounts that identify the right action and say why it is right. Arguably, Aristotelian rationality is a matter of being able to grasp accounts in general.
A Relative Improvement
Authors: Brennan Tad , Lee Jongsuh James 
Published: June 2014

Abstract
The Mode of Relativity in Agrippa’s Five Modes does not fit with the other four modes, and disrupts an otherwise elegant system. We argue that it is not the familiar argument from epistemic relativism, but a formal condition on the structure of justifications: the principle that epistemic grounding relations cannot be reflexive. This understanding of Agrippan Relativity leads to a better understanding of the Modes of Hypothesis and Reciprocity, a clearer outline of the structure of Agrippa’s system as a whole, and a new insight into the Two Modes that follow the Five.
Proclus and Iamblichus on Moral Education
Authors: van den Berg Robbert M. 
Published: June 2014

AbstractThis paper studies moral education in Proclus and Iamblichus. The first section analyses Proclus’ theory of moral education and its psychological underpinnings. Especially important in this context is the identification of the faculty of choice (prohairesis) with the passive or teachable intellect. The second section investigates the implementation of this theory into practice with the help of Iamblichus’Letter to Sopater: On Bringing up Children. The final section demonstrates how Proclus’ famous tripartite division of poetry should be understood in the context of his program of moral education.
Young people’s perceptions of mental and physical health in the context of general wellbeing
Authors: Singletary Joanne H , Bartle Craig L , Svirydzenka Nadzeya , Suter-Giorgini Nicola M , Cashmore Annette M , Dogra Nisha 
Published: June 2014

Objectives: Increased recognition of the need for health education in schools has seen advances in health literacy in recent years. Most of these have focussed on physical health, whereas education about mental health is generally lacking and focussed on tackling stigma rather than promoting good mental health. This study evaluated a pilot intervention designed to improve young people’s understanding of good mental health as a key aspect of wellbeing and explored their perceptions of health and wellbeing. Methods: A total of 218 13-year-olds participated in an interactive workshop about healthy eating, physical activity and mental health. Young people’s understanding and perceptions were assessed through anonymous questionnaires at the start and end of the workshop. Common themes were identified and differences pre- and post-workshop and between girls and boys were analysed. Results: Nearly all young people (100% before, 97% after) perceived being healthy to mean being physically healthy. A minority (8%) also considered mental health to be a component of general health, which increased to 12% after the workshop. Understandings of mental health broadened after the workshop. Interestingly, many mentioned physical health when asked to describe mental health, both before and after the workshop. Girls’ and boys’ responses were similar except for more girls including social relationships in their descriptions of mental health. Conclusion: In this study, we have discovered much about how young people perceive health in general and mental health. Such information is useful for targeting future interventions. Students’ understanding of mental health and its importance to wellbeing can be improved through short combined health interventions.
Low-income mothers’ food practices with young children: A qualitative longitudinal study
Authors: Harden Jeni , Dickson Adele 
Published: June 2014

Objective: Young children living in socioeconomically deprived areas of Scotland have an increased risk of becoming overweight or obese. To enhance understanding of the wider contexts within which family food practices are developed, this study examined the experiences of low-income mothers with young children. Design: Qualitative longitudinal design. Setting: The Lothians, Scotland. Method: Two waves of individual interviews were conducted with 13 mothers at two time points within an 18-month period. All the mothers lived in socioeconomically disadvantaged areas in Eastern Scotland, and had at least one child aged 6 years and under. An inductive thematic analysis was conducted, through which the data were analysed both cross-sectionally and longitudinally. Findings: Women experienced socioeconomic challenges which limited the financial and emotional resources, and the time they were able to commit to healthy eating practices. For some, change and instability were part of their lives, over which they had little control. Despite insecure socioeconomic contexts, women positioned themselves as expert mothers, evidenced through their strategies in dealing with the problem of ‘fussy eaters’ and their challenges of ‘expert’ advice. Conclusion: This research demonstrates the significance of the broader difficulties that living in poverty presents to mothers, beyond the issue of cost, and which preventive health interventions should address.
UNESCO’s Guidance on puberty and sexual health education for students aged 9–12 years compared to an upper primary school curriculum
Authors: Goldman Juliette DG 
Published: June 2014

Background: Children and young adolescents are reaching puberty earlier. Providing information about such changes before puberty can help them develop in a more competent and informed manner. Context and Objective: UNESCO’s International Technical Guidance on Sexuality Education forms a comprehensive, evidence-based, authoritative document. This review analyses the Guidance for children and young adolescents aged 9–12 years who attend upper primary school. These students are very likely to be experiencing puberty, but are very unlikely, in many countries, to receive sufficient sexuality health information or education from parents or school at this crucial time. Design: This review analyses the text and narrative of this internationally-acknowledged sexuality education curriculum, and the relevant learning objectives/key ideas of a comparable state-designed health and physical education curriculum. Setting: Children and young adolescents who attend upper Primary school. Method: Analysis of text and narrative of this UNESCO Guidance. Results: Analysis shows that UNESCO’s Guidance has greater, more relevant content, wider coverage, specific definitions and vocabulary, and more learning objectives, than does a contemporary upper primary school curriculum for the same cohort. Conclusion: Health curriculum designers and teachers can use this helpful Guidance to provide students with a fulsome puberty learning experience including age-appropriate knowledge, understanding, skills and values.
The Sustained Attention to Response Task (SART) Does Not Promote Mindlessness During Vigilance Performance
Authors: Dillard Michael B. , Warm Joel S. , Funke Gregory J. , Funke Matthew E. , Finomore Victor S. , Matthews Gerald , Shaw Tyler H. , Parasuraman Raja 
Published: June 2014

Objective In this study, we evaluated the validity of the Sustained Attention to Response Task (SART) as a means for promoting mindlessness in vigilance performance. Background Vigilance tasks typically require observers to respond to critical signals and to withhold responding to neutral events. The SART features the opposite response requirements, which supposedly leads it to promote a mindless, nonthoughtful approach to the vigilance task. To test that notion, we compared the SART to the traditional vigilance format (TVF) in terms of diagnostic accuracy assessed through decision theory measures of positive and negative predictive power (PPP and NPP), perceived mental workload indexed by the Multiple Resource Questionnaire, and oculomotor activity reflected in the Nearest Neighbor Index and fixation dwell times. Method Observers in TVF and SART conditions monitored a video display for collision flight paths in a simulated air traffic control task. Results Diagnostic accuracy in terms of NPP was high in both format conditions. While PPP was poorer in the SART than in the TVF, that result could be accounted for by a loss of motor control rather than a lack of mindfulness. Identical high levels of workload were generated by the TVF and SART tasks, and observers in both conditions showed similar dynamic scanning of the visual scene. Conclusion The data indicate that the SART is not an engine of mindlessness. Application The results challenge the widespread use of the SART to support a model in which mindlessness is considered to be the principal root of detection failures in vigilance.
‘This doctor, I not trust him, I’m not safe’: The perceptions of mental health and services by unaccompanied refugee adolescents
Authors: Majumder Pallab , O’Reilly Michelle , Karim Khalid , Vostanis Panos 
Published: June 2014

Background: Unaccompanied refugee adolescents are a small but clinically significant group. This group is vulnerable with physical and psychiatric needs which are often not met. There are several barriers to providing care for this group, originating with the refugees but also due to service provision. Aims: The aim of this research is to appreciate the views and perceptions that unaccompanied minors hold about mental health and services. Method: Fifteen unaccompanied adolescents engaged with mental health services were interviewed, and thematic analysis was employed to explore relevant issues. Discussion: Their views reflected a range of opinions on mental health and the treatments they received, but many held negative attitudes toward mental health and had a lack of trust in services. This could be explained by their descriptions of their experiences within their home country of psychiatric care, their experiences of being a refugee/asylum-seeker or cultural differences. Conclusion: We argue it is important to engage this group in the development of policy and practice in child mental health, and in developing services.
Risk Factors for Cerebrospinal Leak after Endoscopic Skull Base Reconstruction with Nasoseptal Flap
Authors: Gruss Calvin L. , Al Komser Mohammed , Aghi Manish K. , Pletcher Steven D. , Goldberg Andrew N. , McDermott Michael , El‐Sayed Ivan H. 
Published: June 2014

ObjectiveThe use of expanded endonasal surgery (EES) in the treatment of skull base neoplasms has increased significantly in recent years. Since 2006, the nasoseptal flap (NSF) has become the workhorse for the closure of skull base defects involving the anterior and central skull base. We hypothesized that defect site impacts the rate of cerebrospinal fluid (CSF) leak following EES.Study DesignRetrospective cohort study.Setting/Subjects/MethodsPatients who underwent skull base defect repair using a NSF at the University of California at San Francisco (UCSF) minimally invasive skull base center were retrospectively reviewed. Patient demographics, disease, and defect location and size were recorded along with the presence of a postoperative CSF leak. Data were analyzed using Fisher's exact test.ResultsOne hundred and twenty‐one patients met inclusion criteria. Ten patients had a NSF failure with CSF leakage, 2 in the anterior skull base (frontal sinus, ethmoid, cribriform, planum), and 8 in the central skull base (sella, clivus) (P =. 047). Dural defect size ≥2.0 cm2 in the central skull base strongly correlated with the risk of flap failure (P =. 034).ConclusionsThis study of endoscopic closure of skull base defects using a NSF demonstrates there is an association between both surgical site and dural defect size with NSF failure. Expanded defects of the sella and clivus have an increased risk of failure and may warrant augmented techniques.
Effects of training on upper limb function after cervical spinal cord injury: a systematic review
Authors: Lu Xiao , Battistuzzo Camilla R , Zoghi Maryam , Galea Mary P 
Published: June 2014

Objective: To summarize the evidence for the effectiveness of exercise training in promoting recovery of upper extremity function after cervical spinal cord injury. Data sources: Medline, Cochrane, CINAHL, EMBASE and PEDro were used to search the literature. Review methods: Two reviewers independently selected and summarized the included studies. Methodological quality of the selected articles was scored using the Downs and Black checklist. Results: A total of 16 studies were included, representing a total of 426 participants. Overall, the internal validity and reporting of the studies was fair to good, while power and external validity were poor. Interventions included exercise therapy, electrical stimulation, functional electrical stimulation, robotic training and repetitive transcranial magnetic stimulation. Most of the studies reported improvements in muscle strength, arm and hand function, activity of daily living or quality of life after intervention. Conclusions: Training including exercise therapy, electrical stimulation, functional electrical stimulation of the upper limb following cervical spinal cord injury leads to improvements in muscle strength, upper limb function and activity of daily living or quality of life. Further research is needed into the effects of repetitive transcranial magnetic stimulation and robotic training on upper limb function.
Photoplethysmographic signals to predict the success of lumbar sympathetic blockade for lower extremity pain
Authors: Park Soo Young , Baek Hyun Jae , Park Kwang Suk , Kim Yong Chul 
Published: June 2014

Objective A prospective, observational study to investigate how photoplethysmography (PPG) signals change during lumbar sympathetic blockade (LSB), and whether these changes can predict sympathetically mediated pain (SMP). Methods Patients with unilateral lower extremity pain and self-reported cold hyperalgesia underwent LSB. Bilateral temperature and PPG signals (AC and DC) were recorded. Power spectrum analysis (PSA) was performed. Results Of the total patient cohort ( n = 38), eight patients (22.1%) had excellent pain-relief after LSB and were determined to have SMP. In all patients, the PPG AC signal changed immediately after drug administration, before any temperature change. DC signals decreased slowly in a linear fashion. PSA of DC signals showed significantly lower low-frequency/high-frequency (LF/HF) ratios in the SMP group than the sympathetically independent pain group, both before and after LSB. A cut-off value of 2.92 for LF/HF resulted in sensitivity, specificity and positive predictive values for SMP of 75.0%, 76.7% and 3.21 [1.5, 6.9], respectively. Conclusions PPG may be used as an early indicator of a successful LSB and could also be helpful in diagnosing SMP.
Narrative abilities in subgroups of English language learners and monolingual peers
Authors: Hipfner-Boucher Kathleen , Milburn Trelani , Weitzman Elaine , Greenberg Janice , Pelletier Janette , Girolametto Luigi 
Published: June 2014

Aims and objectives: The objective of this study was to examine the narrative ability of two subgroups of English Language Learners (ELLs) relative to a group of English monolingual (EL1) peers. Specifically, we investigated whether the three groups of children differed on measures of narrative macrostructure and microstructure. Methodology: Two groups of ELLs were identified on the basis of parent report of the language most often heard and spoken at home (ELL English language users, ELL minority language users). A group of monolingual English children served as a comparison group ( n = 25 per language group). The children averaged 56 months of age. All children completed a narrative retell task. Data and analysis: The retell task was scored in relation to macrostructure (narrative information) and microstructure (number of utterances, mean length of utterance, number of different words, grammaticality). ANCOVAs, partialling out age and memory, revealed distinct performance profiles for the two ELL groups. Findings: There were no group differences on the number of utterances or story grammar. However, the performance of the ELL minority language group was significantly different from that of the EL1 and the ELL English language group on all microstructure measures (number of different words, sentence length, and grammaticality). Overall, the performance of the ELL English language users was indistinguishable from the EL1 group. Originality: The study highlights the heterogeneity in an ELL kindergarten sample with respect to English narrative ability, based on the extent to which English was heard and spoken at home. Implications: The findings highlight the need to gather detailed linguistic information about the home language environments of ELL children when involving them in language- or literacy-related tasks. An important implication of this information is the potential to lead to more nuanced expectations or teaching methods for subgroups of ELL children.