bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding the Heterogeneity of Labor and Delivery Units: Using Design Thinking Methodology to Assess Environmental Factors that Contribute to Safety in Childbirth
Authors: Sherman Jules P. , Hedli Laura C. , Kristensen-Cabrera Alexandria I. , Lipman Steven S. , Schwandt Doug , Lee Henry C. , Sie Lillian , Halamek Louis P. , Austin Naola S. ,   Safety Learning Laboratory for Neonatal and Maternal Care
Published: April 2019

Abstract
Objective There is limited research exploring the relationship between design and patient safety outcomes, especially in maternal and neonatal care. We employed design thinking methodology to understand how the design of labor and delivery units impacts safety and identified spaces and systems where improvements are needed.
Study Design Site visits were conducted at 10 labor and delivery units in California. A multidisciplinary team collected data through observations, measurements, and clinician interviews. In parallel, research was conducted regarding current standards and codes for building new hospitals.
Results Designs of labor and delivery units are heterogeneous, lacking in consistency regarding environmental factors that may impact safety and outcomes. Building codes do not take into consideration workflow, human factors, and patient and clinician experience. Attitude of hospital staff may contribute to improving safety through design. Three areas in need of improvement and actionable through design emerged: (1) blood availability for hemorrhage management, (2) appropriate space for neonatal resuscitation, and (3) restocking and organization methods of equipment and supplies.
Conclusion Design thinking could be implemented at various stages of health care facility building projects and during retrofits of existing units. Through this approach, we may be able to improve hospital systems and environmental factors.
Retrosigmoid Approach: A Simple and Safe Way to Resect Intrinsic Pontomedullary Lesions
Authors: González-Darder José M. , Capilla-Guasch Pau , Real-Peña Luis 
Published: April 2019

Objectives The main objective of this article is to describe a simple and safe protocol for the microsurgical management of ventrally located intrinsic pontomedullary lesions based on the retrosigmoid approach, cortectomy performed utilizing safe entry zones of the pons and medulla, and a delicate microsurgical resection. The intraoperative protocol includes redundant procedures that provide security in decision-making during surgery.
Design A prospective series of 11 cases is presented. All patients were studied following the same clinical and imaging workup. A regular retrosigmoid craniotomy surgical approach was utilized. The peritrigeminal area in the pons and the olivary area in the medulla were considered as the safe entry zones. Neuronavigation of the white fiber tracts and electrophysiological monitoring were used as intraoperative aids to locate the lesions, the safe entry zones, and the placement of the cortectomy.
Results Six lesions were pontine, two medullary, and the remaining six pontomedullary. Eight lesions were cavernomas, while the remaining three tumors. Overall, we obtained a postoperative functional improvement in the affected cranial nerves in 90.1% of the patients and a total or partial recovery of long ascending or descending pathway symptoms in 72.3% of the patients. All the patients were satisfied with the procedure and the results.
Conclusions Radical resection of ventral intrinsic pontomedullary lesions displays a high degree of intraoperative reliability, and a good clinical result is possible using simple surgical procedures. The anatomical references are the first element in the decision-making process during surgery.
Variation in sequence dynamics improves maintenance of stereotyped behavior in an example from bird song
Authors: Duffy Alison , Abe Elliott , Perkel David J. , Fairhall Adrienne L. 
Published: April 2019

Significance
In this work, we show a way by which the nervous system maintains precise, stereotyped behavior in the face of environmental and neural changes. Through a model of bird song learning, we show how instability in neural representation of stable behavior can allow a system to more readily adapt and maintain performance with minimal cost. In this perspective, behaviors are made more robust to environmental change by continually seeking subtly new ways of performing the same task. Thus, one should expect to find variability in neural systems executing stereotyped behaviors, and this variability can serve a constructive role in maintaining skilled behavior.
Global warming has increased global economic inequality
Authors: Diffenbaugh Noah S. , Burke Marshall 
Published: April 2019

Significance
We find that global warming has very likely exacerbated global economic inequality, including ∼25% increase in population-weighted between-country inequality over the past half century. This increase results from the impact of warming on annual economic growth, which over the course of decades has accumulated robust and substantial declines in economic output in hotter, poorer countries—and increases in many cooler, wealthier countries—relative to a world without anthropogenic warming. Thus, the global warming caused by fossil fuel use has likely exacerbated the economic inequality associated with historical disparities in energy consumption. Our results suggest that low-carbon energy sources have the potential to provide a substantial secondary development benefit, in addition to the primary benefits of increased energy access.
Preventing adolescent stress-induced cognitive and microbiome changes by diet
Authors: Provensi Gustavo , Schmidt Scheila Daiane , Boehme Marcus , Bastiaanssen Thomaz F. S. , Rani Barbara , Costa Alessia , Busca Kizkitza , Fouhy Fiona , Strain Conall , Stanton Catherine , Blandina Patrizio , Izquierdo Ivan , Cryan John F. , Passani Maria Beatrice 
Published: April 2019

SignificanceA healthy nutritional status is essential for proper brain development and for the maintenance of optimal cognitive function during adulthood and aging. The effects of ω-3 polyunsaturated fatty acids (ω-3 PUFAs) and vitamin supplementation or deficiency on neurodevelopment have been extensively studied in healthy infants and postweaning laboratory animals, but little is known about the influence of these micronutrients on the cognitive and neurochemical consequences of chronic stress during adolescence. We provide evidence that a diet supplemented with ω-3 PUFAs and vitamin A prevents deleterious cognitive impairment and shift of microbiota composition induced by social instability stress during adolescence, and that amelioration is maintained through adulthood, suggesting that a healthy diet may have long-lasting beneficial effects and help fight off neurodegenerative diseases.
In silico learning of tumor evolution through mutational time series
Authors: Auslander Noam , Wolf Yuri I. , Koonin Eugene V. 
Published: April 2019

Significance
Cancer is caused by the effects of somatic mutations known as drivers. Although a number of major cancer drivers have been identified, it is suspected that many more comparatively rare and conditional drivers exist, and the interactions between different cancer-associated mutations that might be relevant for tumor progression are not well understood. We applied an advanced neural network approach to learn the sequence of mutations and the mutational burden in colon and lung cancers and to identify mutations that are associated with individual drivers. A significant ordering of driver mutations is demonstrated, and numerous, previously undetected conditional drivers are identified. These findings broaden the existing understanding of the mechanisms of tumor progression and have implications for therapeutic strategies.
Photoelectric conversion on Earth’s surface via widespread Fe- and Mn-mineral coatings
Authors: Lu Anhuai , Li Yan , Ding Hongrui , Xu Xiaoming , Li Yanzhang , Ren Guiping , Liang Jing , Liu Yuwei , Hong Hao , Chen Ning , Chu Shengqi , Liu Feifei , Li Yan , Wang Haoran , Ding Cong , Wang Changqiu , Lai Yong , Liu Juan , Dick Jeffrey , Liu Kaihui , Hochella Michael F. 
Published: April 2019

Significance
In solar-terrestrial systems, solar energy input has long been recognized to have a profound impact on Earth. The well-known photosynthetic systems enable sustainable solar-to-chemical energy conversion. However, no evidence has yet emerged for the existence of a widespread geological light-harvesting system. This study reveals such a “photoelectric device,” where semiconducting Fe- and Mn (oxyhydr)oxide-mineral coatings are found to overlay vast expanses of natural rock/soil surfaces and exhibit highly responsive and stable photon-to-electron conversion. Our discovery may provide insight supporting vital photon-induced redox chemistry on Earth’s surface via widespread Fe- and Mn-mineral coatings.
The effect of acute caffeine ingestion on upper and lower body anaerobic exercise performance
Authors: Duncan Michael J. , Eyre Emma , Grgic Jozo , Tallis Jason 
Published: April 2019

AbstractThe current study examined the effect of acute caffeine ingestion on mean and peak power production, fatigue index and rating of perceived exertion (RPE) during upper body and lower body Wingate anaerobic test (WANT) performance. Using a double‐blind design, 22 males undertook one upper body and one lower body WANT, 60 min following ingestion of caffeine (5 mg*kg−1) and one upper body and one lower body WANT following ingestion of placebo (5 mg*kg−1 Dextrose). Peak power was significantly higher (P = .001) following caffeine ingestion in both upper and lower body WANT. Peak power and mean power was also significantly higher during lower body, compared to upper body WANTs irrespective of substance ingested. However, caffeine ingestion did not enhance mean power neither in upper nor lower‐body WANT. There were no significant differences in mean fatigue index as a consequence of substance ingested or mode of exercise (all P > 0.05). For RPE there was also a significant substance ingested X mode interaction (P = .001) where there were no differences in RPE between caffeine and placebo conditions in lower body WANTs but significantly lower RPE during upper body WANT in the presence of caffeine compared to placebo (P = .014). This is the first study to compare the effects of caffeine ingestion on upper and lower body 30‐second WANT performance and suggests that caffeine ingestion in the dose of 5 mg*kg−1 ingested 60 min prior to exercise significantly enhances peak power when data from upper and lower body WANTs are combined.
Analysis of dislocation microstructure characteristics of surface grains under cyclic loading by discrete dislocation dynamics
Authors: El-Achkar T , Weygand D 
Published: April 2019

AbstractThe dislocation structure formation under low-amplitude fatigue infccmetals for multislip loading conditions is investigated using three-dimensional discrete dislocation dynamics. Tools based on graph analysis, a statistical description of stable dislocation arrangements such as dislocation dipoles and prismatic loops are developed and applied. Upon decreasing the loading amplitude one order of magnitude below the persistent slip band threshold, although qualitative microstructural differences are seen, the elementary features of the investigated defects are the same. A critical number of cycles is required to produce sessile Lomer junctions that stabilize the structure and result in dislocation clustering around them. The crystallographic orientation of the crystal with respect to the loading axis results in different patterns strongly linked to sessile junctions, which are analyzed using spatial correlation functions. The increase in irreversible bulk dislocation arrangements results in roughening of the free surface and increase in surface step heights. Furthermore the crystallographic orientation with respect to the free surface is shown to control the dislocation density evolution combined with the macroscopic Schmid factor.
Entanglement-enhanced optical gyroscope
Authors: Fink Matthias , Steinlechner Fabian , Handsteiner Johannes , Dowling Jonathan P , Scheidl Thomas , Ursin Rupert 
Published: April 2019

Abstract
Fiber optic gyroscopes (FOG) based on the Sagnac effect are a valuable tool in sensing and navigation and enable accurate measurements in applications ranging from spacecraft and aircraft to self-driving vehicles such as autonomous cars. As with any classical optical sensors, the ultimate performance of these devices is bounded by the shot-noise limit (SNL). Quantum-enhanced interferometry allows us to overcome this limit using non-classical states of light. Here, we report on an entangled-photon gyroscope that uses path-entangled NOON-states (N = 2) to provide super-resolution and phase sensitivity beyond the shot-noise limit.
Modelling of vorticity, sound and their interaction in two-dimensional superfluids
Authors: Forstner Stefan , Sachkou Yauhen , Woolley Matt , Harris Glen I , He Xin , Bowen Warwick P , Baker Christopher G 
Published: April 2019

Abstract
Vorticity in two-dimensional superfluids is subject to intense research efforts due to its role in quantum turbulence, dissipation and the BKT phase transition. Interaction of sound and vortices is of broad importance in Bose–Einstein condensates and superfluid helium. However, both the modelling of the vortex flow field and of its interaction with sound are complicated hydrodynamic problems, with analytic solutions only available in special cases. In this work, we develop methods to compute both the vortex and sound flow fields in an arbitrary two-dimensional domain. Further, we analyse the dispersive interaction of vortices with sound modes in a two-dimensional superfluid and develop a model that quantifies this interaction for any vortex distribution on any two-dimensional bounded domain, possibly non-simply connected, exploiting analogies with fluid dynamics of an ideal gas and electrostatics. As an example application we use this technique to propose an experiment that should be able to unambiguously detect single circulation quanta in a helium thin film.
Cost and Impact of Dried Blood Spot Versus Plasma Separation Card for Scale-up of Viral Load Testing in Resource-limited Settings
Authors: Nichols Brooke E , Girdwood Sarah J , Shibemba Aaron , Sikota Sharper , Gill Christopher J , Mwananyanda Lawrence , Noble Lara , Stewart-Isherwood Lynsey , Scott Lesley , Carmona Sergio , Rosen Sydney , Stevens Wendy 
Published: April 2019

Abstract

Background
Routine plasma viral load (VL) testing is recommended for monitoring human immunodeficiency virus–infected patients on antiretroviral therapy. In Zambia, VL scale-up is limited due to logistical obstacles around plasma specimen collection, storage, and transport to centralized laboratories. Dried blood spots (DBSs) could circumvent many logistical challenges at the cost of increased misclassification. Recently, plasma separation cards (PSCs) have become available and, though more expensive, have lower total misclassification than DBSs.

Methods
Using a geospatial model created for optimizing VL utilization in Zambia, we estimated the short-term cost of uptake/correct VL result using either DBSs or PSCs to increase VL access on equipment available in-country. Five scenarios were modeled: (1) plasma only (status quo); (2) plasma at high-volume sites, DBS at low-volume sites; (3) plasma at high-volume sites, PSC at low-volume sites; (4) PSC only; (5) DBS only.

Results
Scenario 1 resulted in 795 342 correct results due to limited patient access. When allowing for full and partial adoption of dried specimens, access increases by 19%, with scenario 3 producing the greatest number of correct results expected (929 857). The average cost per correct VL result was lowest in the plasma + DBS scenario at $30.90 compared to $31.62 in our plasma + PSC scenario. The cost per correct result of using dried specimens only was dominated in the incremental analysis, due primarily to fewer correct results.

Conclusions
Adopting the partial use of dried specimens will help achieve improved VL access for patients at the lowest cost per correct result.
British Cardiovascular Intervention Society registry framework: a quality improvement initiative on behalf of the National Institute of Cardiovascular Outcomes Research (NICOR)
Authors: Rashid Muhammad , Ludman Peter F , Mamas Mamas A 
Published: April 2019

Abstract
The British Cardiovascular Intervention Society (BCIS) percutaneous coronary intervention (PCI) registry is hosted by the National Institute of Cardiovascular Outcomes Research (NICOR) at Bart’s Heart Centre and collects clinical characteristics, indications, procedural details, and outcomes of all patients undergoing PCI in the UK. The data are used for audit and research to monitor and improve PCI practices and patient outcomes. Bespoke live data analysis and structured monthly reports are used to provide real-time feedback to all participating hospitals about the provision of care. Risk-adjusted analyses are used as a quality metric and benchmarking PCI practices. The consecutive patients undergoing PCI in all PCI performing hospitals in the UK from 1994 to present. One hundred and thirteen variables encompassing patient demographics, indication, procedural details, complications, and in-hospital outcomes are recorded. Prospective data are collected electronically and encrypted before transfer to central database servers. Data are validated locally and further range checks, sense checks, and assessments of internal consistency are applied during data uploads. Analyses of uploaded data including an assessment of data completeness are provided to all hospitals for validation, with repeat validation rounds prior to public reporting. Endpoints are in-hospital PCI complications, bleeding and mortality. All-cause mortality is obtained via linkage to the Office of National Statistics. No other linkages are available at present. Available for research by application to NICOR at http://www.nicor.org.uk/ using a data sharing agreement.
Age-related regulation and region-specific distribution of ion channel subunits promoting atrial fibrillation in human left and right atria
Authors: Biliczki Peter , Boon Reinier A , Girmatsion Zenawit , Bukowska Alicia , Ördög Balázs , Kaess Bernhard M , Hohnloser Stefan H , Goette Andreas , Varró András , Moritz Anton , Nattel Stanley , Ehrlich Joachim R 
Published: April 2019

Abstract

Aims
Age-induced changes and electrical remodelling are important components of the atrial fibrillation (AF) substrate. To study regional distribution and age-dependent changes in gene expression that may promote AF in human atria.

Methods and results
Human left atrial (LA) and right atrial (RA) tissue samples were obtained from donor hearts unsuitable for transplantation and from patients undergoing mitral valve repair. Atrial fibrillation was mimicked in vitro by tachypacing of human atrial tissue slices. Ionic currents were studied by the whole-cell patch-clamp technique; gene expression was analysed by real-time qPCR and immunoblotting. Both healthy RA and RA from older patients showed greater CACNA1c mRNA and CaV1.2 protein expression than LA. No age-dependent changes of Kir2.1 expression in both atria were seen. Remodelling occurred in a qualitatively similar manner in RA and LA. IK1 and Kir2.1 protein expression increased with AF. MiR-1, miR-26a, and miR-26b were down-regulated with AF in both atria. ICa,L was decreased. CACNA1c and CACNA2b expression decreased and miR-328 increased in RA and LA during AF. Ex vivo tachypacing of human atrial slices replicated these findings. There were age-dependent increases in miR-1 and miR-328, while miR-26a decreased with age in atrial tissues from healthy human donor hearts.

Conclusion
Features of electrical remodelling in man occur in a qualitatively similar manner in both human atria. Age-related miR-328 dysregulation and reduced ICa,L may contribute to increased AF susceptibility with age.
Gazelles and muppets in the city: risk sharing and firm growth quantiles in a junior stock market
Authors: Abbate Cosimo , Sapio Alessandro 
Published: April 2019

Abstract
Financialization is persuading academics and policy-makers that the growth of SMEs can be unleashed by promoting their quotation on stock markets. Is it true? Answering can give clues on the functions that stock markets actually perform in the financialized world, from collecting finance for productive investments, to providing opportunities for value extraction; from a selection device to a risk-sharing mechanism. The associated effects may be amplified in segments catering to companies that do not satisfy the listing requirements of the official list, such as junior markets. In this article, we test hypotheses linking the shape of the firm growth rates distribution to the functions performed by a junior stock market, through quantile regressions. We use a sample of UK manufacturing companies listed on Alternative Investment Market (AIM), the junior segment of the London Stock Exchange, and comparably small and young unlisted companies. We find that the operating revenues and total assets of AIM-listed gazelles grow faster than for their unlisted peers, after controlling for lagged values of size, age, and growth. Yet, there is a loss reinforcing effect for companies listed on the AIM. After controlling for endogeneity by estimating instrumental variable quantile treatment effects, our findings dismiss the existence of a treatment effect of AIM and are consistent with the stock market attracting relatively risky companies.
Critical Exponent and Hausdorff Dimension in Pseudo-Riemannian Hyperbolic Geometry
Authors: Glorieux Olivier , Monclair Daniel 
Published: April 2019

AbstractThe aim of this article is to understand the geometry of limit sets in pseudo-Riemannian hyperbolic geometry. We focus on a class of subgroups of $\textrm{PO}(p,q+1)$ introduced by Danciger, Guéritaud, and Kassel, called ${\mathbb{H}}^{p,q}$-convex cocompact. We define a pseudo-Riemannian analogue of critical exponent and Hausdorff dimension of the limit set. We show that they are equal and bounded from above by the usual Hausdorff dimension of the limit set. We also prove a rigidity result in ${\mathbb{H}}^{2,1}={\mathbb{A}}\textrm{d}{\mathbb{S}}^3$, which can be understood as a Lorentzian version of a famous Theorem of R. Bowen in $3$D hyperbolic geometry.