bluuebunny/crossref_metadata_2025_split huggingface dataset:
Work-related stress indicator surveys in UK Ministry of Defence
Authors: Wattie Sarah C , Bridger R S 
Published: December 2018

IntroductionUK Ministry of Defence (MOD) policy and strategy recommend the use of a ‘Defence MODified’ version of the Health and Safety Executive Management Standards Indicator Tool to help managers identify risks of work-related stress among Defence personnel. The Defence MODified Tool (‘Stress Indicator Survey’) asks personnel to rate their perceptions of eight working conditions known to be significantly associated with work-related stress. MOD psychologists are developing a Defence norm group against which future survey scores can be compared. This article describes the use of the Stress Indicator Survey in MOD and gives an overview of findings from 2016 to 2018.MethodMOD psychologists conducted 27 Stress Indicator Surveys in 2016–2018. Data were collated from 6227 personnel for the Defence norm group and comparisons were conducted between Service personnel and MOD civil servants, and between Services (Royal Navy/Royal Marines (RN/RM), Army and Royal Air Force (RAF)).ResultsService personnel had significantly more favourable perceptions than MOD civil servants of most working conditions. The RN/RM had significantly more favourable perceptions than either the Army or the RAF of all working conditions. These findings indicate differential risks of work-related stress in different groups of personnel.DiscussionPossible explanations for the observed differences in risk of work-related stress are discussed, including the nature of military life and planned changes to Defence civilian headcount. Examples of managerial actions to improve working conditions based on individual survey findings are given.
Association between circulating inflammatory markers and marksmanship following intense military training
Authors: Gepner Yftach , Hoffman J R , Hoffman M W , Zelicha H , Cohen H , Ostfeld I 
Published: December 2018

IntroductionIntense military operations during deployment or training are associated with elevations in inflammatory cytokine markers. However, the influence of an inflammatory response on military-specific skills is unclear. This study examined the association between brain-derived neurotrophic factor (BDNF), glial fibrillar acidic protein, markers of inflammation, marksmanship and cognitive function following a week of intense military field training.MethodsTwenty male soldiers (20.1±0.6 years; 1.78±0.05m; 74.1±7.9kg) from the same elite combat unit of the Israel Defense Forces volunteered to participate in this study. Soldiers completed a five-day period of intense field training including navigation of 27.8km/day with load carriages of ~50% of their body mass. Soldiers slept approximately fivehours per day and were provided with military field rations. Following the final navigational exercise, soldiers returned to their base and provided a blood sample. In addition, cognitive function assessment and both dynamic and static shooting (15 shots each) were performed following a 200 m gauntlet, in which soldiers had to use hand-to-hand combat skills to reach the shooting range.ResultsResults revealed that tumour necrosis factor-α (TNF-α) concentrations were inversely correlated with dynamic shooting (r=−0.646, p=0.005). In addition, a trend (r=0.415, p=0.098) was noted between TNF-α concentrations and target engagement speed (ie, time to complete the shooting protocol). BDNF concentrations were significantly correlated with the Serial Sevens Test performance (r=0.672, p=0.012).ConclusionThe results of this investigation indicate that elevated TNF-α concentrations and lower BDNF concentrations in soldiers following intense military training were associated with decreases in marksmanship and cognitive function, respectively.
Novel Architecture for Low-Power CNTFET-Based Compressors
Authors: Gavaber Morteza Dadashi , Poorhosseini Mehrdad , Pourmozafari Saadat 
Published: December 2018

Carbon nanotube field-effect transistors (CNTFETs) are excellent candidates for the replacement of traditional CMOS circuits. One of the most important modules in many arithmetic circuits is multiplier. Sometimes multipliers may occupy more area as well as consume high power which may cause speed reduction in the critical path. Compressors are important building blocks which are used in most multipliers. In this paper, a low-power architecture is proposed which can be used in compressor designs. The proposed architecture uses a low-power three-input XOR gate to reduce area, delay and power consumption. In order to evaluate the delay and power consumption of circuits, we have used four different types of compressors (3–2, 4–2, 5–2 and 7–2). These four designs were simulated using HSPICE simulation tool with 32-nm CMOS model based on 1-V and 1-GHz frequency operator. The results indicate that the proposed compressor architectures have less power–delay product (PDP) and power consumption in comparison with the existing proposed compressors.
New results of Boda Claystone research: Genesis, mineralogy, geochemistry, petrophysics
Authors: Fedor Ferenc , Máthé Zoltán , Ács Péter , Koroncz Péter 
Published: December 2018

Abstract
Boda Claystone is a very tight clayey rock with extreme low porosity and permeability, nano-size pores and small amounts of swelling clays. Due to this character it is ideal as a potential host rock for research into the possibilities of high-level waste deposition in geological formation. Though the research started more than 30 years ago, the genesis, the geotectonic history of the Boda Claystone Formation (BCF) and the geology of surrounding areas has only been sketched out recently. On the basis of research of the past few years the process of sedimentation of different blocks was able to be reconstructed. Equipment and methodological developments were needed for the investigation of reservoir geological and hydrodynamic behaviour of this rock, which began in the early 2000s. Based on them the pore structure and reservoir could be characterized in detail. Only theoretical approaches were available for the chemical composition of free porewater. Traditional water-extracting methods were not adaptable because of excessively low porosity and nano-scale pore size distribution. Hence, new ways have to be found for getting enough water for analysis. These new results of BCF research help to prepare more sophisticated and directed experiments, in which there is a great interest internationally.
A Serum-Induced Transcriptome and Serum Cytokine Signature Obtained at Diagnosis Correlates with the Development of Early Pancreatic Ductal Adenocarcinoma Metastasis
Authors: Tsai Susan , McOlash Laura , Jia Shuang , Zhang Jian , Simpson Pippa , Kaldunski Mary L. , Aldakkak Mohammed , Grewal Jenny , Palen Katie , Dwinell Michael B. , Johnson Bryon D. , Mackinnon Alexander , Hessner Martin J. , Gershan Jill A. 
Published: December 2018

Abstract

Background:
Despite the accessibility of blood, identification of systemic biomarkers associated with cancer progression has been especially challenging. The aim of this study was to determine a difference in baseline serum immune signatures in patients that experienced early pancreatic ductal adenocarcinoma (PDAC) metastasis compared with patients that did not. We hypothesized that immune mediators would differ in the baseline serum of these patient cohorts. To test this hypothesis, novel approaches of systemic immune analysis were performed.

Methods:
A serum-induced transcriptional assay was used to identify transcriptome signatures. To enable an understanding of the transcriptome data in a global sense, a transcriptome index was calculated for each patient taking into consideration the relationship of up- and downregulated transcripts. For each patient, serum cytokine concentrations were also analyzed globally as a cytokine index (CI).

Results:
A transcriptome signature of innate type I IFN inflammation was identified in patients that experienced early metastatic progression. Patients without early metastatic progression had a baseline transcriptome signature of TGFβ/IL10–regulated acute inflammation. The transcriptome index was greater in patients with early metastasis. There was a significant difference in the CI in patients with and without early metastatic progression.

Conclusions:
The association of serum-induced transcriptional signatures with PDAC metastasis is a novel finding. Global assessment of serum cytokine concentrations as a CI is a novel approach to assess systemic cancer immunity.

Impact:
These systemic indices can be assessed in combination with tumor markers to further define subsets of PDAC that will provide insight into effective treatment, progression, and outcome.
Combined PPARγ Activation and XIAP Inhibition as a Potential Therapeutic Strategy for Ovarian Granulosa Cell Tumors
Authors: Leung Dilys T.H. , Nguyen Trang , Oliver Edwina May , Matti Juliana , Alexiadis Maria , Silke John , Jobling Thomas W. , Fuller Peter J. , Chu Simon 
Published: December 2018

Abstract
Ovarian granulosa cell tumors (GCT) are characterized by indolent growth and late relapse. No therapeutic modalities aside from surgery have proven effective. We previously reported overexpression of the nuclear receptor, peroxisome proliferator-activated receptor-gamma (PPARγ), and constitutive activity of the NFκB and AP1 signaling pathways in GCT. PPARγ presents as a potential therapeutic target as it impedes proliferation and promotes terminal differentiation of granulosa cells. However, resistance to the actions of PPARγ is caused by NFκB transrepression in GCT-derived cell lines, KGN and COV434. We showed that abrogation of NFκB signaling in GCT cells enables PPARγ agonists to initiate apoptosis. In addition, we observed overexpression of an NFκB–induced gene, X-linked inhibitor of apoptosis protein (XIAP), in GCT and GCT-derived cells. XIAP is an attractive therapeutic target due to its role in inhibiting the apoptotic pathway. We investigated the antitumor effects of combined XIAP inhibition using Smac-mimetics and PPARγ activation using thiazolidinediones (TZD) in the GCT-derived cells. Transactivation assays revealed that NFκB transrepression of PPARγ can be relieved by NFκB or XIAP inhibition. Combined Smac-mimetic and TZD significantly induced apoptosis, reduced cell viability and proliferation in KGN cells in monolayer and 3D spheroid culture, and in GCT explant models. The Smac-mimetic and TZD cotreatment also delayed cell invasion, upregulated proapoptotic genes, and compromised cell metabolism in KGN cells. This study provides evidence that PPARγ and XIAP cotreatment has antineoplastic effects in GCT. As therapeutics that target these proteins are already in clinical or preclinical use, expedient translation to the clinic is possible.
Relationship of Inter‐Individual Blood Pressure Variability and the Risk for Recurrent Stroke
Authors: Kim Bum Joon , Kwon Sun U. , Wajsbrot Dalia , Koo Jaseong , Park Jong Moo , Jeffers Barrett W. 
Published: December 2018

Background

Evidence suggests that patients with higher blood pressure variability (
BPV
) have a higher risk for stroke, but any link between
BPV
and stroke recurrence is unknown among those who had a stroke or transient ischemic attack (
TIA
).

Methods and Results

Data for patients with a history of stroke or
TIA
at enrollment were extracted from the
ASCOT
(Anglo Scandinavian Cardiac Outcomes Trial) and the
ALLHAT
(Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial).
BPV
was defined as the within‐subject standard deviation or coefficient of variation of systolic blood pressure across visits from 12 weeks poststroke or
TIA
onward.
BPV
was significantly higher in patients with a history of stroke or
TIA
than those without. BPV was a predictor of recurrent stroke in the pooled analysis. In the
ASCOT
study, 252 patients (12.3%) had a recurrent stroke among 2046 with a history of stroke. Incidence of recurrent stroke was significantly higher in the highest BPV quartile (17.8%) compared with the lowest quartile (10.5%); by treatment arm, this reached significance for the amlodipine‐arm only (high‐
BPV
: 18.7% versus low‐
BPV
: 12.9%;
P
=0.029). Of the 2173 patients from the
ALLHAT
with a history of stroke or
TIA
, patients with the highest quartile of
BPV
had a higher incidence of recurrent stroke (9.6%) compared with the lowest quartile BPV (5.5%); by treatment arm, this reached significance for the chlorthalidone‐arm only (high‐
BPV
: 12.1% versus low‐
BPV
: 5.4%;
P
=0.007).

Conclusions

Visit‐to‐visit
BPV
is a predictor of recurrent stroke in patients with a history of stroke or
TIA
on antihypertensive treatment. Considering
BPV
following a stroke may be important to reduce the risk for a recurrent stroke.
Improved Cardiopulmonary Resuscitation Performance With CODE ACES
2
: A Resuscitation Quality Bundle
Authors: Hunt Elizabeth A. , Jeffers Justin , McNamara LeAnn , Newton Heather , Ford Kenneth , Bernier Meghan , Tucker Elizabeth W. , Jones Kareen , O'Brien Caitlin , Dodge Pamela , Vanderwagen Sarah , Salamone Cheryl , Pegram Tamara , Rosen Michael , Griffis Heather M. , Duval‐Arnould Jordan 
Published: December 2018

Background
Over 6000 children have an in‐hospital cardiac arrest in the United States annually. Most will not survive to discharge, with significant variability in survival across hospitals suggesting improvement in resuscitation performance can save lives.

Methods and Results

A prospective observational study of quality of chest compressions (
CC
) during pediatric in‐hospital cardiac arrest associated with development and implementation of a resuscitation quality bundle. Objectives were to: 1) implement a debriefing program, 2) identify impediments to delivering high quality
CC
, 3) develop a resuscitation quality bundle, and 4) measure the impact of the resuscitation quality bundle on compliance with American Heart Association (
AHA
) Pediatric Advanced Life Support
CC
guidelines over time. Logistic regression was used to assess the relationship between compliance and year of event, adjusting for age and weight. Over 3 years, 317 consecutive cardiac arrests were debriefed, 38% (119/317) had
CC
data captured via defibrillator‐based accelerometer pads, data capture increasing over time: (2013:13% [12/92] versus 2014:43% [44/102] versus 2015:51% [63/123],
P
<0.001). There were 2135 1‐minute cardiopulmonary resuscitation (CPR) epoch data available for analysis, (2013:152 versus 2014:922 versus 2015:1061,
P
<0.001). Performance mitigating themes were identified and evolved into the resuscitation quality bundle entitled
CPR
Coaching, Objective‐Data Evaluation, Action‐linked‐phrases, Choreography, Ergonomics, Structured debriefing and Simulation (CODE ACES
2
). The adjusted marginal probability of a
CC
epoch meeting the criteria for excellent
CPR
(compliant for rate, depth, and chest compression fraction) in 2015, after
CPR
Coaching, Objective‐Data Evaluation, Action‐linked‐phrases, Choreography, Ergonomics, Structured debriefing and Simulation was developed and implemented, was 44.3% (35.3–53.3) versus 19.9%(6.9–32.9) in 2013; (odds ratio 3.2 [95% confidence interval:1.3–8.1],
P
=0.01).

Conclusions

CODE ACES
2
was associated with progressively increased compliance with
AHA CPR
guidelines during in‐hospital cardiac arrest.
Multidisciplinary Neonatal Emergencies Simulation Team-Training (NEST) Improves Participant’s Confidence in Dealing With Simulated Neonatal Emergencies
Authors: Swamy Ravi , Chandrasekaran Manigandan , Venkatagiri Praveen K. , Grover Anuj , Datta Vikram , Sinha Ajay , Mohinuddin Syed 
Published: December 2018

Background: A traditional medical curriculum has limited emphasis on communication skills, teamworking, and human factors. Simulation-based training emphasizes these skills and positively impacts patient safety. A group of Indian neonatologists in collaboration with their UK colleagues conducted adapted Neonatal Emergencies Simulation Team-training (NEST) courses in India. Aim: To evaluate the effectiveness of NEST courses in India and analyze the participant’s feedback Methods: A total of 16 NEST courses were conducted between November 2014 and February 2016. Structured pre- and postcourse feedback from participants was analyzed. Key domains studied included structured approach, human factors, situation-background-assessment-recommendation tool, and teamwork in an emergency. Each category was rated from 1 to 5, indicating a low to high scale. Pre- and posttraining scores and scores between centers were compared using the Wilcoxon signed-rank test and Kruskal-Wallis test, respectively. Results: A total of 191 feedbacks from 58 nurses and 133 doctors from 4 centers were analyzed. The comparison of self-reported pre- and postcourses showed a significant improvement across all domains. There was no statistical difference between scores from different centers showing consistent course results. Conclusions: We have demonstrated that the NEST multiprofessional course can be collaboratively delivered. The analysis of feedback shows a significant improvement in the candidate’s self-reported ability across all domains related to the application of the course principles to simulated neonatal emergencies.
Bivalirudin versus heparin in patients undergoing percutaneous peripheral interventions: A systematic review and meta-analysis
Authors: Olmedo Wilman , Villablanca Pedro A , Sanina Cristina , Walker Jonathan , Weinreich Michael , Brevik Jeannine , Avendano Ricardo , Bravo Claudio A , Romero Jorge , Ramakrishna Harish , Babaev Anvar , Attubato Michael , Hernandez-Suarez DF , Cox-Alomar P , Pyo Robert , Krishnan Prakash , Wiley Jose 
Published: December 2018

Background Bivalirudin may be an effective alternative anticoagulant to heparin for use in percutaneous peripheral interventions. We aimed to compare the safety and efficacy of bivalirudin versus heparin as the procedural anticoagulant agent in patients undergoing percutaneous peripheral intervention. Methods For this meta-analysis and systematic review, we conducted a search in PubMed, Medline, Embase, and Cochrane for all the clinical studies in which bivalirudin was compared to heparin as the procedural anticoagulant in percutaneous peripheral interventions. Outcomes studied included all-cause mortality, all-bleeding, major and minor bleeding, and access site complications. Results Eleven studies were included in the analysis, totaling 20,137 patients. There was a significant difference favoring bivalirudin over heparin for all-cause mortality (risk ratio 0.58, 95% CI 0.39–0.87), all-bleeding (risk ratio 0.62, 95% CI 0.50–0.78), major bleeding (risk ratio 0.61, 95% CI 0.39–0.96), minor bleeding (risk ratio 0.66, 95% CI 0.47–0.92), and access site complications (risk ratio 0.66, 95% CI 0.51–0.84). There was no significant difference in peri-procedural need for blood transfusions (risk ratio 0.79, 95% CI 0.57–1.08), myocardial infarction (risk ratio 0.87, 95% CI 0.59–1.28), stroke (risk ratio 0.77, 95% CI 0.59–1.01), intracranial bleeding (risk ratio 0.77, 95% CI 0.29–2.02), or amputations (OR 0.75, 95% CI 0.53–1.05). Conclusion Our meta-analysis suggests that bivalirudin use for percutaneous peripheral interventions is associated with lower all-cause mortality, bleeding, and access site complications as compared to heparin. Further large randomized trials are needed to confirm the current results.
Factors associated with time from first-symptoms to diagnosis and treatment initiation of Multiple Sclerosis in Switzerland
Authors: Kaufmann Marco , Kuhle Jens , Puhan Milo A , Kamm Christian P , Chan Andrew , Salmen Anke , Kesselring Jürg , Calabrese Pasquale , Gobbi Claudio , Pot Caroline , Steinemann Nina , Rodgers Stephanie , von Wyl Viktor ,   for the Swiss Multiple Sclerosis Registry (SMSR)
Published: December 2018

Background Recent studies emphasise the importance of timely diagnosis and early initiation of disease-modifying treatment in the long-term prognosis of multiple sclerosis. Objectives The objective of this study was to investigate factors associated with extended time to diagnosis and time to disease-modifying treatment initiation in the Swiss Multiple Sclerosis Registry. Methods We used retrospective data (diagnoses 1996–2017) of the survey-based Swiss Multiple Sclerosis Registry and fitted logistic regression models (extended time to diagnosis ≥2 years from first symptoms, extended time to disease-modifying treatment initiation ≥1 year from diagnosis) with demographic and a priori defined variables. Results Our study, based on 996 persons with multiple sclerosis, suggests that 40% had an extended time to diagnosis, and extended time to disease-modifying treatment initiation was seen in 23%. Factors associated with extended time to diagnosis were primary progressive multiple sclerosis (odds ratio (OR) 5.09 (3.12–8.49)), diagnosis setting outside of hospital (neurologist (private practice) OR 1.54 (1.16–2.05)) and more uncommon first symptoms (per additional symptom OR 1.17 (1.06–1.30)). Older age at onset (per additional 5 years OR 0.84 (0.78–0.90)) and gait problems (OR 0.65 (0.47–0.89)) or paresthesia (OR 0.72 (0.54–0.95)) as first symptoms were associated with shorter time to diagnosis. Extended time to disease-modifying treatment initiation was associated with older age at diagnosis (per additional 5 years OR 1.18 (1.09–1.29)). In more recent years, time to diagnosis and time to disease-modifying treatment initiation tended to be shorter. Conclusions Even in recent periods, substantial and partially systematic variation regarding time to diagnosis and time to disease-modifying treatment initiation remains. With the emerging paradigm of early treatment, the residual variation should be monitored carefully.