bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of indices of clinically meaningful change in child and adolescent mental health services: difference scores, reliable change, crossing clinical thresholds and ‘added value’ – an exploration using parent rated scores on the SDQ
Authors: Wolpert Miranda , Görzig Anke , Deighton Jessica , Fugard Andrew J.B. , Newman Robbie , Ford Tamsin 
Published: November 2014

BackgroundEstablishing what constitutes clinically significant change is important both for reviewing the function of services and for reflecting on individual clinical practice. A range of methods for assessing change exist, but it remains unclear which are best to use and under which circumstances.MethodThis paper reviews four indices of change [difference scores (DS), crossing clinical threshold (CCT), reliable change index (RCI) and added value scores (AVS)] drawing on outcome data for 9764 young people from child and adolescent mental health services across England.ResultsLooking at DS, the t‐test for time one to time two scores indicated a significant difference between baseline and follow up scores, with a standardised effect size of d = 0.40. AVS analysis resulted in a smaller effect size of 0.12. Analysis of those crossing the clinical threshold showed 21.2% of cases were classified as recovered, while 5.5% were classified as deteriorated. RCI identified 16.5% of cases as showing reliable improvement and 2.3% of cases as showing reliable deterioration. Across RCI and CCT 80.5% of the pairings were exact (i.e., identified in the same category using each method).ConclusionsFindings indicate that the level of agreement across approaches is at least moderate; however, the estimated extent of change varied to some extent based on the index used. Each index may be appropriate for different contexts: CCT and RCI may be best suited to use for individual case review; whereas DS and AVS may be more appropriate for case‐mix adjusted national reporting.
Rhetoric vs. reality in social work supervision: the experiences of a group of child care social workers in England
Authors: Turner‐Daly Beverly , Jack Gordon 
Published: November 2014

AbstractWhilst the contribution of good supervision to high‐quality social work practice is widely recognized, research exploring practitioners' experiences of supervision is surprisingly limited. Set within the context of the supervision framework for employers of social workers in England, this small‐scale survey, using an extended questionnaire, examined the experiences of supervision of a group of child care social workers. The aim was to find out what aspects of supervision worked well and where there was room for improvement. The findings suggest that whilst the majority of employers had appropriate supervision policies in place, day‐to‐day practice varied enormously, frequently falling well short of national standards, with the quality of supervision often depending more on the characteristics of the supervisor and the agency context than the needs of the worker. Supervision sessions typically focused predominantly on case management, with much less attention paid to the worker and opportunities for them to reflect on their practice. Only a quarter of the social workers in this survey could be considered to be satisfied with their current supervision, with a much higher proportion clearly dissatisfied.
Controversies in the management of acute tonsillitis: an evidence‐based review
Authors: Bird J.H. , Biggs T.C. , King E.V. 
Published: November 2014

BackgroundPatients admitted with acute tonsillitis generate a substantial workload for the National Health Service (NHS), placing huge financial pressures on an already overstretched budget.Objective of reviewDue to the difficulty of accurate diagnosis and varying practices across theUK, there exist a number of controversial areas and non‐standardised practice. These will be highlighted and tackled within this article.Type of review and search strategyA literature review, last performed in September 2013, searched PubMed citing variations on the areas of controversies with ‘tonsillitis’, ‘pharyngitis’ and ‘pharyngotonsillitis’ – from 1956 to present with language restrictions. Excluded articles included those regarding sore throat after tonsillectomy and peritonsillar abscess.Evaluation methodTitles and abstracts were initially screened, and full text of potentially relevant articles obtained. The bibliographies of articles were searched for relevant references. The references were then compiled and reviewed independently by two authors (JB&TB), overseen by the senior author (EK).Results(i) Diagnosis and investigation: Use of the Centor criteria is inadequate within the secondary care setting. Blood testing is unnecessary in the majority of cases where patients do not require admission, as they are unlikely to change management. (ii) Antibiotics: Antibiotics are likely to be indicated in all those presenting to secondaryENTcare, with penicillin being the antibiotic of choice for first‐line therapy. (iii) Corticosteroids: Moderate evidence supports the benefit of steroid administration in this patient cohort, advocating a single dose initially followed by reassessment. (iv) Analgesia: Paracetamol andNSAIDs have good evidence of action. Codeine should be used with caution in the paediatric population. (v) Reduced admission rates and early discharge: There is evidence suggesting that a trial of medical therapy prior to admission is beneficial in reducing rates of admission and length of stay.ConclusionsManagement of acute tonsillitis within a secondary care setting largely consists of anecdotal or relatively low‐quality evidence. Thus, much evidence from management comes from expert opinion or practice within a primary care setting. Management across theUKcan also vary greatly. An evidence‐based review of best practice has been presented here, but further evidence will be required in the future examining the significance of corticosteroids and antibiotic administration in this patient cohort specifically, ensuring practice is evidence based and clinically relevant.
Anatomical considerations for transanal minimal‐invasive surgery: the caudal to cephalic approach
Authors: Aigner F. , Hörmann R. , Fritsch H. , Pratschke J. , D'Hoore A. , Brenner E. , Williams N. , Biebl M. 
Published: November 2014

AbstractAimNerve‐sparing surgery during laparoscopic rectal mobilization is still limited by anatomical constraints such as obesity, the narrowness of the male pelvis, an ultra low rectal cancer or all of these. The transanal approach for total mesorectal excision has overcome the shortcomings of limited access to the rectal ‘no‐man's land’ close to the pelvic floor. The aim of this anatomical study was to define a roadmap of anatomical landmarks for the caudal to cephalic approach so as to standardize nerve‐sparing rectal mobilization procedures.MethodMacroscopic dissections of the pelvis in a caudal to cephalic direction were performed in eight alcohol–glycerol embalmed cadavers. A roadmap of anatomical landmarks was created at different levels of section to demonstrate the sites of nerve injury.ResultsExtrinsic autonomic nerves to the urogenital organs and the internal sphincter muscle are closely adjacent to the lowest portion of the rectum above the pelvic diaphragm.ConclusionThis anatomical guide for the pelvic surgeon should facilitate a safe and nerve‐sparing dissection of the mesorectal plane with a meticulous overview of the lowest autonomic nerve fibres. New anatomical insights by a ‘caudal to cephalic’ approach to the ‘no‐man's land’ should help overcome anatomical constraints of a narrow, obese and male pelvis during rectal mobilization procedures.
Establishment of a regional Danish database for patients with a stoma
Authors: Danielsen A. K. , Christensen B. M. , Mortensen J. , Voergaard L. L. , Herlufsen P. , Balleby L. 
Published: November 2014

AbstractAimTo present the Danish Stoma Database Capital Region with clinical variables related to stoma creation including colostomy, ileostomy and urostomy.MethodThe stomatherapists in the Capital Region of Denmark developed a database covering patient identifiers, interventions, conditions, short‐term outcome, long‐term outcome and known major confounders. The completeness of data was validated against the Danish National Patient Register.ResultsIn 2013, five hospitals included data from 1123 patients who were registered during the year. The types of stomas formed from 2007 to 2013 showed a variation reflecting the subspecialization and surgical techniques in the centres. Between 92 and 94% of patients agreed to participate in the standard programme aimed at handling of the stoma and more than 88% of patients having planned surgery had the stoma site marked pre‐operatively.ConclusionThe database is fully operational with high data completeness and with data about patients with a stoma from before surgery up to 12 months after surgery. The database provides a solid basis for professional learning, clinical research and benchmarking.
Predicting developmental delay in a longitudinal cohort of preschool children with single‐suture craniosynostosis: is neurobehavioral assessment important?
Authors: Gray Kristen E , Kapp‐Simon Kathleen A , Starr Jacqueline R , Collett Brent R , Wallace Erin R , Speltz Matthew L 
Published: November 2014

AimThe aim of this study was to determine whether neurobehavioral assessment before and after cranial vault surgery can improve prediction of developmental delay in children with single‐suture craniosynostosis (SSC), after accounting for ‘baseline’ demographic and clinical variables (SSC diagnosis and surgery age).MethodChildren with SSC were referred by the treating surgeon or pediatrician before surgery. Neurobehavioral assessments were performed at ages of approximately 6, 18, and 36 months. Iterative models were developed to predict delay, as determined by one or more tests of cognitive, motor, and language skills at 36 months. We selected from groups of variables entered in order of timing (before or after corrective surgery), and source of information (parent questionnaire or psychometric testing).ResultsGood predictive accuracy as determined by area under the receiver operating characteristic curve (AUC), was obtained with the baseline model (AUC=0.66), which incorporated age at surgery, sex, and socio‐economic status. However, predictive accuracy was improved by including pre‐ and post‐surgery neurobehavioral assessments. Models incorporating post‐surgery neurobehavioral testing (AUC=0.79), pre‐surgery testing (AUC=0.74), or both pre‐ and post‐surgery testing (AUC=0.79) performed similarly. However, the specifity of all models was considered to be moderate (≤0.62).InterpretationPrediction of delay was enhanced by assessment of neurobehavioral status. Findings provide tentative support for guidelines of care that call for routine testing of children with SSC.
Otolith size differences during early life of dwarf and cannibal Arctic char (Salvelinus alpinus)
Authors: Florø‐Larsen Bjørn , Finstad Anders G. , Berg Ole K. , Olsen Per H. 
Published: November 2014

AbstractIn Arctic and alpine lakes, Arctic char [Salvelinus alpinus (L.)] often form two distinct morphs: invertebrate feeders (‘dwarfs’) and piscivores (‘giant or cannibals’). Here, we test for early life history growth variation in dimorphic Arctic char as a proximate explanation for the observed life history variation between the two forms. Char were sampled in 11 alpine and Arctic Norwegian lakes. Dwarfs (defined as sexually mature char less than 15 cm long; N = 304) had a mean total length of 105 mm, whereas the typical cannibal (body length above 20 cm; N = 153) was 388 mm long. A positive correlation between egg size and otolith hatching ring were ascertained in a separate hatching experiment with brown trout (Salmo trutta) and it is assumed that this relationship also is valid for Arctic char, and otolith size was used as a proxy for length. Otolith hatching ring from Arctic char cannibals was larger (mean ± SD; 187 ± 24 μm) than those from dwarfs (mean ± SD; 164 ± 23 μm). There were only minor size differences between dwarfs and cannibals during the next three years, after which dwarfs usually matured. Two mutually nonexclusive, proximate explanations for the differentiation into separate morphs (dwarfs and cannibals) are therefore maternal effects and/or genetic based differentiation. The high catchability of large piscivorous char and low production in alpine and Arctic lake ecosystems may make these stocks particularly vulnerable to overexploitation.
Prevalence and distribution of iron overload in patients with transfusion‐dependent anemias differs across geographic regions: results from the CORDELIA study
Authors: Aydinok Yesim , Porter John B. , Piga Antonio , Elalfy Mohsen , El‐Beshlawy Amal , Kilinç Yurdanur , Viprakasit Vip , Yesilipek Akif , Habr Dany , Quebe‐Fehling Erhard , Pennell Dudley J. 
Published: November 2014

AbstractObjectivesThe randomized comparison of deferasirox to deferoxamine for myocardial iron removal in patients with transfusion‐dependent anemias (CORDELIA) gave the opportunity to assess relative prevalence and body distribution of iron overload in screened patients.MethodsPatients aged ≥10 yr with transfusion‐dependent anemias from 11 countries were screened. Data were summarized descriptively, overall and across regions.ResultsAmong 925 patients (99.1% with β‐thalassemia major; 98.5% receiving prior chelation; mean age 19.2 yr), 36.7% had myocardial iron overload (myocardial T2* ≤20 ms), 12.1% had low left ventricular ejection fraction. Liver iron concentration (LIC) (mean 25.8 mg Fe/g dw) and serum ferritin (median 3702 ng/mL) were high. Fewer patients in the Middle East (ME; 28.5%) had myocardial T2* ≤20 ms vs. patients in the West (45.9%) and Far East (FE, 40.9%). Patients in the West had highest myocardial iron burden, but lowest LIC (26.9% with LIC <7 mg Fe/g dw) and serum ferritin. Among patients with normal myocardial iron, a higher proportion of patients from the ME and FE had LIC ≥15 than <7 mg Fe/g dw (ME, 56.7% vs. 17.2%; FE, 78.6% vs. 7.8%, respectively), a trend which was less evident in the West (44.6% vs. 33.9%, respectively). Transfusion and chelation practices differed between regions.ConclusionsEvidence of substantial myocardial and liver iron burden across regions revealed a need for optimization of effective, convenient iron chelation regimens. Significant regional variation exists in myocardial and liver iron loading that are not well explained; improved understanding of factors contributing to differences in body iron distribution may be of clinical benefit.
Predicting Scottish topsoil organic matter content from colour and environmental factors
Authors: Aitkenhead M. J. , Donnelly D. , Sutherland L. , Miller D. G. , Coull M. C. , Black H. I. J. 
Published: November 2014

SummaryAssessment of soil organic matter content using laboratory analysis can be costly and time consuming, so limiting how often land managers assess this important property. This work demonstrates an ability to estimate topsoil organic matter content from field observations alone and provides a method by which rapid and cost‐effective assessments of soil organic matter status may be made. Models using environmental factors from the National Soil Inventory of Scotland (NSIS) dataset as inputs to a neural network model were used to predict loss on ignition (LOI). Two models, one for all soils and one for soils with small organic matter contents (LOI< 20%), were developed. It was found that the model developed for all soils produced reasonable predictive results across the entireLOIrange (R2= 0.877), although it was not as effective at predicting smallLOIvalues (R2= 0.354) as the small organic matter content model (R2= 0.674). Both models were tested with imagery and data from samples outwith theNSISdataset to validate the approach. Predictive results were less accurate than when usingNSISdata. A discussion of possible improvements to make the model useful for field observations of soils is given.
The NET, the trap and the pathogen: neutrophil extracellular traps in cutaneous immunity
Authors: Stephan Alexander , Fabri Mario 
Published: November 2014

AbstractNeutrophil extracellular traps (NETs), large chromatin structures casted with various proteins, are externalized by neutrophils upon induction by both self‐ and non‐self‐stimuli. It has become clear that NETs are potent triggers of inflammation in autoimmune skin diseases. Moreover, the ability of NETs to trap pathogens suggests a crucial role in innate host defense. However, the outcome of the encounter between pathogens and NETs remains highly controversial. Here, we discuss recent insights into the morphology and formation of NETs, their role in skin inflammation and how NETs might contribute to host protection in skin infection.
Periostin induces fibroblast proliferation and myofibroblast persistence in hypertrophic scarring
Authors: Crawford Justin , Nygard Karen , Gan Bing Siang , O'Gorman David Brian 
Published: November 2014

AbstractHypertrophic scarring is characterized by the excessive development and persistence of myofibroblasts. These cells contract the surrounding extracellular matrix resulting in the increased tissue density characteristic of scar tissue. Periostin is a matricellular protein that is abnormally abundant in fibrotic dermis, however, its roles in hypertrophic scarring are largely unknown. In this report, we assessed the ability of matrix‐associated periostin to promote the proliferation and myofibroblast differentiation of dermal fibroblasts isolated from the dermis of hypertrophic scars or healthy skin. Supplementation of a thin type‐I collagen cell culture substrate with recombinant periostin induced a significant increase in the proliferation of hypertrophic scar fibroblasts but not normal dermal fibroblasts. Periostin induced significant increases in supermature focal adhesion formation, α smooth muscle actin levels and collagen contraction in fibroblasts cultured from hypertrophic scars under conditions of increased matrix tension in three‐dimensional type‐I collagen lattices. Inhibition of Rho‐associated protein kinase activity significantly attenuated the effects of matrix‐associated periostin on hypertrophic scar fibroblasts and myofibroblasts. Depletion of endogenous periostin expression in hypertrophic scar myofibroblasts resulted in a sustained decrease in α smooth muscle actin levels under conditions of reducing matrix tension, while matrix‐associated periostin levels caused the cells to retain high levels of a smooth muscle actin under these conditions. These findings indicate that periostin promotes Rho‐associated protein kinase‐dependent proliferation and myofibroblast persistence of hypertrophic scar fibroblasts and implicate periostin as a potential therapeutic target to enhance the resolution of scars.
Modelling nutrient transport and transformation by pool‐breeding amphibians in forested landscapes using a 21‐year dataset
Authors: Capps Krista A. , Berven Keith A. , Tiegs Scott D. 
Published: November 2014

Summary

Migrations of animals can transfer energy and nutrients through and among terrestrial and aquatic habitats. Pool‐breeding amphibians, such as the wood frog (Lithobates sylvaticus), make annual breeding migrations to ephemeral wetlands in forest habitats in the eastern and midwestern United States and Canada.

To model the influence of wood frogs on nutrient transport and transformation through time, we coupled long‐term population monitoring data (1985–2005) from a wood frog population with estimates of the elemental composition of wood frog egg masses and emerging juveniles.

Over the 21‐year study period, 8.8 kg carbon (C), 2.0 kg nitrogen (N) and 0.20 kg phosphorus (P) were transported from the terrestrial to the aquatic habitat and approximately 21 kg C, 5.5 kg N and 1.2 kg P were exported to the surrounding terrestrial habitat by wood frogs.

During the study period, the average net flux of C, N and P was from aquatic to terrestrial habitats, but the magnitude and direction of the net flux was element dependent. Thus, the net flux of C, N and P did not always flow in the same direction.

Predicting long‐term trends in nutrient and energy flux by organisms with biphasic life cycles should rely on long‐term population data to account for temporal variability. This is especially true for organisms that are sensitive to long‐term shifts in temperature and precipitation patterns, such as amphibians that breed in ephemeral pools.
Diet composition affects the rate and N:P ratio of fish excretion
Authors: Moody Eric K. , Corman Jessica R. , Elser James J. , Sabo John L. 
Published: November 2014

Summary

Nutrient recycling by fish can be an important part of nutrient cycles in both freshwater and marine ecosystems. As a result, understanding the mechanisms that influence excretion elemental ratios of fish is of great importance to a complete understanding of aquatic nutrient cycles. As fish consume a wide range of diets that differ in elemental composition, stoichiometric theory can inform predictions about dietary effects on excretion ratios.

We conducted a meta‐analysis to test the effects of diet elemental composition on consumption and nutrient excretion by fish. We examined the relationship between consumption rate and diet N : P across all laboratory studies and calculated effect sizes for each excretion metric to test for significant effects.

Consumption rate of N, but not P, was significantly negatively affected by diet N : P. Effect sizes of diet elemental composition on consumption‐specific excretion N, P and N : P in laboratory studies were all significantly different from 0, but effect size for raw excretion N : P was not significantly different from zero in laboratory or field surveys.

Our results highlight the importance of having a mechanistic understanding of the drivers of consumer excretion rates and ratios. We suggest that more research is needed on how consumption and assimilation efficiency vary with N : P and in natural ecosystems in order to further understand mechanistic processes in consumer‐driven nutrient recycling.
Nutrient enrichment scarcely affects ecosystem impacts of a non‐native herbivore in a spring‐fed river
Authors: Datri Crystal W. , Pray Corey L. , Zhang Yixin , Nowlin Weston H. 
Published: November 2014

Summary

Non‐native invasive species (NNIS) are a global issue whose introduction into novel ecosystems can fundamentally alter nutrient recycling and storage. It is therefore important to understand factors that affect the abundance and distribution of NNIS and their effects on ecosystems.

We investigated how nutrient enrichment and herbivorous armoured catfish separately and in combination affect ecosystem processes in a subtropical spring‐fed river (San Marcos, River, TX, U.S.A.). A replicated stream channel experiment in which nutrient enrichment was cross‐classified with the presence and the absence of armoured catfish was conducted to evaluate how nutrient enrichment may affect the ecosystem and nutrient cycling effects of catfish.

The presence of catfish reduced periphyton biomass and altered detrital decomposition rates and, contrary to predictions, decreased periphyton N:P. In addition, the presence of catfish increased the severity of periphyton P‐limitation. We found little evidence that adding nutrients altered the effects of armoured catfish on ecosystem dynamics.

Armoured catfish likely play an important role in the nutrient dynamics of the San Marcos River, but nutrient enrichment has little influence on determining the magnitude of ecosystem and nutrient cycling effects of this invasive and stoichiometrically unique consumer.