bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brief report: Impact of applied behaviour analysis (ABA) on carer burden and community participation in challenging behaviour: results from a randomised controlled trial
Authors: Hassiotis A. , Robotham D. , Canagasabey A. , Marston L. , Thomas B. , King M. 
Published: September 2011

AbstractBackground  Applied behaviour analysis (ABA) reduces challenging behaviour in people with intellectual disability. There is interest, however, in whether such interventions reduce carer burden and increase community participation in this group.Methods  A 6‐month randomised controlled trial was followed by a longer‐term naturalistic follow‐up of participants. We studied the impact of the challenging behaviour on the carers and on the daily activities of the participants measured by the Carer Uplift and Burden Scale and Guernsey Community Participation and Leisure Assessment respectively.Results  Both community participation and carer burden improved at 6 and 24 months. Burden showed significant reduction in family carers compared with paid carers. There was no significant intervention effect on the variables under consideration.Conclusions  ABA appears to be no more effective than standard care in improving social outcomes in people with intellectual disabilities and challenging behaviour but this requires further examination in a larger trial.
A computer‐based interactive multimedia program to reduce HIV transmission for women with intellectual disability
Authors: Wells J. , Clark K. D. , Sarno K. 
Published: September 2011

AbstractBackground  Despite recent recognition of the need for preventive sexual health materials for people with intellectual disability (ID), there have been remarkably few health‐based interventions designed for people with mild to moderate ID. The purpose of this study was to evaluate the effects of a computer‐based interactive multimedia (CBIM) program to teach HIV/AIDS knowledge, skills and decision making.Methods  Twenty‐five women with mild to moderate ID evaluated the program. The study used a quasi‐experimental within‐subjects design to assess the efficacy of the CBIM program. Research participants completed five qualitative and quantitative instruments that assessed HIV knowledge, and decision‐making skills regarding HIV prevention practices and condom application skills (i.e. demonstration of skills opening a condom and putting it on a model penis). In addition, 18 service providers who work with women with ID reviewed the program and completed a demographics questionnaire and a professional customer satisfaction survey.Results  Women with ID showed statistically significant increases from pre‐test to post‐test in all knowledge and skill domains. Furthermore, the statistical gains were accompanied by medium to large effect sizes. Overall, service providers rated the program highly on several outcome measures (stimulation, relevance and usability).Conclusions  The results of this study indicate the CBIM program was effective in increasing HIV/AIDS knowledge and skills among women with ID, who live both semi‐independently and independently, in a single‐session intervention. As the CBIM program is not dependent on staff for instructional delivery, it is a highly efficient teaching tool; and CBIM is an efficacious means to provide behavioural health content, compensating for the dearth of available health promotion materials for people with ID. As such, it has a potential for broad distribution and implementation by medical practitioners, and public health offices. People with ID are part of our society, yet continue to be overlooked, particularly in the area of health promotion. Special tools need to be developed in order to address the health disparities experienced by people with ID.
Self‐injurious behaviour in intellectual disability syndromes: evidence for aberrant pain signalling as a contributing factor
Authors: Peebles K. A. , Price T. J. 
Published: September 2011

AbstractBackground  In most individuals, injury results in activation of peripheral nociceptors (pain‐sensing neurons of the peripheral nervous system) and amplification of central nervous system (CNS) pain pathways that serve as a disincentive to continue harmful behaviour; however, this may not be the case in some developmental disorders that cause intellectual disability (ID). Moreover, individuals affected by ID disorders may initiate self‐injurious behaviour to address irritating or painful sensations. In normal individuals, a negative feedback loop decreases sensation of pain, which involves descending inhibitory neurons in the CNS that attenuate spinal nociceptive processing. If spinal nociceptive signalling is impaired in these developmental disorders, an exaggerated painful stimulus may be required in order to engage descending anti‐nociceptive signals.Methods  Using electronic databases, we conducted a review of publications regarding the incidence of chronic pain or altered pain sensation in ID patients or corresponding preclinical models.Results  There is a body of evidence indicating that individuals with fragile X mental retardation and/or Rett syndrome have altered pain sensation. These findings in humans are supported by mechanistic studies using genetically modified mice harbouring mutations consistent with the human disease. Thus, once self‐injurious behaviour is initiated, the signal to stop may be missing. Several developmental disorders that cause ID are associated with increased incidence of gastroesophageal reflux disease (GERD), which can cause severe visceral pain. Individuals affected by these disorders who also have GERD may self‐injure as a mechanism to engage descending inhibitory circuits to quell visceral pain. In keeping with this hypothesis, pharmacological treatment of GERD has been shown to be effective for reducing self‐injurious behaviour in some patients. Hence, multiple lines of evidence suggest aberrant nociceptive processing in developmental disorders that cause ID.Conclusions  There is evidence that pain pathways and pain amplification mechanisms are altered in several preclinical models of developmental disorders that cause ID. We present hypotheses regarding how impaired pain pathways or chronic pain might contribute to self‐injurious behaviour. Studies evaluating the relationship between pain and self‐injurious behaviour will provide better understanding of the mechanisms underlying self‐injurious behaviour in the ID population and may lead to more effective treatments.
Quality improvement in long‐term mental health: results from four collaboratives
Authors: STRATING M. M. H. , BROER T. , VAN ROOIJEN S. , BAL R. A. , NIEBOER A. P. 
Published: September 2011

Accessible summary
Overall, the four collaboratives lead to significant improvement in most objective outcomes, such as health, loneliness, and clients' problem areas.
With respect to perceived effectiveness significant differences between the four collaboratives were found. Team members participating in the Social Psychiatric Care collaborative scored significantly lower than team members in the other three collaboratives. The Recovery‐Oriented Care collaborative scored weakly higher.
Multilevel regression analyses indicated that innovation attributes, appropriate measures, usable data collection tools, and an innovative team culture could explain variation in perceived effectiveness.
The results supported the notion that a layered approach is necessary to achieve improvements in quality of care.
AbstractThis multiple case study evaluates four quality improvement collaboratives (QICs) in long‐term mental health care focusing on social psychiatric care, recovery oriented care, social participation and somatic co‐morbidity of psychiatric patients. The aim is to explore (1) effectiveness in terms of objective outcome indicators and impact of changes as perceived by team members; and (2) associations between collaborative‐, organizational‐ and team‐level factors and perceived effectiveness. Most objective outcomes, such as health, loneliness and clients' problem areas, showed significant improvement. Because of the diversity in content no single measure for objective effectiveness could be computed across the four collaboratives. Perceived effectiveness of team members was used as an indicator of the overall impact. In all, 55 of the 94 participating team leaders and 117 remaining team members completed a written survey at the end of each quality improvement collaborative. Multilevel regression analyses indicated that innovation attributes, appropriate measures, usable data collection tools and an innovative team culture could explain variation in perceived effectiveness. In conclusion, overall positive changes for clients were realized as demonstrated by objective outcomes and team members' perceptions of improvements in care processes. The results supported the notion that a layered approach is necessary to achieve improvements in quality of care.
Ganoderma boninense basidiospores in oil palm plantations: evaluation of their possible role in stem rots of Elaeis guineensis
Authors: Rees R. W. , Flood J. , Hasan Y. , Wills M. A. , Cooper R. M. 
Published: September 2011

Basidiospores are implicated in the distribution and genetic diversity of Ganoderma boninense, cause of basal stem rot (BSR) and upper stem rot (USR) of oil palm (Elaeis guineensis). Measurement of aerial basidiospores within plantations in Sumatra showed continuous and high production over 24 h (range c. 2–11 000 spores m−3) with maximum release during early evening. Basidiospores applied to cut surfaces of fronds, peduncles and stems germinated in situ. Equivalent, extensive wounds are created during plantation harvesting and management and represent potential sites for formation of infective heterokaryons following mating of haploid basidiospore germlings. Use of spore‐sized micro‐beads showed that basidiospores could be pulled up to 10 cm into severed xylem vessels, where they are relatively protected from dehydration, UV irradiation and competing microflora. Diversity of isolates from five locations on two plantations was assessed by RAMS fingerprinting. Isolates from within individual palms with USR were identical and represent single infections, but different USR infections had unique band patterns and revealed separate infections. Some BSR‐affected trees contained more than one isolate, and thus had multiple infections. There was one example of adjacent BSR palms with the same isolate, indicating vegetative spread, but there were no identical genets from BSR infections and adjacent fallen palms. Isolate diversity was as great within a plantation as between plantations. It is evident that basidiospores play a major role in spread and genetic variability of G. boninense. Evidence for direct basidiospore infection via cut fronds, indirectly through roots via colonized debris and less frequently, infection by vegetative, clonal spread is considered.
Airway Angiogenesis in Stable and Exacerbated Chronic Obstructive Pulmonary Disease
Authors: Kristan S. S. , Marc M. M. , Kern I. , Flezar M. , Suskovic S. , Kosnik M. , Korosec P. 
Published: September 2011

AbstractAngiogenesis is a prominent feature of structural tissue remodelling that occurs in chronic airway diseases, including chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the airway levels of VEGF, angiogenin, IL‐8 and TNF‐α in patients with COPD during the stable phase and during acute exacerbation of the disease. We analysed induced sputum samples from 28 patients with COPD. Thirteen of these patients were followed up and second samples of sputum were obtained during acute exacerbation of the disease. The two control groups consisted of 12 healthy smokers and seven healthy non‐smokers, all with normal lung function tests. Concentrations of VEGF, angiogenin, IL‐8, TNF‐α and bFGF were measured by cytometric bead array. In the induced sputum of patients with stable COPD, concentrations of VEGF (P < 0.001, P = 0.02), angiogenin (P < 0.0001, P < 0.0001), IL‐8 (P < 0.0001, P = 0.0021) and TNF‐α (P < 0.001, P = 0.03) were significantly elevated in comparison with healthy smokers and non‐smokers. No additional elevation of angiogenic factors was demonstrated at the time of exacerbation. There was a significant negative correlation between FEV1 and VEGF (P < 0.05, r = −0.38), angiogenin (P < 0.0001, r = −0.68) and IL‐8 (P < 0.001, r = −0.54) among smokers (smoking COPD patients and healthy smokers). No significant differences were observed between groups of healthy smokers and non‐smokers. These results showed increased airway angiogenesis in patients with COPD. Moreover, VEGF, IL‐8 and angiogenin negatively correlated with pulmonary function, which suggests their important role in COPD airway remodelling. However, no additional angiogenic activation was found during exacerbation of COPD.
The durability of bioclastic sediments and implications for coral reef deposit formation
Authors: FORD MURRAY R. , KENCH PAUL S. 
Published: September 2011

AbstractThe generation and composition of carbonate sediment within tropical carbonate settings is controlled by the skeletal production of CaCO3 in conjunction with physical, biological and chemical processes which act to break down and disperse skeletal remains. Using the results of detailed tumbling barrel experiments, this paper discusses the role the physical durability of common constituents of reef sediment plays in the composition of coral reef deposits. The durability of the skeletal remains of six reef sediment constituents was determined experimentally using tumbling barrels. Results indicate that constituent durability varies considerably amongst common reef sediment constituents. Calcareous algae Halimeda was the least durable constituent tested, followed by larger benthic foraminifera Baculogypsina sphaerulata and Marginopora vertebralis and the pelecypod Fragum fragum. Two species of branching coral (Acropora sarmentosa and Acropora nasuta) were found to be the most resistant to physical destruction. These findings provide increased power to interpret reef and island deposits and the potential role skeletal durability plays in the retention of constituent skeletons within coral reef associated sedimentary systems.
Arabidopsis is Susceptible to Rice stripe virus Infections
Authors: Sun Feng , Yuan Xia , Zhou Tong , Fan Yongjian , Zhou Yijun 
Published: September 2011

AbstractRice stripe virus (RSV), a member of the genus Tenuivirus, causes rice stripe disease in East Asia and is one of the most economically important rice pathogens. The pathogenesis of RSV and the molecular basis of plant responses to the pathogen are poorly understood. We investigated the process of RSV infection in Arabidopsis thaliana which is highly susceptible to the virus. A simple inoculation method using viruliferous small brown planthoppers was developed to infect A. thaliana plants with RSV. The symptoms were developed within 2 weeks of inoculation. One month after inoculation, all infected plants showed stunted growth and vein chlorosis in newly emerged leaves. Forty‐five days after inoculation, RSV‐infected plants showed severely stunted growth and distorted flower stalks. RSV replication in A. thaliana was confirmed using a dot immunobinding assay, reverse transcription‐polymerase chain reaction, and a protein gel blot assay. RSV infection strongly induced PR1, PR2 and GST1 but not PDF1.2 expression, indicating that the pathogen activated salicylic acid‐dependent basal defence mechanism, which is consistent with the characteristics of plant RNA virus. This Arabidopsis–RSV pathosystem provides an approach for analysing interactions between RSV and plants.
Neurodegeneration in familal amyloidotic polyneuropathy
Authors: Gasperini Robert J , Small David H 
Published: September 2011

Summary1. Familial amyloid polyneuropathies (FAP) constitute a group of inherited amyloidoses that affect peripheral nerves. One common form of FAP is caused by transthyretin (TTR) misfolding and deposition in the peripheral nervous system, leading to neuronal toxicity and death.2. The molecular mechanisms responsible for this toxicity are unclear; however, there is good biochemical and histopathological evidence that the toxicity of TTR mutations is correlated to their aggregation state. In addition, neuronal calcium dysregulation is a mechanism that has been suggested to drive the pathogenesis of FAP.3. Amyloidogenic TTR mutations cause significant calcium influx via L‐type calcium channels in neuronal cell lines, while in primary sensory neurons, TTR mediates a calcium influx via a novel mechanism of transient receptor potential melanostatin (TRPM8) and voltage‐gated sodium and calcium channel activation.4. Significantly, calcium dysregulation is a pathological hallmark of other neurodegenerative diseases involving amyloidosis, for example Alzheimer’s disease, and this mechanism could explain the molecular events that drive amyloid toxicity in other neurodegenerative diseases.
Role of intrahepatic tumor control in the prognosis of patients with hepatocellular carcinoma and extrahepatic metastases
Authors: Jung Seung Min , Jang Jeong Won , You Chan Ran , Yoo Sun Hong , Kwon Jung Hyun , Bae Si Hyun , Choi Jong Young , Yoon Seung Kew , Chung Kyu Won , Kay Chul Seung , Jung Hyun Suk 
Published: September 2011

AbstractBackground and Aim:  There has been little information about the long‐term outcome and prognostic factors in patients with hepatocellular carcinoma (HCC) and extrahepatic metastases. The purpose of this study was to investigate the clinical factors affecting survival after extrahepatic metastasis and to determine the survival benefit of controlling intrahepatic HCC.Methods:  Between 2004 and 2009, a total of 240 consecutive patients with HCC and extrahepatic metastasis were recruited. Based on tumor extent, performance, and hepatic function, the patients underwent locoregional and/or systemic treatments. The treatment response of the intrahepatic tumor after extrahepatic metastasis and other prognostic parameters were analyzed retrospectively.Results:  During the mean follow up of 276 days, 222 patients died; the median survival time was 146 days. Multivariate analysis revealed that Child–Pugh class A, smaller hepatic tumor size, absence of portal venous invasion, single metastatic organ involvement, and objective treatment response of the intrahepatic tumor were the favorable prognostic factors for survival. Of the 183 evaluable patients, 24 achieved complete or partial response for intrahepatic tumors after treatment. The overall survival for the 24 responders was significantly improved, with a median of 521 days, as compared to 170 days for the remaining 159 patients without objective tumor response. The leading cause of death was progressive intrahepatic tumor.Conclusions:  Intrahepatic tumor status and hepatic reserve are among the significant predictors of survival in patients with HCC and extrahepatic metastases. This study indicates that even in patients with metastases from advanced HCC, therapeutic approaches to control intrahepatic tumors are important in improving patient survival.
Impact of endoscopic submucosal dissection for the therapeutic strategy of large colorectal tumors
Authors: Hotta Kinichi , Saito Yutaka , Fujishiro Mitsuhiro , Ikehara Hisatomo , Ikematsu Hiroaki , Kobayashi Nozomu , Sakamoto Naoto , Takeuchi Yoji , Uraoka Toshio , Yamaguchi Yuichiro 
Published: September 2011

AbstractBackground and Aims:  The change of therapeutic strategy for large colorectal tumors after the introduction of endoscopic submucosal dissection (ESD) has not yet been clarified. The aim of this study was to estimate the impact of ESD as an initial treatment strategy.Methods:  A questionnaire was administered to nine expert panelists in colorectal ESD. The questionnaire used retrospective data from consecutive case series. Forty‐seven cases of early colorectal tumors (≥ 20 mm) were included. Endoscopic growth types were 25 laterally‐spreading tumors (LST) of granular type (G), 15 LST of non‐granular types (NG), and seven protruded types. Pathological diagnoses included 15 adenomas (Ad), 18 intramucosal cancers (M), three submucosally‐shallow invasive cancers (< 1000 µm) (SMs), and 11 submucosally‐deep invasive cancers (≥ 1000 µm) (SMd). The expert panelists completed questionnaires about recommended initial treatment under suppositions of before and after the introduction of ESD. Over‐surgery was defined as surgery for Ad, M, and SMs. Non‐curative endoscopic resection (ER) was defined as ER for SMd.Results:  After the introduction of ESD, the reduction in the over‐surgery rate was estimated at 10.8% for Ad, M, and SMs, and the increase in the non‐curative ER rate was estimated at 27.2% for SMd. By endoscopic growth type, the reduction of over‐surgery rates for LST–NG, LST–G, and protruded type was 15.5%, 10.5%, and 2.2%, respectively.Conclusions:  The endoscopists changed their therapeutic strategy for large colorectal tumors to reduce over‐surgery, especially in LST–NG, demonstrating the impact of ESD.
Endoscopic ultrasonography for the diagnosis and selecting treatment of esophageal leiomyoma
Authors: Xu Guo‐Qiang , Qian Jing‐Jing , Chen Miao‐Hui , Ren Guo‐Ping , Chen Hong‐Tan 
Published: September 2011

AbstractBackground and Aim:  To investigate the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes (MUP) for the diagnosis and treatment of esophageal leiomyoma.Methods:  A total of 229 patients with esophageal leiomyoma, diagnosed using EUS, with 12‐MHz MUP and a double‐cavity electronic endoscope, were enrolled. The clinical characteristics of the patients were analyzed, and those who had therapeutic indications received endoscopic resection or surgical excision. Postoperative histological diagnostic results were compared with the preoperative diagnosis of EUS. All patients, including those with or without endoscopic resection or surgical excision were periodically followed up with EUS.Results:  Of the 229 patients, 118 received endoscopic resection, and seven received surgical excision. Postoperative histology showed that 110 patients were completely consistent with the preoperative diagnosis of EUS, and the diagnostic accuracy of EUS was 88.6%. No treatment‐related complications occurred among the patients who received endoscopic resection or surgical excision, and no recurrence was observed during the follow‐up examinations.Conclusions:  Esophageal leiomyoma is a benign tumor of the esophagus. EUS is a useful technique for the diagnosis of esophageal leiomyoma and for making treatment‐related decisions.
Efforts to promote vaginal delivery after a previous cesarean section
Authors: Hamai Yoko , Imanishi Yukio 
Published: September 2011

AbstractAim:  The aim of this study was to examine the results of vaginal delivery in patients with a past history of cesarean section.Methods:  The type of delivery, interventions during delivery, and the prognoses of the mothers and babies were examined in 145 women with a history of cesarean section over the 10‐year period from January 2000 to December 2009.Results:  A scheduled cesarean section was performed in 27 cases. Vaginal delivery was recommended in 118 cases and the success rate was 94.9% (112/118). Uterine rupture was observed in one patient who experienced a natural rupture at home and whose previous cesarean section was an inverse T incision. No cases required a blood transfusion or hysterectomy.Conclusions:  The prognoses of both mothers and babies were good and the vaginal delivery success rate was 94.9%. Uterine rupture was observed in one case. Vaginal delivery with previous cesarean section should be considered in cases with expectation and informed consent.