bluuebunny/crossref_metadata_2025_split huggingface dataset:
A small‐scale investigation of hospital experiences among people with a learning disability on Merseyside: speaking with patients and their carers
Authors: Dinsmore Adam Peter 
Published: June 2011

Accessible summary
We did twelve interviews all about the times people with learning disabilities had been to hospital since March 2007. Some of them were with people with learning disabilities and some of them were with the carers of people with learning disabilities.
This article talks about what people told us in the interviews and makes some recommendations to hospital staff which we think would help improve hospital experiences for people with learning disabilities in the future.
This research should be important to people with learning disabilities because people with learning disabilities often have more need to attend hospital than other people, and so it is important that the care they receive is of a good enough standard when they are there.
SummaryPeople with a learning disability face a number of challenges when seeking access to hospital care which are often distinct from those faced by the general population. Numerous statistics indicative of these challenges are represented in the academic literature. Previous research has suggested several reasons for the continued existence of these challenges, including a lack of expertise in the provision of health care to people with learning disabilities and negative attitudes towards this population held by healthcare professionals. As a means of elucidating the hospital experiences of people with learning disabilities on Merseyside, the researcher conducted 13 semi‐structured interviews – an analysis of 12 of which are included in this article. Of these 12 interviews, two were conducted with an unaccompanied person with a learning disability, three were conducted with a person with a learning disability alongside their carer, and seven were conducted with the carer or carers of a person with a learning disability. The topics discussed in these semi‐structured interviews were determined by the findings of a literature search and pilot interview. Emergent themes within the interview transcripts are discussed and recommendations made for healthcare professionals engaged in the hospital care of people with learning disabilities. It is concluded that people with learning disabilities on Merseyside continue to contest with the same difficulties during hospital experiences as have been identified previously by numerous national and international investigations.
Dopamine release mediated by the dopamine transporter, facts and consequences
Authors: Leviel Vincent 
Published: June 2011

J. Neurochem. (2011) 118, 475–489.AbstractSpontaneous and/or stimulated neural activity of the nigrostriatal dopamine (DA) pathway makes amines run out from the neurons. This DA dynamic follows a rather complex path, running in or out the terminals, and flushing or diffusing into the extracellular space. The location of this leakage is not limited to the axon terminals; it also occurs from the cell bodies and dendrites. This molecular release mechanism was, for a long time, considered as being produced, in part, by the exocytosis of previously stored vesicles. The DA carrier protein (DAT, DA transporter) embedded in the DA cell membrane is known to clear previously released amines through an inward DA influx. The DAT also appears to be an active vector of amine release. Particular local conditions and the presence of numerous psychostimulant substances are able to trigger an outward efflux of DA through the DAT. This process, delivering slowly large amounts of amine could play a major regulatory role in extracellular DA homeostasis.
Endogenous presynaptic nitric oxide supports an anterograde signaling in the central nervous system
Authors: Fernández‐Alvarez Adriana , Gómez‐Sena Leonel , Fabbiani María Gabriela , Budelli Ruben , Abudara Verónica 
Published: June 2011

J. Neurochem. (2011) 118, 546–557.AbstractThe source size and density determine the extent of nitric oxide (NO) diffusion which critically influences NO signaling. In the brain, NO released from postsynaptic somas following NMDA‐mediated activation of neuronal nitric oxide synthase (nNOS) retrogradely affects smaller presynaptic targets. By contrast, in guinea pig trigeminal motor nucleus (TMN), NO is produced presynaptically by tiny and disperse nNOS‐containing terminals that innervate large nNOS‐negative motoneurons expressing the soluble guanylyl‐cyclase (sGC); consequently, it is uncertain whether endogenous NO supports an anterograde signaling between pre‐motor terminals and postsynaptic trigeminal motoneurons. In retrogradely labeled motoneurons, we indirectly monitored NO using triazolofluorescein (DAF‐2T) fluorescence, and evaluated sGC activity by confocal cGMP immunofluorescence. Multiple fibers stimulation enhanced NO content and cGMP immunofluorescence into numerous nNOS‐negative motoneurons; NOS inhibitors prevented depolarization‐induced effects, whereas NO donors mimicked them. Enhance of cGMP immunofluorescence required extracellular Ca2+, a nNOS‐physiological activator, and was prevented by inhibiting sGC, silencing neuronal activity or impeding NO diffusion. In conclusion, NO released presynaptically from multiple cooperative tiny fibers attains concentrations sufficient to activate sGC in many motoneurons despite of the low source/target size ratio and source dispersion; thus, endogenous NO is an effective anterograde neuromodulator. By adjusting nNOS activation, presynaptic Ca2+ might modulate the NO diffusion field in the TMN.
Delayed response of human melanopsin retinal ganglion cells on the pupillary light reflex
Authors: Tsujimura Sei‐ichi , Tokuda Yuta 
Published: June 2011

Citation information: Tsujimura S & Tokuda Y. Delayed response of human melanopsin retinal ganglion cells on the pupillary light reflex. Ophthalmic Physiol Opt 2011, 31, 469–479. doi: 10.1111/j.1475‐1313.2011.00846.xAbstractPurpose:  A recent study has shown that retinal ganglion cells containing the photopigment melanopsin, which are intrinsically photosensitive in primates, project to the pupillary control centre in the pretectum. The aim of this study was to investigate how melanopsin retinal ganglion cells (mRGCs) contribute to the pupillary pathway.Methods:  We designed and built a novel multi‐primary stimulation system to control stimulation of the three cone types and mRGCs independently in the human eye. We measured the latency and amplitude of transient pupillary responses to three types of test stimuli modulating excitations of mRGCs and cones (mRGC, luminance and the light flux stimuli).Results:  It was found that the transient pupillary response to mRGC stimuli has a longer latency than that to luminance and the light flux stimuli when an onset of sinusoidal stimulus was used.Conclusions:  The results indicate that we successfully demonstrated the pupillary response to mRGCs under conditions where mRGCs are isolated in humans. Furthermore, the data confirm that the delayed response disappeared when the stimulus is presented as a square‐wave pulse and not weighted by a sinusoid. The similarity of time courses for the earlier phase of pupillary responses to all stimuli suggested that these transient pupillary responses were driven by a single mechanism, which is perhaps associated with cone‐mediated signals.
Health Expenditure Dynamics and Years of U.S. Residence: Analyzing Spending Disparities among Latinos by Citizenship/Nativity Status
Authors: Vargas Bustamante Arturo , Chen Jie 
Published: June 2011

Objective. We investigate health expenditure disparities between Latinos and non‐Latino whites by years of United States residence and citizenship/nativity status.
Data Sources. We link the Medical Expenditure Panel Survey and the National Health Interview Survey from 2000 to 2007. The sample consists of 31,514 Latinos and 76,021 white adults (18–64 years).
Study Design. The likelihood of any health spending, total health expenditure, and the out‐of‐pocket (OOP) share of health expenditure are our main dependent variables. We use two‐part multivariate models to adjust for confounding factors. A stratified analysis by insurance status checks for the results' robustness. The decomposition technique is implemented to estimate the share of disparities that can be explained by observed and unobserved variables.
Principal Findings. Latinos are much less likely to have any health spending (68 percent), total health expenditure (57 percent), and more likely to pay OOP (6 percent) compared with the white population. Overall, disparities narrow or disappear for naturalized Latinos the longer they stay in the country. Among noncitizen Latinos, disparities remain constant or decline slightly, but they remain large over time.
Conclusions. Low‐health spending by foreign‐born Latinos contributes to health expenditure disparities between Latinos and whites. Our findings provide preliminary evidence on health‐spending convergence over time between foreign‐born Latinos and that of whites.
Tree modelling from mobile laser scanning data‐sets
Authors: Rutzinger Martin , Pratihast Arun Kumar , Oude Elberink Sander J. , Vosselman George 
Published: June 2011

AbstractIn recent times mobile laser scanning (MLS) has been used to acquire massive 3D point clouds in urban areas and along road corridors for the collection of detailed data for 3D city modelling, building façade reconstruction and capture of vegetation and road features for inventories. The objectives of this paper are the extraction of tree features from such data‐sets and the modelling of trees for the purpose of visualisation in 3D city models. After the detection of high vegetation the point cloud is reduced using a 3D alpha shape approach. Then the required model parameters such as crown and stem height, crown and stem diameter, and crown shape are derived and the trees are modelled individually in a realistic manner. The tree model so generated correctly represents the overall appearance of the tree. However, the inner structure such as the branching of the tree crown is parameterised. The workflow reduces the point cloud by means of a step‐by‐step process, which eases the handling of the massive MLS data‐sets. The thinning using 3D alpha shapes reduces the amount of data to be processed by about 95%. It is shown that the model parameters are not influenced by the thinning procedure employed. This proves the robustness of the data reduction method and the tree modelling approach.
Quantitation of coated platelet potential during collection, storage, and transfusion of apheresis platelets
Authors: Charania Roseleen , Smith James , Vesely Sara K. , Dale George L. , Holter Jennifer 
Published: June 2011

BACKGROUND: Coated platelets (PLTs), a subpopulation of PLTs observed upon dual agonist stimulation with collagen and thrombin, are known to retain several procoagulant α‐granule proteins on their surface. By formation of a highly active membrane‐bound prothrombinase complex, these PLTs represent an important step in the coagulation cascade as a consequence of their ability to generate thrombin at the site of vascular injury. Various clinical observations suggest that higher levels of coated PLTs are associated with thrombosis while a deficiency of coated PLTs results in a bleeding diathesis. Current quality control guidelines for in vitro PLT storage measure PLT viability but no routine evaluation of the hemostatic function of stored PLTs and particularly no estimation of coated PLT potential is performed. Our primary objective was to evaluate if the process of apheresis and storage of PLT units alters the levels of coated PLTs. In addition, we sought to determine how transfusion of stored PLTs into patients with thrombocytopenia affects the patient's coated PLT levels.STUDY DESIGN AND METHODS: Coated PLT levels were analyzed in 13 voluntary PLT donors before donation, in the fresh apheresis product (Trima, CaridianBCT) and in the stored apheresis product just before transfusion. In addition, 10 patients with thrombocytopenia were analyzed for coated PLTs before and after transfusion of a stored PLT product.RESULTS: Coated PLT levels were significantly decreased after the process of apheresis (17% relative decline; p < 0.01) and with prolonged storage (1 to 5 days; 53% relative decline; p < 0.001). Transfusion of stored PLT units did not result in significant increment of coated PLT levels in patients with thrombocytopenia as expected considering the low level of coated PLTs in stored PLT units. Furthermore, there was no suggestion of regeneration of coated PLT potential upon reinfusion.CONCLUSIONS: Isolation and storage of apheresis PLTs by standard blood bank procedures results in a significant decline in coated PLT potential. Reinfusion of stored apheresis PLTs into patients with thrombocytopenia resulted in a predictable change in coated PLT potential with no suggestion of regeneration of lost coated PLT potential.
Transfusion of fresh murine red blood cells reverses adverse effects of older stored red blood cells
Authors: Hendrickson Jeanne E. , Hod Eldad A. , Hudson Krystalyn E. , Spitalnik Steven L. , Zimring James C. 
Published: June 2011

BACKGROUND: Although a subset of recent studies have suggested that red blood cell (RBC) storage length is associated with adverse patient outcomes, others have shown no such relationship. Adults may be transfused with RBC units of different storage lengths, and existing studies do not take into consideration that fresh RBCs may alter responses to concurrently transfused stored RBCs. To test this possibility, we utilized a murine model and investigated transfusion outcomes of fresh, stored, or fresh‐plus‐stored RBCs.STUDY DESIGN AND METHODS: Fresh, 14‐day‐stored or fresh plus 14‐day‐stored leukoreduced RBCs from HOD‐transgenic donors (with RBC‐specific expression of hen egg lysozyme, ovalbumin, and human Duffyb) were transfused into naïve C57BL/6 recipients. Serum cytokines and anti‐HOD alloimmunization were evaluated after transfusion.RESULTS: In six of six experiments (n = 90 mice total), a proinflammatory serum cytokine storm of interleukin‐6, keratinocyte‐derived chemokine/CXCL1, and monocyte chemoattractant protein‐1 was observed in transfusion recipients of stored but not fresh RBCs, along with high degrees of anti‐HOD alloimmunization. However, concurrent transfusion of fresh HOD RBCs along with stored HOD RBCs significantly decreased these adverse outcomes (p < 0.05).CONCLUSIONS: These results are consistent with fresh murine HOD RBCs losing protective properties during storage, and introduce a previously unrecognized variable in RBC storage studies. If translatable to humans, uniform “old blood” groups may be needed in future clinical studies to more accurately investigate the biologic effects of older RBC units.
Estimation of variant Creutzfeldt‐Jakob disease infectivity titers in human blood
Authors: Gregori Luisa , Yang Hong , Anderson Steven 
Published: June 2011

BACKGROUND: Blood of individuals with variant Creutzfeldt‐Jakob disease (vCJD) is infectious but the titer is unknown. Current estimates of possible vCJD infectivity titers in blood have largely relied on an assumption that the titers of vCJD agent in human blood are likely to be similar to those in blood of rodents infected with model transmissible spongiform encephalopathy agents, assayed by intracerebral inoculations of rodents of the same species.STUDY DESIGN AND METHODS: We analyzed published descriptions of experimental transfusion‐transmitted (TT) bovine spongiform encephalopathy and scrapie in sheep and reports of TTvCJD in humans, applying statistical approaches to estimate the probable number of intravenous infectious doses (IDiv) per unit of transfused blood (IDiv/unit). For humans, IDiv/unit of nonleukoreduced red blood cells (NLR‐RBCs) were estimated by two statistical models.RESULTS: Sheep blood collected at or near onset of clinical illness contained a mean of 0.80 IDiv/unit. Estimates of infectivity in NLR‐RBCs from donors incubating vCJD indicated a probable mean infectivity of 0.29 IDiv/unit (Model 1) and 0.75 IDiv/unit (Model 2). The analysis predicted a mean of 21 vCJD‐infected recipients expected in a cohort transfused with vCJD‐implicated NLR‐RBCs in the United Kingdom.CONCLUSION: Our analysis suggested that, while less than one IDiv is likely to be present in a given unit of NLR‐RBCs collected from a donor incubating vCJD, there is a high probability of TT infection among recipients of vCJD‐implicated blood components. The analysis supports continuing measures currently recommended to reduce the risk of TTvCJD.
Postoperative complications associated with transfusion of platelets and plasma in cardiac surgery
Authors: Bilgin Yavuz M. , van de Watering Leo M.G. , Versteegh Michel I.M. , van Oers Marinus H.J. , Vamvakas Eleftherios C. , Brand Anneke 
Published: June 2011

BACKGROUND: Studies in cardiac surgery have reported increased postoperative morbidity and mortality after allogeneic red blood cell (RBC) transfusions. Whether platelet (PLT) and/or plasma transfusions are a marker for more concomitant RBC transfusions or are independently associated with complications after cardiac surgery is unknown.STUDY DESIGN AND METHODS: Data from two randomized controlled studies were combined to analyze the effects of PLT and/or plasma transfusions on postoperative infections, length of stay in the intensive care unit (ICU), all‐cause mortality, and mortality in the presence or absence of infections in the postoperative period.RESULTS: After adjusting for confounding factors, plasma units and not RBC transfusions were associated with all‐cause mortality. White blood cell (WBC)‐containing RBC transfusions and PLT transfusions were associated with mortality occurring in the presence of or after infections. The number of (WBC‐containing) RBC transfusions was also significantly associated with postoperative infections and with ICU stay for 4 or more days.CONCLUSION: Although it is difficult to separate the effects of blood components, we found that in cardiac surgery, perioperative plasma transfusions are independently associated with all‐cause mortality. WBC‐containing RBC transfusions and PLT transfusions are independently associated with mortality in the presence of infections in the postoperative period. Future transfusion studies in cardiac surgery should concomitantly consider the possible adverse effects of all the various transfused blood components.
Transmission of cytomegalovirus (CMV) infection by leukoreduced blood products not tested for CMV antibodies: a single‐center prospective study in high‐risk patients undergoing allogeneic hematopoietic stem cell transplantation (CME)
Authors: Thiele Thomas , Krüger William , Zimmermann Kathrin , Ittermann Till , Wessel Antje , Steinmetz Ivo , Dölken Gottfried , Greinacher Andreas 
Published: June 2011

BACKGROUND: Measures to prevent transfusion‐transmitted cytomegalovirus (TT‐CMV) infection after hematopoietic stem cell transplantation (HSCT) include transfusion of CMV antibody–negative blood units and/or transfusion of leukoreduced cellular blood products. We assessed the incidence of TT‐CMV in CMV‐seronegative patients receiving CMV‐seronegative HSC transplants, who were transfused with leukoreduced cellular blood products not tested for anti‐CMV.STUDY DESIGN AND METHODS: In a prospective observational study between 1999 and 2009, all HSCT patients received leukoreduced cellular blood products not tested for anti‐CMV. Patients were screened for CMV serostatus and CMV‐negative recipients of CMV‐negative transplants were systematically monitored for TT‐CMV clinically and by CMV nucleic acid testing. Anti‐CMV antibodies (immunoglobulin [Ig]G and IgM) were assessed after three time intervals (Interval 1, study inclusion to Day +30 after HSCT; Interval 2, Day +30‐Day +100; Interval 3, after Day +100).RESULTS: Among 142 patients treated with allogeneic HSCT, 23 CMV‐negative donor‐patient pairs were identified. These 23 patients received 1847 blood products from 3180 donors. All patients remained negative for CMV DNA and none developed CMV‐associated clinical complications. This results in a risk for TT‐CMV per donor exposure of 0% (95% confidence interval, 0.0%‐0.12%). However, 17 of 23 patients seroconverted for anti‐CMV IgG, but none for anti‐CMV IgM. CMV IgG seroconverters received significantly more transfusions per week than nonconverters.CONCLUSION: The risk of TT‐CMV is low in high‐risk CMVneg/neg HSCT patients transfused with leukoreduced blood products not tested for anti‐CMV. The cause of anti‐CMV IgG seroconversion is most likely passive antibody transmission by blood products.
Defined Benefit or Defined Contribution? A Study of Pension Choices
Authors: Cocco João F. , Lopes Paula 
Published: June 2011

AbstractWe solve an empirically parameterized life‐cycle model of consumption and pension choices to show how expected earnings growth and risk affect the benefits of final‐salary defined benefit (DB) pension plans, relative to pension plans that are defined contribution (DC) in nature. We use micro data on the pension choices of individuals to provide evidence consistent with the model predictions: (1) individuals who expect a higher growth rate of earnings are more likely to choose DB final‐salary schemes, and (2) individuals who face a higher variance of persistent income shocks are less likely to choose DB final‐salary schemes. We control for cohort and age fixed effects in the empirical analysis.
Commitment and Lapse Behavior in Long‐Term Insurance: A Case Study
Authors: Pinquet Jean , Guillén Montserrat , Ayuso Mercedes 
Published: June 2011

AbstractThis article presents a case study of a portfolio of individual long‐term insurance contracts sold by a Spanish mutual company. We describe the risk levels, the rating structure, and the implied cross‐subsidies on a portfolio of policies providing health, life, and long‐term care insurance. We show evidence of reclassification risk through the history of disability spells. We also analyze the lapse behavior and seek to provide a rationale for the portfolio’s dynamics. We discuss the lack of commitment from the policyholders (lapses) and from the mutual company (which took a run‐off decision). Finally, we draw conclusions regarding the design of such contracts.
Do Small‐Group Health Insurance Regulations Influence Small Business Size?
Authors: Kapur Kanika , Karaca‐Mandic Pinar , Gates Susan M. , Fulton Brent 
Published: June 2011

AbstractState small‐group health insurance reforms, implemented in the 1990s, aimed at controlling the variability of health insurance premiums and to improve access to health insurance. These reforms only affected firms within a specific size range, and as a result, they may have affected the size of small firms around the legislative threshold and may also have affected the propensity of small firms to offer health insurance. We examine the relationship between small‐group reform and firm size and find evidence that small firms just below the regulatory threshold that were offering health insurance grew in order to bypass reforms.