bluuebunny/crossref_metadata_2025_split huggingface dataset:
Professional perspectives on systemic barriers to admission avoidance: learning from a system dynamics study of older people's admission pathways
Authors: Walsh Bronagh , Lattimer Valerie , Wintrup Julie , Brailsford Sally 
Published: May 2014

BackgroundThere is debate worldwide about the best way to manage increased healthcare demand within ageing populations, particularly rising rates of unplanned and avoidable hospital admissions.ObjectivesTo understand health and social care professionals' perspectives on barriers to admission avoidance throughout the admissions journey, in particular: the causes of avoidable admissions in older people; drivers of admission and barriers to use of admission avoidance strategies; and improvements to reduce unnecessary admissions.DesignA qualitative framework analysis of interview data from a System dynamics (SD) modelling study.MethodsSemi‐structured interviews were conducted with twenty health and social care professionals with experience of older people's admissions. The interviews were used to build understanding of factors facilitating or hindering admission avoidance across the admissions system. Data were analysed using framework analysis.ResultsThree overarching themes emerged: understanding the needs of the patient group; understanding the whole system; and systemwide access to expertise in care of older people. There were diverse views on the underlying reasons for avoidable admissions and recognition of the need for whole‐system approaches to service redesign.ConclusionsParticipants recommended system redesign that recognises the specific needs of older people, but there was no consensus on underlying patient needs or specific service developments. Access to expertise in management of older and frailer patients was seen as a barrier to admission avoidance throughout the system.Implications for practiceProviding access to expertise and leadership in care of frail older people across the admissions system presents a challenge for service managers and nurse educators but is seen as a prerequisite for effective admission avoidance. System redesign to meet the needs of frail older people requires agreement on causes of avoidable admission and underlying patient needs.
Age‐related changes in perception of movement in driving scenes
Authors: Lacherez Philippe , Turner Laura , Lester Robert , Burns Zoe , Wood Joanne M. 
Published: May 2014

AbstractPurposeAge‐related changes in motion sensitivity have been found to relate to reductions in various indices of driving performance and safety. The aim of this study was to investigate the basis of this relationship in terms of determining which aspects of motion perception are most relevant to driving.MethodsParticipants included 61 regular drivers (age range 22–87 years). Visual performance was measured binocularly. Measures included visual acuity, contrast sensitivity and motion sensitivity assessed using four different approaches: (1) threshold minimum drift rate for a drifting Gabor patch, (2) Dmin from a random dot display, (3) threshold coherence from a random dot display, and (4) threshold drift rate for a second‐order (contrast modulated) sinusoidal grating. Participants then completed the Hazard Perception Test (HPT) in which they were required to identify moving hazards in videos of real driving scenes, and also a Direction of Heading task (DOH) in which they identified deviations from normal lane keeping in brief videos of driving filmed from the interior of a vehicle.ResultsIn bivariate correlation analyses, all motion sensitivity measures significantly declined with age. Motion coherence thresholds, and minimum drift rate threshold for the first‐order stimulus (Gabor patch) both significantly predicted HPT performance even after controlling for age, visual acuity and contrast sensitivity. Bootstrap mediation analysis showed that individual differences in DOH accuracy partly explained these relationships, where those individuals with poorer motion sensitivity on the coherence and Gabor tests showed decreased ability to perceive deviations in motion in the driving videos, which related in turn to their ability to detect the moving hazards.ConclusionsThe ability to detect subtle movements in the driving environment (as determined by the DOH task) may be an important contributor to effective hazard perception, and is associated with age, and an individuals' performance on tests of motion sensitivity. The locus of the processing deficits appears to lie in first‐order, rather than second‐order motion pathways.
Challenging Diagnosis of Peripillous Sheaths
Authors: Gnarra Maria , Saraceni Pierluigi , Rossi Alfredo , Murabit Amera , Caradonna Emanuela , Fania Luca , Feliciani Claudio 
Published: May 2014

AbstractPeripillous sheaths, or hair casts, are asymptomatic, white, cylindrical concretions that encircle the hair without adhering to it. They are infrequently documented in the literature, are often misdiagnosed, and generate avoidable apprehension and expense for parents and caregivers. Dermoscopy is the standard for a rapid, noninvasive, cost‐effective diagnosis. We describe a case of peripillous sheaths presenting in a boy.
Transmission of ‘Candidatus Liberibacter solanacearum’ in carrot seeds
Authors: Bertolini E. , Teresani G. R. , Loiseau M. , Tanaka F. A. O. , Barbé S. , Martínez C. , Gentit P. , López M. M. , Cambra M. 
Published: May 2014

A protocol for the specific detection and quantification of ‘Candidatus Liberibacter solanacearum’ in carrot seeds using real‐time PCR was developed. The bacterium was detected in 23 out of 54 carrot seed lots from 2010 to 2014, including seeds collected from diseased mother plants. The average total number of ‘Ca. L. solanacearum’ cells in individual seeds ranged from 4·8 ± 3·3 to 210 ± 6·7 cells per seed from three seed lots, but using propidium monoazide to target live cells, 95% of the cells in one seed lot were found to be dead. Liberibacter‐like cells were observed in the phloem sieve tubes of the seed coat and in the phloem of carrot leaf midrib from seedlings. The bacterium was detected as early as 30 days post‐germination, but more consistently after 90 days, in seedlings grown from PCR positive seed lots in an insect‐proof P2 level containment greenhouse. Between 12% and 42% of the seedlings from positive seed lots tested positive for ‘Ca. L. solanacearum’. After 150 days, symptoms of proliferation were observed in 12% of seedlings of cv. Maestro. ‘Candidatus Liberibacter solanacearum’ haplotype E was identified in the seeds and seedlings of cv. Maestro. No phytoplasmas were detected in seedlings with symptoms using a real‐time assay for universal detection of phytoplasmas. The results show that to prevent the entry and establishment of the bacterium in new areas and its potential spread to other crops, control of ‘Ca. L. solanacearum’ in seed lots is required.
Interim Responses of Littoral River Channel Vegetation to Reestablished Flow after Phase I of the Kissimmee River Restoration Project
Authors: Bousquin Stephen G. , Colee James 
Published: May 2014

AbstractMeasurements of littoral vegetation stands and species‐level surveys of associated plant communities were made in channels of the Kissimmee River from 1998 through 2008, a period that spanned channelized, non‐flowing conditions through 7 years of near‐continuous reestablished flow. Dissected by flood control canal C‐38 in 1971, the river was virtually without flow until early 2001, when Phase I of the Kissimmee River Restoration Project (KRRP) reestablished flow to a central section of river channel. This study evaluated the effects of reestablished flow on littoral vegetation in river channels as an indicator of system status and progress toward the project goal of ecological integrity. Predictions of vegetation response to reestablished flow included reduction in the width of vegetation stands, and changes in the growth‐form composition of littoral stands from near‐equal dominance by floating and emergent species to overwhelming dominance by emergent growth forms. Variables included plant cover by species and growth‐form, width of vegetation stands, and vegetated percentage of channel. Under the currently incomplete (interim) status of the KRRP, results for littoral vegetation stands indicate trends in the predicted directions of change, and three of four predicted changes have occurred. Vegetation stand widths decreased substantially and littoral plant communities became heavily dominated by emergent species; BACIPS (before‐after‐control‐impact‐paired series) analyses indicated significant restoration effects for most littoral stand metrics.
Galápagos History, Restoration, and a Shifted Baseline
Authors: Bush Mark B. , Restrepo Alejandra , Collins Aaron F. 
Published: May 2014

AbstractAn ecological system that had been resilient to climatic change for thousands of years was transformed in decades by the introduction of livestock to the Galápagos. Habitat restoration at El Junco, San Cristobal Island, has included the exclusion of cattle, removal of exotic species, and replanting with the endemic shrub, Miconia robinsoniana. M. robinsoniana was known to form a characteristic zone of near mono‐dominant shrub cover at equivalent elevations on other islands. Analysis of modern and fossil pollen data from El Junco Crater Lake showed that two of the most common shrubs of the San Cristóbal uplands, Acalypha and Alternanthera, were the most common pollen types for more than two thousand years. In the 1930s, 30 years before the first scientific description of that habitat, the abundance of both taxa declined rapidly as livestock densities increased. The restoration target, based on the assumption that mono‐dominance by M. robinsoniana is the natural state, reflects a shifted baseline. Acalypha and Alternanthera should be considered for inclusion within future restoration efforts.
Flexible and Adaptable Restoration: An Example from South Korea
Authors: Temperton Vicky M. , Higgs Eric , Choi Young D. , Allen Edith , Lamb David , Lee Chang‐Seok , Harris James , Hobbs Richard J. , Zedler Joy B. 
Published: May 2014

AbstractEcological restoration is set to play a key role in mitigating biodiversity loss. While many restorationists worry about what to do about and what to call rapidly changing ecosystems (no‐analog, novel, or other terms), ecologists and managers in some parts of the world have avoided these controversies and proceeded with developing and implementing innovative restoration projects. We discuss examples from South Korea, including the Cheonggyecheon river project in Seoul and the new National Institute of Ecology, which combines scientific research, planted reference systems for future restoration, and an Ecorium for outreach and education. South Korea faces a range of restoration challenges, including managing even‐aged planted forests, major land use changes (especially urbanization) affecting valuable tidal flats, and fragmented landscapes caused by intensive land use and the fenced Demilitarized Zone (DMZ). The examples from South Korea provide insights that might guide future actions more broadly. These include flexible targets for restoration not based on historical precedents, considering ecosystem functions and functional trait diversity as well as species composition, creating model restoration projects, and managing adaptively.
The Unintended Consequences of Education Policies on South African Participation and Unemployment
Authors: Burger Rulof , van der Berg Servaas , von Fintel Dieter 
Published: May 2014

AbstractIn the late 1990s, theSouthAfricanDepartment ofEducation implemented two policies that were meant to reduce the large number of over‐aged learners in the school system: schools were no longer allowed to accept students who were more than two years older than the correct grade age, and students could not be held back more than once in each of four schooling phases. Our analysis uses school administrative data and household survey data to show that these policies coincided with a decrease in school enrolment of at least 400,000 and possibly more than 900,000 learners. These policies appear to have pushed many students into the labour market at earlier ages than was observed for previous generations, which explains much of the sudden increase in labour force participation and unemployment during this period. However, since these individuals would probably have entered the labour market sooner if not for their poor employment prospects, we argue that the resulting increase in unemployment signifies a more accurate reflection of disguised unemployment that already existed in the mid‐1990s rather than a deterioration of labour market conditions.
Carbon Monoxide–Releasing Molecule‐A1 Inhibits Th1/Th17 and Stimulates Th2 Differentiation In vitro
Authors: Nikolic I. , Vujicic M. , Stojanovic I. , Stosic‐Grujicic S. , Saksida T. 
Published: May 2014

AbstractCarbon monoxide (CO) is endogenously produced by haeme oxygenase‐1 and has profound effects on intracellular signalling processes, generating anti‐inflammatory, antiproliferative and antiapoptotic effects. A boron‐containing compound CORM‐A1 is capable of releasing CO in such a way to mimic physiological functions of haeme oxygenase‐1. Considering the importance of Th1/Th17 versus Th2 balance in the final outcome of immune and inflammatory responses in this study we focused on immune‐modulatory effects of CORM‐A1 on murine lymph node–derived T cells in vitro and its influence on T‐cell proliferation, activation and differentiation. Anti‐CD3/CD28 antibody‐triggered lymph node cells proliferation remained unaffected after 24‐hour CORM‐A1 treatment, as well as the expression of the early activation marker CD25. However, CORM‐A1 successfully reduced the secretion of the two representative pro‐inflammatory cytokines, IFN‐γ and IL‐17, while the secretion of anti‐inflammatory cytokine IL‐4 remained unchanged. Furthermore, CORM‐A1 efficiently reduced the percentage of CD4+IFN‐γ+ and CD4+IL‐17+ cells, whereas CD4+IL‐4+ cell population increased after treatment. Also, CORM‐A1 significantly reduced expression of transcription factor RORγT, necessary for Th17 development, but the expression of Th1‐related and Th2‐related transcription factors (T‐bet and GATA‐3, respectively) remained unchanged. In conclusion, our findings indicate that CO has anti‐inflammatory role through the regulation of balance between pro‐inflammatory Th1/Th17 and anti‐inflammatory Th2 cells. Observed immunomodulatory effects of CORM‐A1 could be useful for developing novel therapeutic approaches in managing Th1/Th17‐mediated immune disorders.
Vitamin A Supplementation Reduces IL‐17 and RORc Gene Expression in Atherosclerotic Patients
Authors: Mottaghi A. , Ebrahimof S. , Angoorani P. , Saboor‐Yaraghi A.‐A. 
Published: May 2014

AbstractVitamin A is a potential mediator of T helper cells in atherosclerosis. The purpose of this study was to evaluate the effect of vitamin A supplementation on expression of Th17 cells‐related IL‐17 and RORc genes in atherosclerotic patients. Thirty one atherosclerotic patients and 15 healthy controls were studied for 4 months. Atherosclerotic patients were randomly divided into vitamin A or placebo groups. Healthy controls and patients in vitamin A group received 25,000 IU retinyl palmitate per day. Peripheral blood mononuclear cells were isolated, cultured and divided into three groups including fresh cells, phytohemagglutinin (PHA)‐activated T cells and ox‐LDL‐activated T cells. Gene expressions of T cells were studied by real‐time PCR. In atherosclerotic patients, vitamin A supplementation resulted in significant decrease in IL‐17 gene expression by 0.63‐fold in fresh cell, 0.82‐fold in PHA‐activated cells and 0.65‐fold in ox‐LDL‐activated cells (P < 0.05 for all). RORc gene expression in fresh cells as well as ox‐LDL‐activated cells decreased significantly after vitamin A supplementation in atherosclerotic patients (P = 0.0001 for both). In PHA‐activated cells, vitamin A supplementation significantly decreased RORc gene in both atherosclerotic patients and healthy subjects by 0.87‐fold and 0.72, respectively, while in placebo group, the RORc gene expression significantly increased by 1.17‐fold (P < 0.05 for all). Findings of this study suggest that vitamin A supplementation may be an effective approach to slow progression of atherosclerosis.
Establishment of culture systems for Genotypes 3 and 4 hepatitis E virus (HEV) obtained from human blood and application of HEV inactivation using a pathogen reduction technology system
Authors: Owada Takashi , Kaneko Moe , Matsumoto Chieko , Sobata Rieko , Igarashi Masashi , Suzuki Ko , Matsubayashi Keiji , Mio Kazuhiro , Uchida Shigeharu , Satake Masahiro , Tadokoro Kenji 
Published: May 2014

BackgroundIt has been demonstrated that the hepatitis E virus (HEV) can be transmitted via blood transfusion, and the risk of HEV transmission via transfusion has become a major global concern. An HEV culture system for blood‐derived HEV has been sought to obtain valuable knowledge of the virus and the risk of HEV infection through blood products.Study Design and MethodsWe endeavored to establish an HEV culture system using RNA‐positive blood specimens for Genotypes (G) 3 and 4 and applied this system to evaluate tissue culture infectious dose (TCID). We applied this method to investigate the potential of the Mirasol pathogen reduction technology (PRT) system (Terumo BCT) to inactivate live HEV in contaminated platelet samples (PLTs). PLTs were spiked with cultured HEV G3 or G4 and then treated with the Mirasol PRT system. PLTs were examined before and after the treatment for HEV load using TCID titration.ResultsWe successfully established two strains for HEV production: the JRC‐HE3 strain for G3 and the UA1 strain for G4. The Mirasol PRT system expressed more than 3 log inactivation for JRC‐HE3 and more than 2 log inactivation for UA1.ConclusionThe Mirasol PRT system inactivated greater than 2 to 3 logs of live HEV in PLTs and can potentially be used to lower the possibility of blood‐borne HEV transmission. The G3 and G4 HEV inocula identified in this study and the hepatoma cell culture system provide a new means to assess HEV infectious titer and to evaluate other pathogen reduction strategies.
Fourteen‐year experience of a tertiary hospital transfusion committee in West Africa
Authors: Opare‐Sem Ohene , Bedu‐Addo George , Karikari Patrick , Boateng Peter , Sarkodie Francis , Rahman Rabiniatu , Asenso‐Mensah Kwame , Awuah Baffour , Osei Akoto Alex , Munin S.A. Abdul , Mensah‐Acheampong Fred , Allain Jean‐Pierre , Owusu‐Ofori Shirley 
Published: May 2014

BackgroundHospital transfusion committees (HTCs) have been established in the United States to link producers and users as well as to ensure appropriate use of blood. The HTC has been little reported in sub‐Saharan Africa (SSA), although it has been established in some hospitals.Study Design and MethodsThe minutes of three to four HTC meetings per year in a tertiary hospital hosting its own blood service have been reviewed to examine the HTC role over a period of 14 years. Minutes were broken down into themes and indexes, and incomplete data were reinforced by other information sources. Specific data on progress over time were reviewed.ResultsThe HTC systematically scrutinized the blood supply, blood safety, donor care, clinical use of blood products, and costs. It operated more as a blood transfusion service supervisory board than the limited function allocated to western HTCs. Clinicians and hospital administration were directly involved in decision making and directing investigations to support potential changes and advances in the role and function of the blood transfusion service. The close relation with a UK major blood center and university laboratory provided the impetus and support for research and investigations preliminary to decision making. Data collected and analyzed were reported in the international literature and contributed to disseminate progress made.ConclusionsThe HTC in a major SSA tertiary hospital inclusive of all sections of hospital organization was critically instrumental in decision making, funding, and implementing measures improving the amount and quality of blood products on the basis of evidence collected despite lack of resources. Steps are taken to ensure sustainability of the HTC.
Inactivation of dengue virus in plasma with amotosalen and ultraviolet A illumination
Authors: Musso Didier , Richard Vaea , Broult Julien , Cao‐Lormeau Van‐Mai 
Published: May 2014

BackgroundDengue virus (DENV) is the most prevalent arbovirus in tropical and subtropical regions. Transfusion‐transmitted DENV infections have already been reported and the risk for blood products to be contaminated by DENV needs to be considered in dengue‐endemic areas, especially during outbreaks. Blood product inactivation processes, including amotosalen and ultraviolet A (UVA) illumination, have been developed to reduce transfusion‐transmitted infections. In this study we demonstrate the efficiency of using amotosalen and UVA illumination for DENV inactivation in human plasma.Study Design and MethodsPlasma units from volunteer blood donors were spiked with DENV. Viral titers and viral RNA loads were measured in plasma before and after amotosalen and UVA photochemical treatment.ResultsThe mean DENV titer in plasma before inactivation was 5.61 log 50% tissue culture infectious dose (TCID50)/mL and the mean viral RNA load was 10.21 log copies/mL. In inactivated plasma, the mean DENV RNA load was 9.37 log copies/mL, but cell cultures inoculated with inactivated plasma did not result in infected cells and did not produce any replicative virus nor detectable viral RNA.ConclusionWe report here that amotosalen combined with UVA light inactivated DENV in fresh‐frozen plasma (5.61 log inactivation of viral titer). This inactivation process is an efficient method to prevent plasma transfusion‐transmitted DENV infections.
Cerebral Doppler velocimetry to predict fetal anemia after more than three intravenous fetal exchange transfusions
Authors: Hermann Monika , Poissonnier Marie‐Hélène , Grangé Gilles 
Published: May 2014

BackgroundWe aimed to assess usefulness of the middle cerebral artery peak systolic velocity (MCA‐PSV) in the prediction of fetal anemia after more than three intravenous fetal‐exchange transfusions (IFET).Study Design and MethodsA retrospective study was conducted over 6 years of 15 consecutive pregnancies with severe red blood cell fetomaternal alloimmunization requiring more than three IFETs. We evaluated correlation between MCA‐PSV (expressed as multiples of the mean [MoM]) and pretransfusion hemoglobin (Hb) in the fetus (MoM). Analyses were also performed to assess the value of MCA‐PSV to predict moderate to severe fetal anemia.ResultsTwenty‐seven MCA‐PSV measurements performed before the fourth to last IFET were coupled with pretransfusion Hb in the fetus. The median number of IFETs per fetus was five (range, four to eight). Five Hb samples found fetuses with severe (19%), seven with moderate (26%), and 15 with mild anemia (56%). There was a linear correlation between MCA‐PSV(x) and Hb in the fetus(y): y = −0.21x + 0.93 (r = −0.50, p < 0.01). For the prediction of moderate to severe anemia the negative predictive value of MCA‐PSV with a threshold of 1.5 MoM was 75%, positive predictive value 73%, specificity 80%, sensibility 67%, and positive likelihood ratio 3.33. The area under the receiver operating characteristic curve was 0.78 (95% confidence interval, 0.59‐0.96; p < 0.001). For the prediction of severe anemia, MCA‐PSV with a threshold of 1.5 MoM had 94% negative predictive value, 80% sensibility, and a positive likelihood ratio of 2.5.ConclusionsThis study shows that a correlation between MCA‐PSV and Hb in the fetus persists even after more than three IFETs. MCA‐PSV measurements thus remain useful to monitor fetuses at risk of anemia.